cssi/SciSciGPT-SciSciNet huggingface dataset:
Hospital and Payer Costs Associated With Surgical Complications

Importance Increased costs of surgical complications have been borne mostly by third-party payers. However, numerous policy changes aimed at incentivizing high-quality care shift more of this burden to hospitals. The potential effect of these policies on hospitals and payers is poorly understood. Objective To evaluate costs associated with surgical quality and the relative financial burden on hospitals and payers. Design, Setting, and Participants We performed an observational study merging complication data from the Michigan Surgical Quality Collaborative and internal cost accounting data from the University of Michigan Health System from January 2, 2008, through April 16, 2015; the merged files from these data were created between June 5, 2015, and July 22, 2015. A total of 5120 episodes of surgical care for 24 surgical procedure groups (17 general surgical, 6 vascular, and 1 gynecologic) were examined. We report unadjusted and log-transformed risk-adjusted costs. Main Outcomes and Measures We compared hospital costs, third-party reimbursement (ie, payer costs), and hospital profit margin for cases with and without complications. Results The mean (SD) age of the 5120 patients was 56.0 (16.4) years, and 2883 (56.3) were female. The overall complication rate was 14.5% (744 of 5120) for all procedures, 14.7% (580 of 3956) for general surgery, 15.5% (128 of 828) for vascular surgery, and 10.7% (36 of 336) for gynecologic surgery. For all studied procedures, mean hospital costs were $19 626 (119%) higher for patients with complications ($36 060) compared with those without complications ($16 434). Mean third-party reimbursement was $18 497 (106%) higher for patients with complications ($35 870) compared with those without complications ($17 373). Consequently, with risk adjustment, overall profit margin decreased from 5.8% for patients without complications to 0.1% for patients with complications. Conclusions and Relevance Hospitals and third-party payers experience increased costs with surgical complications, with hospitals experiencing a reduction in profit margin. Both hospitals and payers appear to currently have financial incentives to promote surgical quality improvement.
A Study of the Effects of Background Subtraction on Occultation Imaging

One of the crucial steps in the occultation transform imaging technique involves the removal of the time-varying instrumental background. Previous versions of this imaging technique applied to BATSE data have used simple high-pass filtering to eliminate background variations on timescales longer than the typical duration of an occultation step (of order 10 s). We have investigated an alternative technique in which the imaging algorithm is applied to the residuals generated from fitting the raw data with a semi-empirical model of the background. Comparison of the resulting maps shows that the latter does not significantly improve imaging performance.
‘Microsoft bought Minecraft … who knows what’s going to happen?!’: a sociocultural analysis of 8–9-year-olds’ understanding of commercial online gaming industries

ABSTRACTThis study investigates children’s media literacy with a specific focus on socially situatedness of children’s understanding of online gaming industries and related marketing. This article analyzes interviews with 8–9-year-olds and their parents in homes in the U.S.A. Rather than concentrating on developmental factors, the article uses a sociocultural approach to analyze various aspects of children’s gaming culture in domestic settings that relate to their understanding of gaming industries. The article considers implications for how children as consumers are understood by key stakeholders, including researchers and educators.
Recovering the Falklands: the Diplomacy of War

After its successful invasion, Argentina refused to withdraw from the Falkland Islands without a promise from Britain that negotiations between the two over their future would resume. Britain would have to agree in advance that these negotiations would last for a limited time only, after which it would relinquish its claim to sovereignty in favour of Argentina. This was unacceptable to Britain and, accordingly, within a day of the attack, Thatcher announced that a naval task force would be dispatched to the South Atlantic, declaring that the government’s objective was ‘… to see the islands were freed from invasion and returned to British administration at the earliest possible moment.’1 Meanwhile, Argentina declared them a province and began to strengthen its own garrison. In the course of these events, several attempts at mediation were made by third parties, the Peruvian president, Belaunde Terry, the UN Secretary General, Perez de Cuellar and the American Secretary of State, Al Haig, all without success. The British recaptured the Falkland Island dependency of South Georgia on 26 April and military operations to recover the main Islands began in earnest on 1 May after a last British peace proposal which amounted to an ultimatum had been rejected by Argentina.
Non-invasive PET imaging of brown adipose tissue (BAT) and quantification of the kinetics of the thermogenic function using the voltage sensor 18F-FBnTP (fluorobenzyl triphenyl phosphonium)

