cssi/SciSciGPT-SciSciNet huggingface dataset:
Diagnosis and Treatment of Non-24-h Sleep–Wake Disorder in the Blind

Non-24-h sleep–wake disorder (non-24) is a circadian rhythm disorder occurring in 55–70% of totally blind individuals (those lacking conscious light perception) in which the 24-h biological clock (central, hypothalamic, circadian pacemaker) is no longer synchronized, or entrained, to the 24-h day. Instead, the overt rhythms controlled by the biological clock gradually shift progressively earlier or later (free run) in accordance with the clock’s near-24-h period, resulting in a recurrent pattern of daytime hypersomnolence and night-time insomnia. Orally administered melatonin and the melatonin agonist tasimelteon have been shown to entrain (synchronize) the circadian clock, resulting in improvements in night-time sleep and daytime alertness. We review the basic principles of circadian rhythms necessary to understand and treat non-24. The time of melatonin or tasimelteon administration must be considered carefully. For most individuals, those with circadian periods longer than 24 h, low-dose melatonin should be administered about 6 h before the desired bedtime, while in a minority, those with circadian periods shorter than 24 h (more commonly female individuals and African–Americans), melatonin should be administered at the desired wake time. Small doses (e.g., 0.5 mg of melatonin) that are not soporific would thus be preferable. Administration of melatonin or tasimelteon at bedtime will entrain individuals with non-24 but at an abnormally late time, resulting in continued problems with sleep and alertness. To date, tasimelteon has only been administered 1 h before the target bedtime in patients with non-24. Issues of cost, dose accuracy, and purity may figure into the decision of whether tasimelteon or melatonin is chosen to treat non-24. However, there are no head-to-head studies comparing efficacy, and studies to date show comparable rates of treatment success (entrainment).
Ranolazine and Hallucinations

Ranolazine is a piperazine derivative which produces its anti-ischemic effect by decreasing myocardial oxygen demand and enhancing myocardial perfusion without having any effect on heart rate or blood pressure. Many trials have proved its benefits in the management of chronic stable angina; however, some rare neurological side effects have been seen in elderly population. In this case report, we describe a case of a 75-year-old female with underlying coronary artery disease, chronic kidney disease and mild cognitive impairment who was admitted for a new onset auditory and visual hallucinations along with new onset tremors in both upper and lower extremity after she was started on ranolazine for management of her chronic stable angina. Her workup was negative for any source of infection and no metabolic derangements, drugs or stroke were found. Her symptoms resolved after the ranolazine was discontinued. We recommend starting ranolazine in elderly population only when other anti-ischemic therapies have been exhausted and starting with the lowest therapeutic dose possible. Ranolazine should be discontinued immediately if any signs of neurological adverse effect appear. We also recommend monitoring renal functions in these patients and withholding ranolazine if any signs of worsening renal functions appear. J Med Cases. 2017;8(3):90-92 doi: https://doi.org/10.14740/jmc2774w
Genetic-epigenetic interactions in cis: a major focus in the post-GWAS era.

Studies on genetic–epigenetic interactions, including the mapping of methylation quantitative trait loci (mQTLs) and haplotype-dependent allele-specific DNA methylation (hap-ASM), have become a major focus in the post-genome-wide-association-study (GWAS) era. Such maps can nominate regulatory sequence variants that underlie GWAS signals for common diseases, ranging from neuropsychiatric disorders to cancers. Conversely, mQTLs need to be filtered out when searching for non-genetic effects in epigenome-wide association studies (EWAS). Sequence variants in CCCTC-binding factor (CTCF) and transcription factor binding sites have been mechanistically linked to mQTLs and hap-ASM. Identifying these sites can point to disease-associated transcriptional pathways, with implications for targeted treatment and prevention.
Identifying Wafer-Level Systematic Failure Patterns via Unsupervised Learning

In this paper, we propose a novel methodology for detecting systematic failure patterns at the wafer level for yield learning. Our proposed methodology takes the binary testing results (i.e., pass or fail) of all dies over multiple wafers, cluster these wafers according to their spatial signatures of failures, and eventually identify the underlying systematic failure patterns. Several data processing techniques, including singular value decomposition, hierarchical clustering, etc., are adopted to make the proposed methodology robust to random failures. In addition, a Pseudo-Boolean satisfiability solver is used to extract a minimal set of systematic failure patterns that explain all wafer-level spatial signatures. These patterns help process engineers identify the root causes of failures and accelerate yield learning. The efficacy of our proposed approach is demonstrated by one synthetic data set and one industrial data set.
Anatomy of Commonly Performed Bariatric Procedures

The bariatric endoscopist, whether a surgeon or gastroenterologist, should familiarize themselves with the anatomy of the most common bariatric procedures being done today. The following is a summary of the four most common bariatric operations: adjustable gastric banding, Roux-en-Y gastric bypass, vertical sleeve gastrectomy, and biliopancreatic diversion with duodenal switch. Knowledge of expected postoperative anatomy and their endoscopic findings should set a foundation for endoscopic investigations in patients with symptoms and possible postoperative complications.
Size-dependent mechanical responses of metallic glasses

