cssi/SciSciGPT-SciSciNet huggingface dataset:
A systematic review of osteoporosis medication adherence and osteoporosis-related fracture costs in men.

Male osteoporosis is an increasingly important public health concern. Although several medications are approved for the treatment of osteoporosis, medication non-adherence and the associated consequences are not well documented in male populations. Our objective was to identify and summarize the current knowledge related to osteoporotic medication adherence, the potential implications of non-adherence to the medication, and the cost of osteoporosis-related fractures and health-resource utilization in men. Two separate systematic searches were conducted concurrently: one to identify literature reporting male-specific adherence to anti-osteoporotic medication and the clinical consequence of non-adherence in men, and the other to identify literature reporting the cost and resource burden of osteoporosis-related fractures in men. The PubMed, MEDLINE, EMBASE, and Cochrane databases were searched using a date range of 1 January 1998 to 30 June 2012, and citations were screened based on pre-defined criteria. The percentage of males adherent to bisphosphonates [medication possession ratio (MPR) >0.8] over a 1-year period ranged from 32 % to 64 %. The data imply worse clinical outcomes with treatment non-adherence. Costs and resource use associated with osteoporosis-related fractures in men are high, with hip fractures generating the most cost. One-third to two-thirds of men are not adherent to bisphosphonates. Non-adherence is associated with increased fracture risk. Estimates of direct and indirect osteoporosis-related fracture costs are also substantial in men, and may even be more costly than in women. More robust data would better inform disease management initiatives that could improve adherence to medication and outcomes in men with osteoporosis.
The Definition of the Situation and its Impact on Israeli-Jordanian Water Relations

Despite the presence of significant material constraints that raised Jordanﾒs and Israelﾒs interest in reaching a peace agreement in 1994 that included arrangements for managing and distributing their shared water resources, material factors did not have a decisive impact. The material factors at work were formidable and produced a strong incentive to change the fundamental pattern of Israeli-Jordanian relations, yet were not so powerful or overriding as to foreclose any avenue but cooperation. Moreover, many of these material forces were of an enduring nature, thus begging the question: why did Jordan and Israel sign the peace treaty and related protocol over shared water resources when they did? The timing of their decision, I argue, is far better accounted for by the development of trust between the two co-riparian states. Israeli and Jordanian leaders had long been aware of convergent interests with respect to both natural resources and other areas of their bilateral relationship. However, their perceptions of each otherﾒs trustworthiness acted as a filter for how they understood their interests. Prospects for peace did not ripen until the negotiations fell under the purview of leaders who proved able to overcome the obstacles of the past through the strong sense of interpersonal trust they forged, reinforcing their determination to guide negotiations over water sharing to a successful conclusion.
An Improved Larval Medium for Colonized Culicoides variipennis

The laboratory colony of Culicoides variipennis (Coquillett) was made more uniform, and production was increased by using a standardized larval medium composed of an inert substrate and a broth-microoganism system developed from commercially available products rather than from cow manure. A standard inoculum was used to initiate bacterial growth in larval pans, and a standard photoperiod of 13 hr of light was adopted for the larval colony.
Complexity-Based Metric for Process Mass Intensity in the Pharmaceutical Industry

Process mass intensity (PMI) is a key metric for evaluating the sustainability of a manufacturing process. Within Eli Lilly and Co. (Lilly), a process based on the molecular complexity and the proj...
Analysis of the Risk Factors for Psychological Disorders in Children with Severe Influenza A virus (H1N1) Infection

Objective To investigate the risk factors for psychological disorders in children with severe pandemic H1N1 influenza and to find out the influences on their psychology under the treatments with medical machines.Methods Twelve patients aged 2～11 years diagnosed with severe pandemic H1N1 influenza were admitted to Intensive Care Unit from Oct.18th 2009 to Jan.20th 2010.Five patients with psychological disorders were regarded as positive group while the other seven patients without psychological disorders were regarded as negative group.Comparison between the two groups of children was made via retrospective analysis in terms of gender, age, capability to adaptation to environmental change, first-time hospitalization, pediatric critical illness scores, mechanical ventilation times and the times of traumatic operation.Results The development of psychological disorders in children with severe pandemic H1N1 influenza was associated with age, capability to adaptation to environmental changes and first-time hospitalization rather than gender and pediatric critical illness scores, mechanical ventilation times and the times of traumatic operation.Conclusion The risk factors of psychological disorders in children with severe pandemic H1N1 Influenza include:age between 2～5 years, poor capability to adaptation to environmental change and first-time-hospitalization while the uses of medical machines in clinical treatments do not increase the risk of their psychological disorders.
Robotics in pediatric surgery

Despite the extensive use of robotics in the adult population, the use of robotics in pediatrics has not been well accepted. There is still a lack of awareness from pediatric surgeons on how to use the robotic equipment, its advantages and indications. Benefit is still controversial. Dexterity and better visualization of the surgical field are one of the strong values. Conversely, cost and a lack of small instruments prevent the use of robotics in the smaller patients. The aim of this manuscript is to present the controversies about the use of robotics in pediatric surgery.
Consequences of microbial contamination during extended intravenous therapy using inline filters.