1475 Objectives Recent clinical studies with FDG PET triggered renewed interest in thermogenic BAT as a mechanism that regulates the balance between caloric intake and energy expenditure, constituting a target for anti-obesity drugs. There is still no reliable means for non-invasive detection of unstimulated BAT and quantification of thermogenesis. The core mechanism of BAT thermogenesis is activation of the mitochondrial uncoupler protein (UCP1), which is directly linked to the dissipation of the organelle’s membrane potential (ΔΨm). Efficacy of the ΔΨm-targeting voltage sensor 18F-FBnTP to detect unstimulated BAT and quantify the kinetics of the thermogenic function was studied using dynamic PET. Methods In 6 Brown Norway (BN) rats, FBnTP (1 mCi) was introduced via a tail vein and a 60-min dynamic PET imaging of BAT was carried out at room temperature. In 7 BN rats, dynamic FBnTP PET was carried out for 30 min before and for 90 min after cold stimulation, while rectal temperature was monitored, followed by a third PET static scan, acquired after surgical excision of BAT. A CT scan was acquired immediately after PET. In 3/7 rats, effect of the noradrenergic antagonist propranolol (PROP, 5mg/kg, IP) was studied. Quantitative analysis of BAT ROI was performed. Results In all studied animals, FBnTP demonstrated strong uptake in unstimulated BAT. The mean BAT-to-muscle ratio was >5 and BAT-to-heart was 0.88±0.13 by PET. Cold stimulation induced an early rapid followed by late slow washout of FBnTP from BAT. FBnTP BAT activity declined linearly with decrease of rectal temperature (R2 = 0.77±0.12). Static PET acquired after surgical removal of BAT confirmed FBnTP uptake in BAT. PROP significantly attenuated the effect of cold on FBnTP BAT washout. Conclusions 18F-FBnTP PET is a unique tool for high-contrast noninvasive detection of unstimulated BAT and can quantify the kinetics of noradrenergic-mediated thermogenesis by direct targeting UCP1 - the core mechanism of thermogenesis
Ore and Chv\'atal-type Degree Conditions for Bootstrap Percolation from Small Sets

Bootstrap percolation is a deterministic cellular automaton in which vertices of a graph~$G$ begin in one of two states, "dormant" or "active". Given a fixed integer $r$, a dormant vertex becomes active if at any stage it has at least $r$ active neighbors, and it remains active for the duration of the process. Given an initial set of active vertices $A$, we say that $G$ $r$-percolates (from $A$) if every vertex in $G$ becomes active after some number of steps. Let $m(G,r)$ denote the minimum size of a set $A$ such that $G$ $r$-percolates from $A$. Bootstrap percolation has been studied in a number of settings, and has applications to both statistical physics and discrete epidemiology. Here, we are concerned with degree-based density conditions that ensure $m(G,2)=2$. In particular, we give an Ore-type degree sum result that states that if a graph $G$ satisfies $\sigma_2(G)\ge n-2$, then either $m(G,2)=2$ or $G$ is in one of a small number of classes of exceptional graphs. We also give a Chvatal-type degree condition: If $G$ is a graph with degree sequence $d_1\le d_2\le\dots\le d_n$ such that $d_i \geq i+1$ or $d_{n-i} \geq n-i-1$ for all $1 \leq i < \frac{n}{2}$, then $m(G,2)=2$ or $G$ falls into one of several specific exceptional classes of graphs. Both of these results are inspired by, and extend, an Ore-type result in [D. Freund, M. Poloczek, and D. Reichman, Contagious sets in dense graphs, to appear in European J. Combin.]
Arthroprosthetic cobaltism associated with cardiomyopathy

Systemic cobaltism related to metal-on-metal total hip arthroplasty has been published in case reports and series with effects on the cardiac, neurologic, endocrine, and immunologic systems. This case report presents a 46-year-old male who underwent bilateral metal-on-metal total hip arthroplasty and subsequently developed cardiomyopathy requiring left ventricular assist device implantation. Intervention with bilateral revision to non-cobalt-containing implants resulted in improved cardiac function. This case report will alert clinicians to the presentation of this rare but devastating complication while also displaying improvement following revision total hip arthroplasty. It is our hope this case will aid in early recognition and intervention of this condition.
Hybrid Thoracoscopic and Transvenous Catheter Ablation of Atrial Fibrillation: Is This the Answer We Are Searching For?⁎

During the past decade, catheter ablation of atrial fibrillation (AF) has emerged as an important treatment option for patients with symptomatic AF refractory to 1 or more antiarrhythmic agents. Electrical isolation of the pulmonary vein musculature (PVI) has been identified as the primary end point
Extrapyramidal Symptoms II (Dystonia, Akathisia, Tardive Dyskinesia)

Extrapyramidal symptoms (EPS) refer to movement disorders that result from lesions in the basal ganglia and its connections, due to interference with dopaminergic transmission. Antipsychotics are a common cause of EPS.
Tau aggregates: Where, When, Why and What consequences?