ABSTRACTMetallic glasses (MGs) are arguably one of the most exciting metallic systems in the past 30 years, attracting significant research effort and undergoing rapid development. Parallel to research on crystalline metals, the sample size has been exploited as property-tuning parameters for MGs. It has been shown that nanometre-sized MG samples exhibit higher-than-bulk elastic limit, tensile strength, and non-zero tensile ductility. While some of the size-related observations have been generally accepted, others have been poorly understood, even hotly debated. Of particular interests is the importance of sample preparation in experiments and model generation in simulations. Here, we will review how the sample size affects mechanical properties including the elastic, plastic, fracture properties, and fatigue endurance, as well as various proposed size-dependent mechanisms and relevant length scales.
Effect of Consolidation Method on the Mechanical Properties of Nonwoven Fabric Reinforced Composites

Nonwoven fabrics provide low cost reinforcement for composites. The consolidation behavior of E-glass nonwoven preforms and the mechanical properties of the resulting composites are studied. The reinforcement structures include stitch-bonded chopped-strand mat, powder-bonded chopped-strand mat, and continuous-strand mat. A woven fabric is also included for comparison. The bulkiness of the fabric influences their processibility in the hand lay-up and resin transfer molding (RTM) processes. Mechanical properties of specimens from the hand lay-up and the RTM processes are evaluated in tensile, compressive, and flexural tests. The test results and failure mechanisms are reported, and the effect of consolidation condition on the mechanical properties are analyzed. Theoretical analysis of the elastic properties of nonwoven composites are discussed. The tensile moduli from the experiment for such composites are compared with theoretical predictions and good agreement is observed.
Levi Subgroup Actions on Schubert Varieties, and Some Geometric Consequences

In this chapter, we consider certain Levi subgroup actions on Schubert varieties in the Grassmannian, and derive some geometric consequences on the singularities of Schubert varieties as well as sphericity consequences. To be more precise, let L ω be the Levi part of the stabilizer Q ω in GL N (ℂ) (for left multiplication) of a Schubert variety X(ω) in the Grassmannian G d,N .
The Temperature Skewness Budget in the Lower Atmosphere and Its Implications for Turbulence Modeling

Recent research has shown that carrying rate equations, rather than parameterizations, for third moments in turbulence models gives improved simulations of buoyancy-driven flows. Little is known about these rate equations, or budgets, so we present an analysis for the case of temperature fluctuations. Data from the convective atmospheric boundary layer show clearly how temperature skewness is maintained.
An Inverse Design Algorithm for a G2 Interpolating Spline Motion

This paper deals with smooth motion interpolation. Recently, a direct construction algorithm was developed for generating rigid body motions with second order geometric continuity (G 2 ). The present paper shows how the G 2 spline motion can be used to fulfill the task of motion interpolation by solving the problem of inverse design for the G 2 spline motion. The results are useful for computer graphics, mechanical systems animation, and Cartesian trajectory generation for robot manipulators.
Endothelial Regulation of Vasomotor Tone in Atherosclerosis

During the last ten years it has become clear that the vascular endothelium modulates blood flow and vascular resistance by elaborating a variety of potent vasoactive factors. These include the endothelium-derived relaxing factor1–4, now recognized to be either nitric oxide or a related nitrosyl compound5,6, a variety of vasoconstrictor and vasodilator prostaglandins7,8,9, angiotensin II10, and the peptide endothelin11. Of these, the most thoroughly studied has been the endothelium-derived relaxing factor. The existence of this substance was first discovered by Furchgott and co-workers who showed that the endothelium must be intact for acetylcholine to produce vascular relaxation4. It was subsequently realized that the endothelium released an extremely labile substance in response to a variety of stimuli which diffuses to the underlying vascular smooth muscle, activates guanylate cyclase13,14,15, and subsequently produces potent vessel relaxation.
Symmetric equations on the surface of a sphere as used by model GISS:IB

Abstract. Standard vector calculus formulas of Cartesian three space are projected onto the surface of a sphere. This produces symmetric equations with three nonindependent horizontal velocity components. Each orthogonal axis has a velocity component that rotates around its axis (eastward velocity rotates around the north–south axis) and a specific angular momentum component that is the product of the velocity component multiplied by the cosine of axis' latitude. Angular momentum components align with the fixed axes and simplify several formulas, whereas the rotating velocity components are not orthogonal and vary with location. Three symmetric coordinates allow vector resolution and calculus operations continuously over the whole spherical surface, which is not possible with only two coordinates. The symmetric equations are applied to one-layer shallow water models on cubed-sphere and icosahedral grids, the latter being computationally simple and applicable to an ocean domain. Model results are presented for three different initial conditions and five different resolutions.
Mapping kernel texture in a soft durum (Triticum turgidum subsp. durum) wheat population