A study was conducted to determine: (1) the effectiveness of 0.22-mum and 0.45-mum pore size membrane filters in retaining microorganisms over a period of 72 hours of intravenous fluid administration; (2) the growth and multiplication characteristics of microorganisms retained on the filter; and (3) the possibility of pyrogens being released by microorganisms trapped on the filter. Lactated Ringer's injection was used as the i.v. solution. The 0.45-mum filter was found to be effective in retaining all microorganisms studied for at least 6 hours. However, Esherichia coli and Pseudomomas aeruginosa began passing through the 0.45-mum filter between 6 and 8 hours after seeding. All other microorganisms (Candida albicans, Citrobacter freundii, Klebsiella pneumoniae, Staphyloccus aureus) were retained for at least 72 hours. None of the microorganisms passed through the 0.22-mum filter during the 72-hour study period. With viable microorganisms on the filter for 72 hours, no detectable endotoxins or pyrogens were found in the filtrates as examined by the limulus and rabbit tests.
Distress intolerance during smoking cessation treatment.

Distress intolerance is a key vulnerability factor implicated in the maintenance and relapse of cigarette smoking. Yet, past work has not examined changes in these processes during smoking cessation treatment or their relation to smoking cessation outcomes. The aim of the present study was to examine the effect of two smoking cessation interventions on changes in self-report and behavioral distress intolerance indices during treatment, and whether these changes are associated with smoking cessation outcomes. Treatment-seeking smokers (N = 384) were randomly assigned to one of two 4-session smoking cessation treatment programs: Standard Cessation Program (SCP) or Smoking Treatment and Anxiety Management Program (STAMP). Quit dates were scheduled to coincide with the final treatment session. Physical domains of distress intolerance were assessed at baseline and at each weekly session, via the Discomfort Intolerance Scale (DIS; higher scores indicate more intolerance for discomfort) and Breath Holding Duration Task (shorter durations indicate more intolerance for respiratory distress). The STAMP condition produced a greater rate of reduction in DIS scores than did the SCP condition. Changes in DIS scores during treatment mediated the effect of STAMP treatment on 7-day point prevalence abstinence at Month 3 post-quit attempt. There were no treatment conditions differences in changes in Breath-Holding duration. Data suggest self-reported distress intolerance is malleable in the context of stress sensitivity reduction treatment, but not standard smoking cessation treatment, and such reductions may result in promotion of smoking abstinence.
A transgenic approach for controlling Lygus in cotton

Lygus species of plant-feeding insects have emerged as economically important pests of cotton in the United States. These species are not controlled by commercial Bacillus thuringiensis (Bt) cotton varieties resulting in economic losses and increased application of insecticide. Previously, a Bt crystal protein (Cry51Aa2) was reported with insecticidal activity against Lygus spp. However, transgenic cotton plants expressing this protein did not exhibit effective protection from Lygus feeding damage. Here we employ various optimization strategies, informed in part by protein crystallography and modelling, to identify limited amino-acid substitutions in Cry51Aa2 that increase insecticidal activity towards Lygus spp. by >200-fold. Transgenic cotton expressing the variant protein, Cry51Aa2.834_16, reduce populations of Lygus spp. up to 30-fold in whole-plant caged field trials. One transgenic event, designated MON88702, has been selected for further development of cotton varieties that could potentially reduce or eliminate insecticide application for control of Lygus and the associated environmental impacts.
2582: Bone marrow regulated local protective mechanisms of vascularized composite allografts in non-human primates

Background Vascularized composite allografts (VCA) containing vascularized bone marrow (VBM) prolongs graft survival Cell populations within the co-transplanted VBM are believed to protect the skin...
Finite-time partial stability for stochastic dynamical systems

In this paper, we address finite-time partial stability in probability for nonlinear stochastic dynamical systems. Specifically, we provide Lyapunov conditions involving a Lyapunov function that is positive definite and decrescent with respect to part of the system state, and satisfies a differential inequality involving fractional powers for guaranteeing finite-time partial stability in probability. In addition, we show that finite-time partial stability leads to uniqueness of solutions in forward time and we establish necessary and sufficient conditions for almost sure continuity of the settling-time operator of the nonlinear stochastic dynamical system.
The case for applying tissue engineering methodologies to instruct human organoid morphogenesis.