Neuropathologists have been aware of neurofibrillary tangles for more than a century following their description as part of Alois Alzheimer's initial report. Since those early days, our understanding of the relationship of this particular type of cellular inclusion associated with neurodegeneration has continually broadened. Textbooks, now a partially antiquated concept, commonly list a range of disorders as being associated with tangles -NDASH- including typical neurodegenerative diseases (Alzheimer disease [AD], forms of frontotemporal lobar degenerations [FTLD-tau], progressive supranuclear palsy [PSP], corticobasal degeneration [CBD], primary aged related tauopathy [PART]), secondary degenerative diseases such as chronic traumatic encephalopathy, metabolic disease (Niemann-Pick disease type C) and infections (SSPE). Because such a wide range of disorders include tangles as a component of the neuropathologic findings, it appears that a range of cellular injury can result in the initiation of the pathologic processes which manifest as a tangle. This article is protected by copyright. All rights reserved.
Computational study of granular shear flows of dry flexible fibres using the discrete element method

In this study, shear flows of dry flexible fibres are numerically modelled using the discrete element method (DEM), and the effects of fibre properties on the flow behaviour and solid-phase stresses are explored. In the DEM simulations, a fibre is formed by connecting a number of spheres in a straight line using deformable and elastic bonds. The forces and moments induced by the bond deformation resist the relative normal, tangential, bending and torsional movements between two bonded spheres. The bond or deforming stiffness determines the flexibility of the fibres and the bond damping accounts for the energy dissipation in the fibre vibration. The simulation results show that elastically bonded fibres have smaller effective coefficients of restitution than rigidly connected fibres. Thus, smaller solid-phase stresses are obtained for flexible fibres, particularly with bond damping, compared with rigid fibres. Frictionless fibres tend to align with a small angle from the flow direction as the solid volume fraction increases, and fibre deformation is minimized due to the alignment. However, jamming, with a corresponding sharp stress increase, large fibre deformation and dense contact force network, occurs for fibres with friction at high solid volume fractions. It is also found that jamming is more prevalent in dense flows with larger fibre friction coefficient, rougher surface, larger stiffness and larger aspect ratio.
Experimental and Computational Interrogation of Fast SCR Mechanism and Active Sites on H-Form SSZ-13

Experiments and density functional theory (DFT) models are combined to develop a unified, quantitative model of the mechanism and kinetics of fast selective catalytic reduction (SCR) of NO/NO2 mixtures over H-SSZ-13 zeolite. Rates, rate orders, and apparent activation energies collected under differential conditions reveal two distinct kinetic regimes. First-principles thermodynamics simulations are used to determine the relative coverages of free Bronsted sites, chemisorbed NH4+, and physisorbed NH3 as a function of reaction conditions. First-principles metadynamics calculations show that all three sites can contribute to the rate-limiting N–N bond forming step in fast SCR. The results are used to parametrize a kinetic model that encompasses the full range of reaction conditions and recovers observed rate orders and apparent activation energies. Observed kinetic regimes are related to changes in most-abundant surface intermediates.
Risk Management for Contaminated Sediments

Contaminated sediments present a serious and vexing problem. The legacy of poor environmental practices related to industrial, agricultural, and residential uses of chemicals, waste water treatment, storm water management, as well as numerous other activities affecting water quality are evident in the current challenges facing public and private organizations addressing the risks posed by contaminated sediments. Managing these risks involves detailed consideration of a complex set of processes (e.g., physical, chemical, biological, socioeconomic, etc.) operating over broad spatial and temporal scales. Large uncertainties related to these processes cloud projections about the future performance of remedies. The number of technologies that are currently available for application at contaminated sediment sites is limited to a small number of variations of dredging, capping, treatment (both in situ and ex situ) and monitored natural recovery (MNR). The economic and environmental costs of managing contaminated sediment risks are large (e.g., project costs for each of the Fox and Hudson River cleanup projects in the United States are pushing $1 billion). Sediment cleanup projects are further complicated by the diverse range of policies, perspectives, risk attitudes and personal values that pertain to risk management decisions. Government institutions, private organizations and local communities face a number of difficult problems connected to risk management for contaminated sediments. Our purpose here is to analyze the risk management problem posed by contaminated sediments, present a series of guidelines for advancing risk management practice, and describe the path toward more effective risk management solutions.
Supporting Emergency Medical Care Teams with an Integrated Status Display Providing Real-Time Access to Medical Best Practices, Workflow Tracking, and Patient Data