Abstract Kernel texture (”hardness”) is one of the major determinants of wheat quality and is primarily controlled by the Puroindoline (Pin) genes, located at the Hardness (Ha) locus. The absence of the Ha locus is responsible for the extremely hard kernels of durum wheat (T. turgidum subsp. durum). Recently, the Pin genes from a soft common wheat variety were introgressed into durum wheat through homoeologous recombination. The objective of this study was to map kernel hardness in a soft durum wheat population derived from the cross between the varieties “Creso” and “Langdon 1–678“. In all, 428 F6 lines were evaluated for kernel hardness through the Single Kernel Characterization System; Hardness Index (HI) values ranged from −2 to 44. The same lines were genotyped using genotyping-by-sequencing, targeted amplicon sequencing, and sequence-tagged-site markers. A total of 8537 markers were used to conduct single marker-trait association analysis and two major significant regions were identified on chromosomes 3AL and 6AS each responsible for an additive effect of ∼6 HI units. Kompetitive allele specific markers targeting these regions were selected and tested in the whole population. To date, this is the first study to investigate the genetic factors behind hardness variation in durum wheat.
Multilevel ACDF Versus Corpectomy

Anterior approaches to the cervical spine are routinely used to treat degenerative cervical spondylosis, as well as traumatic, neoplastic, and infectious pathologies. Improved clinical outcomes following the two most common procedures, anterior cervical discectomy and fusion (ACDF) and cervical corpectomy, are well established in the literature. Both techniques can be effectively used to alleviate pain and improve function by decompressing the neural elements and restoring stability and alignment to the cervical spine. However, there are inherent advantages and disadvantages associated with each technique that may favor ACDF or corpectomy in a given case. In this chapter, we will discuss anterior approaches to multilevel cervical pathology, including indications, surgical strategy, and technique. The advantages and disadvantages of cervical corpectomy will be compared and contrasted with multilevel ACDF. Special attention will be paid to a growing body of evidence that supports the use of a hybrid approach in select clinical scenarios, which incorporates both ACDF and corpectomy in a single construct.
Gender Disparities in Deep Brain Stimulation for Parkinson's Disease

OBJECTIVES This study sought to determine whether there is a gender disparity in patients undergoing deep brain stimulation (DBS) surgery for Parkinson's disease (PD) at a single health system, and better understand the reasons for this discrepancy. MATERIALS AND METHODS We analyzed data from the University of Miami DBS Database, which included 3251 PD patients, using chi-square, repeated measures ANOVA, and t tests to examine gender differences in the number of patients referred for surgery, reasons for referral, number receiving/not receiving surgery, reasons for not receiving surgery, and postsurgical outcomes. RESULTS During the study period, 207 PD patients were referred for DBS (75.8% male), and 100 underwent surgery (77.0% male). Of those who did not receive surgery, the most common reasons were need for further medical optimization (26.2%), suboptimal performance on neuropsychological evaluation (22.4%), other reason (20.6%), lost to follow-up (18.7%), or patient preference (12.2%). However, in women one of the most common reasons was patient preference (28.0%), and this was significant compared to men (p < 0.001). Men were more likely to be lost to follow-up (p = 0.046). There was no statistically significant difference in postsurgical outcomes. CONCLUSIONS Despite similar postsurgical improvements, women were less likely to undergo DBS surgery due to their own preference, while men were more likely to be lost to follow-up. These data underscore the need for increased education and awareness of DBS so that all patients with PD who qualify for surgery can benefit from this procedure.
Explosive summit collapse of Kīlauea Volcano in 1924 preceded by a decade of crustal contamination and anomalous Pb isotope ratios

Abstract A geochemical time-series analysis of lavas from frequently active basaltic volcanoes has the potential to reveal the enigmatic mantle controls on volcanic behavior and hazards. In May 1924, the century-long lava lake within Halemaʻumaʻu pit crater at the summit of Kīlauea Volcano drained and the floor of Halemaʻumaʻu collapsed, triggering ∼3 weeks of phreatic explosions due to the interaction of groundwater with hot rock. For the next three decades, eruptions at Kīlauea were sporadic (the longest hiatus was from 1934 to 1952), small in volume, and short (typically 10 km). The Pb isotopic heterogeneity of the samples on short length (hand specimen to lava flow) and time (∼1–4 yr) scales can be explained by inefficient mixing as small batches of contaminated magma were delivered to the remnants of Kīlauea’s summit magma storage reservoir. Our results confirm that the Pb isotope ratios of basalts from ocean-island volcanoes may be significantly modified by assimilation of materials from the underlying oceanic crust. In particular, the 207Pb/204Pb ratio may be a sensitive tracer of such crustal contamination at Hawaiian shield volcanoes. Mauna Loa lavas display a factor of ∼5 more scatter towards higher 207Pb/204Pb at a given 206Pb/204Pb ratio than most Kīlauea lavas (excluding the samples from 1912 to 1954). This might be caused by more pervasive crustal contamination at Mauna Loa due to its lower magma supply rate over the last ∼4 kyr.
Biliopancreatic Diversion Induces Greater Metabolic Improvement Than Roux-en-Y Gastric Bypass