Abstract Three-dimensional organoids derived from human pluripotent stem cell (hPSC) derivatives have become widely used in vitro models for studying development and disease. Their ability to recapitulate facets of normal human development during in vitro morphogenesis produces tissue structures with unprecedented biomimicry. Current organoid derivation protocols primarily rely on spontaneous morphogenesis processes to occur within 3-D spherical cell aggregates with minimal to no exogenous control. This yields organoids containing microscale regions of biomimetic tissues, but at the macroscale (i.e. 100’s of microns to millimeters), the organoids’ morphology, cytoarchitecture, and cellular composition are non-biomimetic and variable. The current lack of control over in vitro organoid morphogenesis at the microscale induces aberrations at the macroscale, which impedes realization of the technology’s potential to reproducibly form anatomically correct human tissue units that could serve as optimal human in vitro models and even transplants. Here, we review tissue engineering methodologies that could be used to develop powerful approaches for instructing multiscale, 3-D human organoid morphogenesis. Such technological mergers are critically needed to harness organoid morphogenesis as a tool for engineering functional human tissues with biomimetic anatomy and physiology. Statement of Significance Human PSC-derived 3-D organoids are revolutionizing the biomedical sciences. They enable the study of development and disease within patient-specific genetic backgrounds and unprecedented biomimetic tissue microenvironments. However, their uncontrolled, spontaneous morphogenesis at the microscale yields inconsistences in macroscale organoid morphology, cytoarchitecture, and cellular composition that limits their standardization and application. Integration of tissue engineering methods with organoid derivation protocols could allow us to harness their potential by instructing standardized in vitro morphogenesis to generate organoids with biomimicry at all scales. Such advancements would enable the use of organoids as a basis for ‘next-generation’ tissue engineering of functional, anatomically mimetic human tissues and potentially novel organ transplants. Here, we discuss critical aspects of organoid morphogenesis where application of innovative tissue engineering methodologies would yield significant advancement towards this goal.
“Ideas About Human Possibilities”: Connecticut’s PA 12–40 and Developmental Education in the Era of Neoliberalism

In this chapter, we examine how the many different variables discussed in Chaps. 23 and 24 can come into play in the actual lives of real community college students. In 2012, the State of Connecticut enacted Public Act 12–40, legislation that dramatically changed the way remedial education was theorized, designed, and delivered at community colleges and regional state universities in Connecticut. One of the most controversial features of this legislative movement was that it appeared to establish a “floor” for matriculation into open admissions institutions in Connecticut—thereby effectively abandoning students who scored below certain cutoff scores. This chapter reports on an ethnographic study conducted with individuals enrolled in one of the first classes designed for this cohort of students.
Non-Monotonicity of Equilibrium Price

This paper examines the implications for equilibrium price of a shift in demand. First, I consider two static Cournot oligopoly models with linear demand, linear costs, and a finite number of firms, and I prove strong non-monotonicity of any equilibrium price. In a stochastically indefinite horizon simultaneous moves Cournot oligopoly model with a countable number of firms, with the discount factors and the demand parameters following general stochastic processes, I prove that for a path which follows a stationary function of the demand parameter and which is sustainable in a strategy profile that is efficient among the set of perfect equilibrium strategy profiles, any equilibrium price is strongly non-monotonic.
Withdrawing Water from an Aquifer: The Economics

Water is a renewable natural resource. Driven by solar energy and gravity, the global water cycle indefinitely circulates water through the atmosphere, over continents, and across oceans. On a more local level, however, water sometimes has more of a nonrenewable character because it can be depleted, at least to some degree. Withdrawing too much water from an aquifer that has only limited recharge, for example, diminishes stored water. This note discusses groundwater withdrawal, how it is optimally done, and how it depends on the particular institutional setting. Excerpt UVA-GEM-0119 Feb. 25, 2014 Withdrawing Water from AN Aquifer: THE ECONOMICS Water is a renewable natural resource. Driven by solar energy and gravity, the global water cycle indefinitely circulates water through the atmosphere, over continents, and across oceans. On a more local level, however, water sometimes has more of a nonrenewable character because it can be depleted, at least to some degree. Withdrawing too much water from an aquifer that has only limited recharge, for example, diminishes stored water. This note discusses groundwater withdrawal, how it is optimally done, and how it depends on the particular institutional setting. Unlike surface water, which is measured as a flow over a period of time, groundwater is a stored stock and is measured at a particular moment in time. Withdrawing groundwater now, therefore, will require explicit consideration of future water use: Indeed, using more scarce groundwater today means having less stored for the future. Consequently, water users will want to use available groundwater optimally over time (i.e., they will want to use water in such a way that it achieves the maximum possible benefit over cost, explicitly comparing the benefits and costs of water use at each moment in time). Figure 1. Demand for water and the cost of pumping. . . .
Improved positioning procedures for 6YO and 10YO ATDs based on child occupant postures