Summary Diabetes remission is greater after biliopancreatic diversion (BPD) than Roux-en-Y gastric bypass (RYGB) surgery. We used a mixed-meal test with ingested and infused glucose tracers and the hyperinsulinemic-euglycemic clamp procedure with glucose tracer infusion to assess the effect of 20% weight loss induced by either RYGB or BPD on glucoregulation in people with obesity ( ClinicalTrials.gov number: NCT03111953 ). The rate of appearance of ingested glucose into the circulation was much slower, and the postprandial increases in plasma glucose and insulin concentrations were markedly blunted after BPD compared to after RYGB. Insulin sensitivity, assessed as glucose disposal rate during insulin infusion, was ∼45% greater after BPD than RYGB, whereas β cell function was not different between groups. These results demonstrate that compared with matched-percentage weight loss induced by RYGB, BPD has unique beneficial effects on glycemic control, manifested by slower postprandial glucose absorption, blunted postprandial plasma glucose and insulin excursions, and greater improvement in insulin sensitivity.
National trends and outcomes in timing of ERCP in patients with cholangitis.

Abstract Introduction Guidelines recommend early endoscopic retrograde cholangiopancreatography for the management of acute cholangitis, but the definition of the term “early” remains debatable. This study analyzed national trends in the timing of endoscopic retrograde cholangiopancreatography and identified the ideal time to perform preoperative endoscopic retrograde cholangiopancreatography in patients with acute cholangitis. Methods The 2005 to 2016 National Inpatient Sample was used to identify patients undergoing cholecystectomy for acute cholangitis. Severity of cholangitis was defined using the 2013 Tokyo Grading Criteria, where Tokyo grade III patients were defined as having organ dysfunction and non-Tokyo grade III patients were defined as grades I and II. Multivariable regressions (accounting for patient and hospital characteristics) were used to identify the timing of preoperative endoscopic retrograde cholangiopancreatography associated with the least mortality risk. Results Of 91,051 patients undergoing cholecystectomy for cholangitis, 55% underwent preoperative endoscopic retrograde cholangiopancreatography: 24% of patients received endoscopic retrograde cholangiopancreatography on the day of admission, 41% on hospital day 2, and the use of endoscopic retrograde cholangiopancreatography decreased gradually thereafter. Mortality rates remained under 1% if endoscopic retrograde cholangiopancreatography was performed during the first 3 days and increased as endoscopic retrograde cholangiopancreatography was performed during days 4 to 7 (P 72 hours after admission was associated with increased mortality (adjusted odds ratio 1.80, P = .01). Receiving endoscopic retrograde cholangiopancreatography P > 72 hours increased risk of death among Tokyo grade III patients (adjusted odds ratio 1.88, P = .01). Overall, during the study period, the utilization of preoperative endoscopic retrograde cholangiopancreatography for all grades of acute cholangitis increased from 39% of patients in 2005 to 51% in 2016 (P Conclusion There has been an increase in the use of endoscopic retrograde cholangiopancreatography for acute cholangitis. Although endoscopic retrograde cholangiopancreatography on the day of admission was not associated with a decrease in mortality in patients with Tokyo grade III disease, endoscopic retrograde cholangiopancreatography within 72 hours of hospitalization was associated with decreased in-hospital mortality.
Assessing Food Insecurity among US Adults during the COVID-19 Pandemic

This research examines the intersection of social vulnerability, risk, and their impact on individual food insecurity odds during the COVID-19 pandemic. Data come from a national, post-stratificati...
Gene signature of antigen processing and presentation machinery predicts response to checkpoint blockade in non-small cell lung cancer (NSCLC) and melanoma.

Background Limited data exist on the role of alterations in HLA Class I antigen processing and presentation machinery in mediating response to immune checkpoint blockade (ICB). Methods This retrospective cohort study analyzed transcriptional profiles from pre-treatment tumor samples of 51 chemotherapy-refractory advanced non-small cell lung cancer (NSCLC) patients and two independent melanoma cohorts treated with ICB. An antigen processing machinery (APM) score was generated utilizing eight genes associated with APM (B2M, CALR, NLRC5, PSMB9, PSME1, PSME3, RFX5, and HSP90AB1). Associations were made for therapeutic response, progression-free survival (PFS) and overall survival (OS). Results In NSCLC, the APM score was significantly higher in responders compared with non-responders (p=0.0001). An APM score above the median value for the cohort was associated with improved PFS (HR 0.34 (0.18 to 0.64), p=0.001) and OS (HR 0.44 (0.23 to 0.83), p=0.006). The APM score was correlated with an inflammation score based on the established T-cell-inflamed resistance gene expression profile (Pearson’s r=0.58, p Conclusion Our data demonstrate that defects in antigen presentation may be an important feature in predicting outcomes to ICB in both lung cancer and melanoma.
Use of geographically weighted regression to investigate spatial non-stationary environmental effects on the distributions of black sea bass (Centropristis striata) and scup (Stenotomus chrysops) in the Mid-Atlantic Bight, USA

Abstract Regression analyses used to describe a species’ distribution in relation to environmental conditions often employ global models based on the assumption that the influence of environmental variables is constant or uniform across geographic space. We tested the assumption of spatial stationarity in relationships between environmental variables and the distributions (encounters/non-encounters) of black sea bass (Centropristis striata) and scup (Stenotomus chrysops) caught during fishery-independent bottom trawl surveys conducted in US shelf waters of the Mid-Atlantic Bight (MAB). Our tests employed global logistic generalized linear models (GLMs), global logistic generalized additive models (GAMs), and local logistic geographically weighted regression models (GWR). GWR models had a higher goodness-of-fit and predictive accuracy than GLMs and GAMs for both species, and the residuals of the GWR models also demonstrated less spatial autocorrelation. Results of GWR analyses indicated that local relationships between species' distributions and environmental conditions were significant and varied spatially in strength and direction between sampling locations. Local GWR parameter coefficients and t-values were mapped for further evaluation and a k-means cluster analysis using t-values was performed to identify any areas within the survey region with distinct species and environmental relationships. Overall, our results provided new insight about local spatial variability in habitat associations for black sea bass and scup and how environmental conditions shape their distributions in the MAB. Further, our results suggest that GWR should be considered for exploring spatial varying habitat relationships for other species in the MAB as well.
The Fourth Treatise: On Measurements

It contains an introduction and nine chapters that are divided into sections. The introduction contains the definition of area and the terminology used in it.
Learning Repetition, but not Syllable Reversal

Reduplication is common, but analogous reversal processes are rare, even though reversal, which involves nested rather than crossed dependencies, is less complex on the Chomsky hierarchy. We hypothesize that the explanation is that repetitions can be recognized when they match and reactivate a stored trace in short-term memory, but recognizing a reversal requires rearranging the input in working memory before attempting to match it to the stored trace. Repetitions can thus be recognized, and repetition patterns learned, implicitly, whereas reversals require explicit, conscious awareness. To test these hypotheses, participants were trained to recognize either a reduplication or a syllable-reversal pattern, and then asked to state the rule. In two experiments, above-chance classification performance on the Reversal pattern was confined to Correct Staters, whereas above-chance performance on the Reduplication pattern was found with or without correct rule-stating. Final proportion correct was positively correlated with final response time for the Reversal Correct Staters but no other group. These results support the hypothesis that reversal, unlike reduplication, requires conscious, time-consuming computation.
Structure-based design of antisense oligonucleotides that inhibit SARS-CoV-2 replication

Antisense oligonucleotides (ASOs) are an emerging class of drugs that target RNAs. Current ASO designs strictly follow the rule of Watson-Crick base pairing along target sequences. However, RNAs often fold into structures that interfere with ASO hybridization. Here we developed a structure-based ASO design method and applied it to target severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Our method makes sure that ASO binding is compatible with target structures in three-dimensional (3D) space by employing structural design templates. These 3D-ASOs recognize the shapes and hydrogen bonding patterns of targets via tertiary interactions, achieving enhanced affinity and specificity. We designed 3D-ASOs that bind to the frameshift stimulation element and transcription regulatory sequence of SARS-CoV-2 and identified lead ASOs that strongly inhibit viral replication in human cells. We further optimized the lead sequences and characterized structure-activity relationship. The 3D-ASO technology helps fight coronavirus disease-2019 and is broadly applicable to ASO drug development.
The Association of Rural-Urban Inhabitation With Gastric Adenocarcinoma Mortality and Treatment: A Surveillance, Epidemiology, and End Results (SEER)-Based Study.

Background Gastric cancer is one of the most prevalent cancers in the world and the third most common cause of death from cancer. The diagnosis and treatment are often complex and require a multifaceted approach. Hence, appropriate and timely management is essential for better patient outcomes. Our aim was to determine if rural inhabitation affects the mortality of patients with gastric adenocarcinoma. If such an association exists, we propose to ascertain whether this is related to delayed diagnosis, differing tumor characteristics, or treatment inequalities. Methods The Cox model was applied to gastric adenocarcinoma cases diagnosed during 2004-2011 in American residents aged 20+ years in the Surveillance, Epidemiology, and End Results (SEER) program to determine the impact of rurality on mortality. Binary logistic regression was used to compare the odds of not receiving surgical treatment for localized tumors between rural and urban areas. It was also used to measure the association of rurality with stage at diagnosis (non-metastatic vs. metastatic). Results There was a significant association of rurality on 5-year mortality [HR 1.14 (1.09-1.20), p < 0.01]. No significant association was observed between rural-urban residency and stage at diagnosis, with an odds ratio (OR) of 0.95 (0.87-1.03), p = 0.21. The median time from diagnosis to any first-course treatment was one month for both rural and urban counties. Rural residents were far more likely not to receive surgical treatment for localized tumors than their urban counterparts [OR 1.70 (1.41-2.05), p < 0.01]. A greater percentage of rural inhabitants had cardia tumors as compared to urban ones, 39.8% vs. 33.8% respectively. Non-cardia tumors were far less likely not to receive surgical treatment (i.e., more likely to receive surgical treatment) than cardia tumors [OR 0.35 (0.30-0.41), p < 0.01]. Conclusions Rurality is associated with worse gastric adenocarcinoma mortality. This may be due to a lesser probability of receiving surgical treatment for early-stage disease and differences in the primary site of the tumor between rural and urban counties, but not due to differences in stage at presentation. Future research should focus on improving health care access in rural communities.
Intralesional Biologics for Inflammatory Dermatoses: A Systematic Review.