The outcomes of crash tests can be influenced by the initial posture and position of the anthropomorphic test devices (ATDs) used to represent human occupants. In previous work, positioning procedures for ATDs representing adult drivers and rear-seat passengers have been developed through analysis of posture data from human volunteers. The present study applied the same methodology to the development of positioning procedures for ATDs representing six-year-old and ten-year-old children sitting on vehicle seats and belt-positioning boosters. Data from a recent study of 62 children with body mass from 18 to 45 kg were analyzed to quantify hip and head locations and pelvis and head angles for both sitter-selected and standardized postures. In the present study, the 6YO and 10YO Hybrid-III ATDs were installed using FMVSS 213 procedures in six test conditions used previously with children. Data were gathered on a vehicle seat with and without a backless belt-positioning booster at 19-, 23-, and 27-degree seat back angles. The data analysis showed that children sat with their hips further forward and with more reclined pelvis orientations in the sitter-selected posture than in the standardized posture. On the booster, the 6YO ATD head and pelvis positions and orientations corresponded well to the data from similar-size children seated in the standardized posture on the booster, but the 6YO ATD pelvis was about 20 mm rearward of the expected location for similar size children on the booster in sitter-selected postures, and the ATD head was about 20 mm higher than the expected location. Without the booster, the average 6YO ATD hip location was 40 mm rearward of the expected location in sitter-selected postures and the ATD head was 40 mm above the heads of similar-size children. The trends for the 10YO ATD hip- and head-location trends were similar, but the 10YO head was substantially forward of the head locations of similar-size children. Based on these findings, the current ATD positioning procedure was modified by inserting a foam block behind the pelvis and adjusting the 10YO ATD neck angle. A preliminary evaluation using the 10YO ATD indicates that the new procedure produces ATD postures that better represent child passenger postures with respect to hip and head locations and pelvis and head angles.
Race, Gender, and Work: Syrian-Lebanese Women in Turn-of-the Century Sao Paulo

Recently the study of the Syrian-Lebanese communities in Latin America has attracted much attention from scholars across a variety of disciplines (Klich & Lesser, 1998; Zobel, 2006; Akmir, 2009). Although the impact of this emerging body of scholarship has greatly contributed to our understanding of non-European immigrants to Latin America and their contribution to their adoptive countries, less attention has been paid to the roles and experiences of Syrian-Lebanese women or women of Syrian-Lebanese descent. Even less attention has been paid to their transnational experiences. Syrian-Lebanese women are often referenced only in passing and are typically depicted as homebound, or as women of leisure engaged in charitable work. Many of these trivial and anecdotal glimpses into the lives of Syrian-Lebanese women in Brazil reflect and reinforce the constant reproduction of gender and color hierarchies in Brazilian nationalist ideology. There has been even less focus on questions pertaining to the privileged white status the Syrian-Lebanese immigrants enjoyed upon their arrival in Brazil.
Olfactory and Vomeronasal Receptor Feedback Employ Divergent Mechanisms of PERK Activation

Abstract Mutually-exclusive chemoreceptor expression in olfactory and vomeronasal sensory neurons (OSNs and VSNs) enables odorant discrimination. This configuration involves chemoreceptor mediated activation of the endoplasmic reticulum (ER)-resident kinase PERK. PERK drives translation of the transcription factor ATF5 to preclude additional chemoreceptor expression. ATF5 translation is transient in OSNs but persistent in VSNs, suggesting chemoreceptor-specific modes of PERK activation. Herein, we showed that the ER-lumenal domain (LD) of PERK recognized vomeronasal receptor (VR)-derived peptides, suggesting direct PERK activation drives persistent ATF5 translation in VSNs. In contrast, PERK LD did not recognize olfactory receptor (OR)-derived peptides in vitro, and facilitating OR maturation in vivo prevented PERK activation, suggesting that ORs activate PERK indirectly through a failure to exit the ER. Importantly, impairing or prolonging ATF5 expression drove specific chemoreceptor repertoire biases. Together, these results demonstrate mechanistic divergence in chemoreceptor feedback and establish that differences in PERK activation promote qualitatively different gene regulatory results.
A Category of “Undirected Graphs”

In this paper, a category of undirected graphs is introduced where the morphisms are chosen in the style of mathematical graph theory rather than as algebraic structures as is more usual in the area of graph transformation.
The train the trainer model for the propagation of resuscitation knowledge in limited resource settings: A systematic review

Abstract Background The Train the Trainer (TTT) model is increasingly used in limited resource settings as a mechanism to disseminate resuscitation knowledge and skills among providers. Anecdotally, however, many resuscitation programs that use this model fail to achieve sustainability. Objective We aim to systematically review the literature to describe the evidence for the TTT method of knowledge dissemination for resuscitation courses in limited resource settings. Methods We conducted a systematic review of the literature in accordance with PRISMA guidelines of the PubMed, Cochrane Library, MEDLARS online (MEDLINE), and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. Results Eleven manuscripts met inclusion criteria, the majority (7/11) focused on neonatal resuscitation. We found strong evidence for the TTT model for imparting knowledge and skills on providers, however, little evidence exists for the impact of these programs on patient outcomes or long term sustainability. Facilitators associated with successful programming include the use of language and resource appropriate materials, support from the Ministry of Health of the country, and economic support for supplies and salaries. Conclusion While the TTT model of programming for the dissemination of resuscitation education is promising, further research is necessary especially relating to sustainability and impact on patient outcomes. Familiarity with the local environment, language, culture, resources and economic realities prior to the initiation of programming is key to success.
Abstract P4-12-02: Cost-effectiveness of genetic testing with a hereditary cancer panel in women at risk of hereditary breast cancer

Background : The role of the BRCA1/2 genes in breast cancer risk has been well characterized. However, pathogenic variants in additional genes also confer hereditary breast cancer risk and if detected can lead to interventions that can facilitate increased life expectancy. For example, the National Comprehensive Cancer Network (NCCN) guidelines (Version 2.2017) recommend MRI screening for women who carry a pathogenic variant in CHEK2 and MRI screening or risk-reducing mastectomy for women who carry a pathogenic variant in PALB2 . Testing women at risk of hereditary breast cancer with a 7-gene panel was recently reported to be more cost-effective than testing only BRCA1/2 genes (Li et al . Value Health , 2017). Objectives : To evaluate the cost-effectiveness of a multigene panel testing strategy including 11 genes with risk reduction recommendations by the NCCN guidelines compared with testing only BRCA1/2 genes. Methods : Using a Markov model modified from the recent Li et al . publication, the 11-gene model was used to estimate life expectancies and total healthcare costs from a payers9 perspective. The model included costs for genetic testing, genetic consultation, and cancer treatment as well as risk reduction strategies recommended by the guidelines: prophylactic surgery, MRI surveillance, and mammography. Probabilistic sensitivity analyses were carried out to determine the robustness of the modeling. Results : In the base case, the incremental cost-effectiveness ratio (ICER) for the 11-gene multigene testing strategy compared with BRCA1/2 testing was $22,377 per life-year gained ($47,240 per quality-adjusted life-year gained) for a 40-year-old cohort and $36,690 per life-year gained ($63,384 per quality-adjusted life-year gained) for a 50-year-old cohort. The sensitivity analysis indicated that the multigene testing strategy had a 97% chance of costing less than $100,000 per quality-adjusted life-year gained for the 40-year-old cohort. Conclusion : In patients at risk of hereditary breast cancer, testing using a multigene panel followed by risk reducing interventions is cost-effective compared with testing only BRCA1/2 genes. Citation Format: Li Y, Arellano AR, Bare LA, Devlin JJ. Cost-effectiveness of genetic testing with a hereditary cancer panel in women at risk of hereditary breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P4-12-02.
Cerebro-Vascular Accidents and Dysphagia

Dysphagia is common following stroke. Appropriate management begins with the evaluation and should be based on the specific swallowing impairment. Cognitive and communication functioning must be considered when determining compensatory and rehabilitative approaches.
The Statute of Frauds

This article discusses the California Supreme Court case Sterling v. Taylor which held that extrinsic evidence may be admitted to support a claim that the Statute of Frauds has been met. When a writing is not sufficient, the attorney must not only decide whether there is sufficient supporting evidence to get past the Statute of Frauds, but also whether that evidence is sufficiently consistent with the writing.
NONDESTRUCTIVE EXAMINATION AND TESTING - AN OVERVIEW OF MAJOR CHANGES IN ASME SECTION XI, “RULES FOR INSERVICE INSPECTION OF NUCLEAR POWER PLANT COMPONENTS”

ABSTRACT ASME Section XI, “Rules for Inservice Inspection of Nuclear Power Plant Components”, began as a joint effort of ASME, ANSI-N45 and the USAEC in 1966–67. The first draft version of the Code appeared in 1968 with the first official release in 1970. The original Subgroup was a part of Section III and consisted of thirteen members; four still are active in Section XI. Currently the membership exceeds 200. In the period 1970–1986, Divisions dealing with Gas-Cooled and Liquid-Metal Cooled reactors were added as well as major expansions in Division 1 on Light Water Cooled reactors. For example, there is Class 1 (IWB), Class 2 (IWC), Class 3 (IWD), Component Supports (IWF), Pumps (IWP), Valves (IWV), Steel Containments (IWE) and Concrete Containments (IWL). A review is under way to determine if a Subsection on Core Support Structures (IWG) should be incorporated. Section XI has embarked on several new activities in the period 1984–88. These include a major effort in modifying the Code to cover Plant Life Extension. Fracture mechanics criteria are being developed to handle cracked austenitic and ferritic steel piping and to establish criteria for handling reactor pressure-temperature transients. A major effort and the topic of this abstract has been in the areas of nondestructive examination and testing. These activities, starting with changes in the 1986 edition of the code, are discussed herein.
LiCl/HCl ionic solution for efficient conversion of lignocellulose into glucose under mild conditions

Abstract Molten salt hydrates in diluted acid solutions are a great medium to dissolve cellulose by interrupting the formation of intra- and inter-hydrogen bonding in the crystalline structure of cellulose. In this study, lithium chloride in diluted HCl is used as an inexpensive and efficient way to dissolve and hydrolyze cellulose into glucose. 23 completely randomized design (CRD), including three replications at the center point, was applied to evaluate the effect of LiCl concentration, HCl concentration and cellulose concentration with respect to glucose yield. The composition of LiCl/HCl ionic solution for optimal glucose yield at 80 °C is determined to be 50 wt% of LiCl, 2 wt% of HCl, and 10 wt% of cellulose feedstock. A two stage method is designed for obtaining reducing sugars from sugarcane bagasse in which biomass is treated first with 2 wt% diluted HCl at 100 °C for xylose and then with LiCl/HCl ionic solutions in the second stage at 80 °C for glucose. Total reducing sugar yield of sugarcane bagasse is up to 94.8 wt% indicating that the developed LiCl/HCl ionic solution has potential to treat cellulose for the production of inexpensive fermentable sugar.
Microaneurysm Detection Using Principal Component Analysis and Machine Learning Methods