Background Biologic medications are systemic therapeutic options for inflammatory dermatoses. Local forms of administration are less well-studied. Objective To provide a summary of intralesional (IL) administration of biologics for various non-malignant inflammatory dermatologic conditions reported in the literature. Methods A systematic review was performed in the PubMed and Embase databases from 2000-2020. Inclusion criteria included the local use of biologic medications for non-malignant cutaneous conditions. Quality was assessed with the modified Oxford Centre for Evidence-Based Medicine ratings. Results Nineteen articles describing the use of 5 biologic medications in 9 dermatologic conditions were identified, comprising 172 patients. Conditions successfully treated with intralesional biologics included pemphigus vulgaris (rituximab), granuloma faciale (rituximab), perianal Crohn's disease (infliximab), lichen sclerosus (adalimumab), and necrobiosis lipoidica (etanercept and infliximab). Intralesional etanercept reduced pruritus associated with keloids. A case report of the use of infliximab for pyoderma gangrenosum did not demonstrate any efficacy. There was no consistent effect noted with treatments for sarcoidosis (infliximab) or cutaneous lymphoid hyperplasia (rituximab). Conclusions Local administration of biologic medications may offer an additional method of treating refractory inflammatory dermatoses, but further study is needed to develop standardized dosing protocols, clarify efficacy rates, and identify optimal treatment candidates. This article is protected by copyright. All rights reserved.
Challenges to clinical utilization of hereditary cancer gene panel testing: perspectives from the front lines

Next generation sequencing (NGS) technology is rapidly being implemented into clinical practice. Qualitative research was performed to gain an improved understanding of the landscape surrounding the use of NGS in cancer genetics. A focus group was conducted at the Wisconsin Cancer Risk Programs Network biannual meeting. Free flowing discussion with occasional open-ended questions provided insights into the use of NGS. 19 genetic counselors and medical professionals participated. Three major themes were identified with respect to NGS and its use in cancer genetics: knowledge gaps, the evolving clinician role, and uncertain utility. Several corresponding subthemes were identified. With respect to knowledge gaps, participants expressed concern regarding unexpected results and variants of unknown significance, lack of data about NGS findings, absence of standardization regarding use of NGS and guidelines for interpretation, and discomfort with new technology. Regarding the evolving clinician role, necessary changes to the roles of genetic counselors and physicians were noted, as was the resultant impact on care received by patients and their families. Finally, the clinical and economic utility of NGS was questioned. While a shift from traditional Sanger sequencing to NGS is occurring in molecular genetic testing for disease susceptibility, there are several obstacles that need to be overcome before widespread adoption of this technology can occur. Furthermore, key aspects of NGS and it utility remain unexplored. Continued investigation into these subjects is necessary before this technology will consistently be of benefit to patients and their families.
TiTrATE : A Novel, Evidence-Based Approach to Diagnosing Acute Dizziness and Vertigo

Diagnosing dizziness can be challenging, and the consequences of missing dangerous causes, such as stroke, can be substantial. Most physicians use a diagnostic paradigm developed more than 40 years ago that focuses on the type of dizziness, but this approach is flawed. This article proposes a new paradigm based on symptom timing, triggers, and targeted bedside eye examinations (TiTrATE). Patients fall into 1 of 4 major syndrome categories, each with its own differential diagnosis and set of targeted examination techniques that help make a specific diagnosis. Following an evidence-based approach could help reduce the frequency of misdiagnosis of serious causes of dizziness. In the spirit of the flipped classroom, the editors of this Neurologic Clinics issue on emergency neuro-otology have assembled a collection of unknown cases to be accessed electronically in multimedia format. By design, cases are not linked with specific articles, to avoid untoward cueing effects for the learner. The cases are real and are meant to demonstrate and reinforce lessons provided in this and subsequent articles. In addition to pertinent elements of medical history, cases include videos of key examination findings.
Array Signal Processing: Recent Accomplishments and Future Opportunities

Sensor array processing has been a very active area of research in the signal processing community during the past fifteen years. This talk will review some of the more recent developements related to detection and estimation of parameters and/or waveforms of sources of signals and imaging of the characteristics of a medium. A number of applications of current and future interest related to processing with array data will be highlighted.
Mesh improvement by minimizing a weighted sum of squared element volumes