Diabetic retinopathy (DR) is an eye abnormality caused by long-term diabetes and it is the most common cause of blindness before the age of 50. Microaneurysms (MAs), resulting from leakage from retinal blood vessels, are early indicators of DR. In this paper, we analyzed MA detectability using small 25 by 25 pixel patches extracted from fundus images in the DIAbetic RETinopathy DataBase - Calibration Level 1 (DIARETDB1). Raw pixel intensities of extracted patches served directly as inputs into the following classifiers: random forest (RF), neural network, and support vector machine. We also explored the use of two techniques (principal component analysis and RF feature importance) for reducing input dimensionality. With traditional machine learning methods and leave-10-patients-out cross validation, our method outperformed a deep learning-based MA detection method, with AUC performance improved from 0.962 to 0.985 and F-measure improved from 0.913 to 0.926, using the same DIARETDB1 database. Furthermore, we validated our method on a different dataset—retinopathy online challenge (ROC) data set. The performance of the three classifiers and the pattern with different percentage of principal components are consistent on the two data sets. Especially, we trained the RF on DIARETDB1 and applied it to ROC; the performance is very similar to that of the RF trained and tested using cross validation on ROC data set. This result indicates that our method has the potential to generalize to different datasets.
American Higher Education: Issues and Institutions

The latest book in the Core Concepts in Higher Education series brings to life issues of governance, organization, teaching and learning, student life, faculty, finances, college sports, public policy, fundraising, and innovations in higher education today. Written by renowned author John R. Thelin, each chapter bridges research, theory, and practice and discusses a range of institutions – including the often overlooked for-profits, community colleges, and minority serving institutions. A blend of stories and analysis, this exciting new book challenges present and future higher education practitioners to be informed and active participants, capable of improving their institutions.
Platelet TLR4 at the crossroads of thrombosis and the innate immune response

Platelet TLR-4 activation by pathogen- or damage-associated molecular pattern molecules triggers pro-thrombotic, proinflammatory, and pro-coagulant effector responses. Moreover, platelet TLR4 has a prominent role as a sensor of high lipopolysaccharide circulating levels during sepsis and in the clearance of pathogens mediated by neutrophils. This review presents evidence pointing to TLR4 as a bridge connecting thrombosis and innate immunity.
Quantifying time-varying cause-specific hazard and subdistribution hazard ratios with competing risks data:

Various non-proportional hazard models have been developed in the literature for competing risks data. The regression coefficients under these models, however, typically cannot be compared directly. We propose new methods to quantify the average of the time-varying cause-specific hazard ratios and subdistribution hazard ratios through two general classes of transformations and weight functions that are chosen to reflect the relative importance of the hazard ratios in different time periods. We further propose an L∞ -norm type of test statistic that incorporates the test statistics for all possible pairs of the transformation function and weight function under consideration. Extensive simulations are conducted under various settings of the hazards and demonstrate that the proposed test performs well under all settings. An application to a clinical trial in follicular lymphoma is examined in detail.
Room temperature continuous wave THz frequency comb based on quantum cascade lasers

Frequency combs, spectra of phase-coherent equidistant lines, have revolutionized time and frequency metrology. The recently developed quantum cascade laser (QCL) comb has exhibits great potential with high power and broadband spectrum. However, in the terahertz (THz) range, cryogenic cooling has to be applied for THz QCL combs. We report a room temperature THz frequency comb at 3.0 THz based on difference-frequency generation from a mid-IR QCL comb. A largely detuned distributed-feedback grating is integrated into the QCL cavity to provide the single mode operation as well as enhanced spatial hole-burning effect for multimode comb operation. Multiheterodyne spectroscopy with multiple equally spaced lines by beating it with a reference Fabry-Perot comb confirms the THz comb operation. This type of THz comb provides a new solution to chip-based high-speed high-resolution THz spectroscopy with compact size at room temperature.
Introduction: The View from the Mezzanine in Kent, Washington

The book opens with a description of the Blue Origin assembly bay and a description of the work that its founder, Jeff Bezos, is attempting to achieve. McCurdy identifies the central challenges faced by business firms like Blue Origin trying to establish a foothold in the space transportation field. Can such firms raise the funds needed to cover the high cost of space flight? Do they need government help to do it? Leaders of the new space movement want to be sufficiently free of government control to carry out their ideas, but typically need financial support from sources beyond traditional private investment channels. Those other sources include the government agencies from whose control the creators seek to break away.
Angiopoietin-like proteins as therapeutic targets for cardiovascular disease: focus on lipid disorders.

Introduction: Angiopoietin-like (ANGPTL) proteins belong to a family of eight secreted factors that are structurally related to proteins that modulate angiogenesi, commonly known as angiopoietins. ...
Logistics in Simulation-Based Interprofessional Education

The demand to implement interprofessional education (IPE) simulation programs has increased over the past decade because it assists with breaking down silos, improving communication among professions, fostering understanding relate to the scope of practice, and increasing teamwork skills. However, implementing IPE simulation programs can be challenging due to barriers such as time, space, content, resources, the number of learners, costs, assessment, stereotypes, and evaluation. Based upon current literature and the authors’ own experiences of creating an IPE simulation program, this chapter presents how these barriers can be addressed.
Understanding the Deadly Silence of Posterior Fossa A Ependymoma

In a breakthrough study in a recent issue of Cell, Michealraj et al. (2020) demonstrate that posterior fossa A ependymoma, a lethal pediatric brain tumor with a silent genome, is dependent upon metabolic changes associated with hypoxia that drive the tumor's characteristic epigenetic dysregulation.
Is tumor cell specificity distinct from tumor selectivity in vivo? A quantitative NIR molecular imaging analysis of nanoliposome targeting

The significance and ability for receptor targeted nanoliposomes (tNLs) to bind to their molecular targets in solid tumors in vivo has been questioned, particularly as the efficiency of their tumor accumulation and selectivity is not always predictive of their efficacy or molecular specificity. This study presents, for the first time, in situ NIR molecular imaging-based quantitation of the in vivo specificity of tNLs for their target receptors, as opposed to tumor selectivity, which includes influences of enhanced tumor permeability and retention. Results show that neither tumor delivery nor selectivity (tumor-to-normal ratio) of cetuximab and IRDye conjugated tNLs correlate with EGFR expression in U251, U87 and 9L tumors, and in fact underrepresent their imaging-derived molecular specificity by up to 94.2%. Conversely, their in vivo specificity, which we quantify as the concentration of tNL-reported tumor EGFR provided by NIR molecular imaging, correlates positively with EGFR expression levels in vitro and ex vivo (Pearson's r= 0.92 and 0.96, respectively). This study provides a unique opportunity to address the problematic disconnect between tNL synthesis and in vivo specificity. The findings encourage their continued adoption as platforms for precision medicine, and facilitates intelligent synthesis and patient customization in order to improve safety profiles and therapeutic outcomes.
Axial spondyloarthritis: New advances in diagnosis and management

Axial spondyloarthritis (axSpA) is an inflammatory disease of the axial skeleton associated with significant pain and disability. Previously, the diagnosis of ankylosing spondylitis required advanced changes on plain radiographs of the sacroiliac joints. Classification criteria released in 2009, however, identified a subset of patients, under the age of 45, with back pain for more than three months in the absence of radiographic sacroiliitis who were classified as axSpA based on a positive magnetic resonance imaging or HLAB27 positivity and specific clinical features. This subgroup was labeled non-radiographic (nr)-axSpA. These patients, compared with those identified by the older New York criteria, contained a larger percentage of women and demonstrated less structural damage. However, their clinical manifestations and response to biologics were similar to radiographic axSpA. The discovery of the interleukin (IL) IL-23/IL-17 pathway revealed key molecules involved in the pathophysiology of axSpA. This discovery propelled the generation of antibodies directed toward IL-17A, which are highly effective and demonstrate treatment responses in axSpA that are similar to those observed with anti-TNF agents. The finding that agents that block IL-23 were not effective in axSpA came as a surprise and the potential underlying mechanisms underlying this lack of response are discussed. New agents with dual inhibition of the IL-17A and F isoforms and some oral small molecule agents that target the Jak-STAT pathway, have also shown efficacy in axSpA.
Causality Is Logically Definable — Toward an Equilibrium-Based Computing Paradigm of Quantum Agents and Quantum Intelligence (QAQI) (Survey and Research)

A survey on agents, causality and intelligence is presented and an equilibrium-based computing paradigm of quantum agents and quantum intelligence (QAQI) is proposed. In the survey, Aristotle’s causality principle and its historical extensions by David Hume, Bertrand Russell, Lotfi Zadeh, Donald Rubin, Judea Pearl, Niels Bohr, Albert Einstein, David Bohm, and the causal set initiative are reviewed; bipolar dynamic logic (BDL) is introduced as a causal logic for bipolar inductive and deductive reasoning; bipolar quantum linear algebra (BQLA) is introduced as a causal algebra for quantum agent interaction and formation. Despite the widely held view that causality is undefinable with regularity, it is shown that equilibrium-based bipolar causality is logically definable using BDL and BQLA for causal inference in physical, social, biological, mental, and philosophical terms. This finding leads to the paradigm of QAQI where agents are modeled as quantum ensembles; intelligence is revealed as quantum intelligence. It is shown that the ensemble formation, mutation and interaction of agents can be described as direct or indirect results of quantum causality. Some fundamental laws of causation are presented for quantum agent entanglement and quantum intelligence. Applicability is illustrated; major challenges are identified in equilibrium-based causal inference and quantum data mining.
1,050 years of Hurricane Strikes on Long Island in The Bahamas