Summary We describe a new mesh smoothing method that consists of minimizing the sum of squared element volumes over the free vertex positions. To the extent permitted by the fixed vertices and mesh topology, the resulting mesh elements have uniformly distributed volumes. In the case of a triangulation, uniform volume implies well-shaped triangles. If a graded mesh is required, the element volumes may be weighted by centroidal values of a sizing function, resulting in a mesh that conforms to the required vertex density. The method has both a local and a global implementation. In addition to smoothing, the method serves as a simple parameter-free means of untangling a mesh with inverted elements. It applies to all types of meshes, but we present test results here only for planar triangle meshes. Our test results show the new method to be fast, superior in uniformity or conformity to a sizing function, and among the best methods in terms of triangle shape quality. We also present a new angle-based method that is simpler and more effective than alternatives. This method is directly aimed at producing well-shaped triangles and is particularly effective when combined with the volume-based method. It also generalizes to anisotropic mesh smoothing. Copyright © 2014 John Wiley & Sons, Ltd.
Decentralized LQG/LTR Controller Design for Interconnected Systems

The decentralized LQG/LTR design-methodology for interconnected systems is considered. Bounds on the norm of the multiplicative error matrix are calculated and a decentralized design approach which uses only local models is introduced. The presented technique is applied to a controller design problem for an interconnected power system.
Problem Decomposition and Communication Tradeoffs in a Shared-Memory Multiprocessor

Conceptually, a tightly-coupled, shared-memory multiprocessor, such as the BBN Butterfly Parallel Processor, can support a model of computation based on either shared memory or message passing. The choice of model affects the decomposition of the problem into parallel processes and the resultant granularity of communication. An architecture, such as the Butterfly, that supports both models offers the programmer a wide range of choices for problem decomposition, each with different performance attributes. This paper describes a series of experiments using Gaussian elimination to evaluate the tradeoffs between shared memory and message passing, over a range of decomposition strategies. Several different implementations are described and their performance is compared. We conclude that the performance of an application depends not only on the efficiency of the underlying communication, but also on the extent to which the underlying model of computation encourages or discourages communication.
Social Media in Health Care

To identify existing streams of research and develop an agenda for future research, we reviewed and synthesized the existing literature relevant to social media in health care. In particular, our review encompassed two themes - Patient Use of Social Media and Healthcare Organization/Professional Use. Within these overarching themes, we focused on four subthemes (i.e., two under each main theme): community/public health and patient support/use, as well as medical litigation & compliance risk and health education & information sharing. From this review, we have also proposed future research topics and questions to further cultivate this salubrious research domain.
Global Self-Rated Health Status Predicts Reasons for Living Among Older Adults

ABSTRACT This study examined predictors of reasons for living among community-dwelling older adults (N = 104, M age = 69.7 years). Participants completed the Geriatric Depression Scale (GDS), the Elders Life Stress Inventory (ELSI), the Life Orientation Test (LOT), and the Reasons for Living Inventory, and also rated their global health status. Standard multiple regression assessed the extent to which age, depression, stress, optimism, and health status predicted total reasons for living. The model explained 12% of the variance in reasons for living (R 2 = .12, p < .05). Health made the strongest unique and significant contribution to RFL (β = 0.26, p < .05) and age approached significance (β = −0.19, p = .055). The GDS, ELSI, and LOT all made minimal and non-significant contributions. An implication is that attention to physical health status should be a standard part of suicide risk assessment, especially among older adults. Results suggest that reduced quality of life due to poor overall health may ero...
Left ventricular mass regression after aortic valve replacement: Does size really matter'

Since the initial conceptual description of prosthesis-patient mismatch by Rahimtoola in 1978, many studies have been published that have substantiated or called into question its clinical relevance among patients undergoing aortic valve replacement. Most of these studies have narrowly focused on seeking correlations among transprosthetic gradients, indexed effective orifice area, left ventricular (LV)mass regression, and postoperative survival. Conclusions have been inconsistent, suggesting that the determinants of survival after aortic valve replacement may be more complex than simple replacement of a stenotic native valve with a prosthetic that is often just less stenotic. With this notion as a backdrop, Helder and colleagues’ broader analysis of a wider array of factors that might affect LV mass regression prompts provocative questions pertaining to the relative impact of aortic valve replacement on survival, and the significant effects adjunctive therapeutics might exert. The authors quite reasonably analyzed each factor in the context of its effect on LV mass regression based on the well-established premise that LV hypertrophy (LVH) negatively affects postoperative survival after aortic valve replacement. Of most interest in this study were the findings that treatment with beta-blockers or calciumchannel blockers at discharge was independently associated with an increased probability of complete LV mass regression, whereas prosthesis-patient mismatch was not. These findings, coupled with the observation that there was no difference in 5-year survival rates or New York Heart Association functional status among patients with complete versus incomplete LV mass regression, suggest that the absolute extent of LVH reduction after aortic valve replacement may not affect survival rates or symptomatic status among patients undergoing aortic valve replacement as much as a physiologically meaningful and sustained reduction in ventricular afterload and wall stress afforded by the
Cost Effectiveness of Sequencing 34 Cancer-Associated Genes as an Aid for Treatment Selection in Patients with Metastatic Melanoma

Objective To determine whether a next-generation sequencing (NGS) panel of 34 cancer-associated genes would cost-effectively aid in the treatment selection for patients with metastatic melanoma, compared with a single-site BRAF V600 mutation test.
Utilizing a Central Line and Foley Catheter Daily Indicator to Decrease Central-line Associated Blood Stream and Catheter-associated Urinary Tract Infections

ISSUE: Central lineeassociated blood stream infections (CLABSI) and catheter-associated urinary tract infections (CAUTI) are two types of hospital-acquired infections (HAI) that greatly impact the health and lives of patients. These types of HAI increase both the length of hospital stay and the cost of hospitalization. 65% to 70% of CLABSIs may be prevented by implementing evidence-based strategies. A multi-pronged effort has been successful to reduce the incidence of CLABSI and CAUTI. PROJECT: The forms purpose is to 1) inform the healthcare team of the appropriate and inappropriate indications for the device; 2) fulfill National Patient Safety Goals (NPSG 07.04.01, 07.06.01); and 3) stimulate discussion among the health-care team to determine daily necessity. All nursing staff were educated on the need and the process to complete the data. The night shift unit nurse places the form on the appropriate chart and is responsible for completing. If an appropriate indicator is not determined, the form is reviewed at change of shift during report. Further information/orders may be required by contacting the attending physician. RESULTS: The form was trialed in the intensive care unit (20 bed) for three months. The measure of success of the trial was a utilization ratio decrease of both indicators; central lines 0.05 and foley catheters 0.12. The use of daily indicator forms was shown to increase awareness to nursing and physicians to the presence of the device. Daily discussions occurred with physicians and nurses regarding the indication for the device. This heighted awareness resulted in lower CAUTI and CLABSI utilization rates, and a decrease (raw number) of infections. LESSON LEARNED: Ensure physicians and leadership at all levels assist in the development and implementation of the new process. Keep everyone ‘in the know’ at monthly intervals to show the progress towards the end goal of decreased hospital-acquired infections. Rounding daily with bedside nurses/lead nurses will greatly improve compliance and accuracy of choosing the appropriate indicators.
Quality of life after lobectomy for adult liver transplantation.

Introduction. Adult-to-adult living donor liver transplants are being increasingly performed. Although considerable data are available on the quality of life after kidney donation, there is little comparable information on liver donors. Methods. Between August 1998 and July 2000, 48 adults received liver grafts from living donors. At least 2 months after donation, donors were mailed a structured questionnaire and the standardized Medical Outcomes Study Short-Form Health Survey (SF-36), a generic measure assessing health-related quality of life outcomes using eight scales: mental health, emotional limits, vitality, social function, physical function, physical limits, pain, general health. Results. Thirty donors (62.5%) responded at a mean of 280±157 days after donation. Fifteen (50%) of their recipients had major complications (two deaths, four retransplants, nine biliary complications). Regarding overall satisfaction, all said they would donate again. Compared to published U.S. norms (n=2474), our group of donors scored higher than the general population in seven of eight domains on the SF-36. Donors whose recipients had no complications scored significantly higher in mental health (P<0.007) and general health (P<0.008) compared with U.S. norms. Donors whose recipients had major complications scored significantly lower on the mental health scale than those with recipients without major complications. Conclusions. Donors did not regret their decision to donate; several felt the experience had changed their lives for the better. Donors scored as well as or better than U.S. norms in general health. Quality of life after donation must remain a primary outcome measure when we consider the utility of living-donor liver transplants.
Solving a Segregated Storage Problem Using Branch-and-Bound and Extreme Point Ranking Methods

Abstract The problem of storing products in compartments is treated under the restriction that only one type product be stored in a given compartment. Instances of segregated storage problems are cited. The segregated storage problem is formulated as a transportation problem with additional nonlinear constraints. The problem is solved using branch-and-bound and extreme point ranking procedures. An example problem is solved using both solution procedures and the two procedures are compared.
A Motivated Action Theory Account of Goal Orientation.

Rapid organizational change is increasing the pressure on employees to continually update their skills and adapt their behavior to new organizational realities. Goal orientation is a promising motivational construct that may explain why some individuals adapt to change better. Unfortunately, the current goal orientation literature is in a state of conceptual and methodological disarray. This presentation reviews the goal orientation literature and identifies numerous conceptual ambiguities, including definitional inconsistencies, dimensional inconsistencies, and inconsistencies in the conceptualization of stability. These conceptual ambiguities result in a confusing array of goal orientation measures and manipulations and ultimately an incoherent empirical database. A dynamic self-regulation model of goal orientation, termed motivated action theory, is presented to integrate the various conceptual perspectives and to provide guidelines for future goal orientation research.