Sedimentary records of past hurricane activity indicate centennial-scale periods over the past millennium with elevated hurricane activity. The search for the underlying mechanism behind these active hurricane periods is confounded by regional variations in their timing. Here, we present a new high resolution paleohurricane record from The Bahamas with a synthesis of published North Atlantic records over the past millennium. We reconstruct hurricane strikes over the past 1,050 years in sediment cores from a blue hole on Long Island in The Bahamas. Coarse-grained deposits in these cores date to the close passage of seven hurricanes over the historical interval. We find that the intensity and angle of approach of these historical storms plays an important role in inducing storm surge near the site. Our new record indicates four active hurricane periods on Long Island that conflict with published records on neighboring islands (Andros and Abaco Island). We demonstrate these three islands do not sample the same storms despite their proximity, and we compile these reconstructions together to create the first regional compilation of annually resolved paleohurricane records in The Bahamas. Integrating our Bahamian compilation with compiled records from the U.S. coastline indicates basin-wide increased storminess during the Medieval Warm Period. Afterward, the hurricane patterns in our Bahamian compilation match those reconstructed along the U.S. East Coast but not in the northeastern Gulf of Mexico. This disconnect may result from shifts in local environmental conditions in the North Atlantic or shifts in hurricane populations from straight-moving to recurving storms over the past millennium.
Robotic TAPP for Inguinal Hernia Simple to Complex

This chapter explores the role of robotic assisted platforms in the evolution of minimally invasive inguinal hernia repairs. We discuss patient evaluation, surgical technique, and recommended guidelines for hernia repair in cases of increasing anatomic complexity.
Comparison in Suprasegmental Characteristics between Typical and Dysarthric Talkers at Varying Severity Levels

Dysarthria is a speech disorder often characterized by slow speech with reduced intelligibility. This preliminary study investigates suprasegmental characteristics between typical and dysarthric speakers at varying severity levels, with the long-term goal of improving methods for dysarthric speech synthesis/augmentation and enhancement. First, we aim to analyze phonemes, speaking rate and pause characteristics of typical and dysarthric speech using the phoneme- and word-level alignment information extracted by Montreal Forced Aligner (MFA). Then, pitch and intensity declination trends and range analysis are conducted. The pitch and intensity declination are measured by fitting a regression line. These analyses are conducted on dysarthric speech in TORGO, containing 8 dysarthric speakers involved with cerebral palsy or amyotrophic lateral sclerosis and 7 age- and gender-matched typical speakers. These results are important for the development of dysarthric speech synthesis, augmentation to statistically model and evaluate characteristics such as pause, speaking rate, pitch, and intensity.
A Review of “Henry Hulton and the American Revolution: An Outsider's Inside View”

Scholars writing about the American revolutionary era focus heavily on the Patriot side of the war, ranging along the spectrum from studies of the founders and other elites to explorations of the a...
Behavioral Research in Industrial Relations: Symposium Introduction

This paper examines and assesses the behavioral content of industrial relations research in a variety of social science disciplines. The authors compare economic research on the wage and productivity consequences of unionism with psychological research on worker attitudes toward unions; sociological research on the negotiation process and conflict resolution; and industrial relations research on bargaining outcomes. This review shows that although both economic and noneconomic studies of industrial relations are heavily empirical, they differ markedly in analytical frameworks and research designs, dependent variables investigated, the choice of research tools and methods, and the types of data analyzed. The authors also identify and briefly discuss some opportunities for cross-fertilization among disciplines that arise from this portfolio of industrial relations research. (Abstract courtesy JSTOR.)
Novel Use of Intrathecal Baclofen Drug Delivery System for Periodic Focal Dystonia in a Teenager

Introduction: Focal dystonia, often affecting part of a limb, is a manifestation of complex regional pain syndrome (CRPS). This can be difficult to diagnose and treat. Furthermore, there may be significant latency between the onset of dystonia after the diagnosis of CRPS. We present the case of a 15-year-old girl with periodic focal dystonia who has been successfully treated with an intrathecal baclofen pump. Materials and Methods: The patient had sustained a minor ankle fracture four years prior to presentation. Despite radiologic evidence of adequate bony union, the patient continued to complain of spasms and pain in her left foot leading to dystonic posturing of the foot. Multiple therapies including subcutaneous morphine infusion, ankle splinting, physiotherapy, and local botulinum injections had not provided adequate relief. Intrathecal baclofen on three separate occasions resulted in successful temporary resolution of the dystonia. A placebo double-blinded injection of intrathecal saline at a separate setting however did not resolve the dystonia. Results: We then proceeded with permanent delivery of baclofen by implantation of an intrathecal drug delivery pump, which resulted in resolution of the dystonia. The patient also was able to receive bolus doses of intrathecal baclofen. The patient is now able to partake in sporting and dancing activities. A detailed history of the patient, along with the difficulties in diagnosis and management, is presented. Conclusion: Intrathecal baclofen therapy can be effective in the management of focal dystonia after rigorous preoperative testing and counseling of adolescents with CRPS.