The work of a hospital's medical staff is safety critical and often occurs under severe time constraints. To provide timely and effective cognitive support to medical teams working in such contexts, guidelines in the form of best practice workflows for healthcare have been developed by medical organizations. However, the high cognitive load imposed in such stressful and rapidly changing environments poses significant challenges to the medical staff or team in adhering to these workflows. In collaboration with physicians and nurses from Carle Foundation Hospital, we first studied and modeled medical team's individual responsibilities and interactions in cardiac arrest resuscitation and decomposed their overall task into a set of distinct cognitive tasks that must be specifically supported to achieve successful human-centered system design. We then developed a medical Best Practice Guidance (BPG) system for reducing medical teams' cognitive load, thus fostering real-time adherence to best practices. We evaluated the resulting system with physicians and nurses using a professional patient simulator used for medical training and certification. The evaluation results point to a reduction of cognitive load and enhanced adherence to medical best practices.
A continuous assay for monitoring the synthetic and proofreading activities of multiple aminoacyl-tRNA synthetases for high-throughput drug discovery

Aminoacyl-tRNA synthetases (aaRSs) catalyze the aminoacylation of tRNAs to produce the aminoacyl-tRNAs (aa-tRNAs) required by ribosomes for translation of the genetic message into proteins. To ensure the accuracy of tRNA aminoacylation, and consequently the fidelity of protein synthesis, some aaRSs exhibit a proofreading (editing) site, distinct from the aa-tRNA synthetic site. The aaRS editing site hydrolyzes misacylated products formed when a non-cognate amino acid is used during tRNA charging. Because aaRSs play a central role in protein biosynthesis and cellular life, these proteins represent longstanding targets for therapeutic drug development to combat infectious diseases. Most existing aaRS inhibitors target the synthetic site, and it is only recently that drugs targeting the proofreading site have been considered. In the present study, we developed a robust assay for the high-throughput screening of libraries of inhibitors targeting both the synthetic and the proofreading sites of up to four aaRSs simultaneously. Thus, this assay allows for screening of eight distinct enzyme active sites in a single experiment. aaRSs from several prominent human pathogens (i.e., Mycobacterium tuberculosis, Plasmodium falciparum, and Escherichia coli) were used for development of this assay.
Targeted Gene Bisulfite Sequencing Identifies Differential Methylation in p21

Next-generation sequencing (NGS) methods are widely available to assess methylation of whole-genomes, reduced representation of genomes, and target capture of many loci, but simple, flexible, and low-cost methods are needed to leverage NGS for sequencing single-locus amplicons from large numbers of samples. We developed a two-stage PCR approach, targeted gene bisulfite sequencing (TGBS) which uses the Illumina MiSeq and Bismark bisulfite mapper, to assess site specific changes in methylation of the cyclin-dependent kinase inhibitor p21 (CDKN1a) after exposure to a DNA methyltransferase inhibitor, 5-aza-2′-deoxycytidine (5-Aza) and determine the differences between human and rat p21 methylation. TGBS analysis of human embryonic kidney cells (HEK293) and human proximal tubular cells (hPT) demonstrated variation at a known methylation sensitive site (SIE-1), but not in rat kidney cells. Treatment of cells with 5-Aza altered the methylation of this site in correlation with increased p21 protein expression. We also found that human and rat p21 promoter sequences differ considerably in the amount of basal DNA methylation. These data showed the utility of TGBS for rapid analysis of DNA methylation of specific loci. We provide links to a ready-to-run Virtualbox that includes the program and commands for methylation analysis of bisulfite datasets, including step-by-step directions.
Analytical and Experimental Vibration of Sandwich Beams Having Various Boundary Conditions

Generalized differential quadrature (GDQ) method is used to analyze the vibration of sandwich beams with different boundary conditions. The equations of motion of the sandwich beam are derived using higher-order sandwich panel theory (HSAPT). Seven partial differential equations of motions are obtained through the use of Hamilton’s principle. The GDQ method is utilized to solve the equations of motion. Experiments are conducted to validate the proposed theory. The results from the analytical model are also compared to those from the literature and finite element method (FEM). Parametric studies are conducted to investigate the effects of different parameters on the natural frequency and response of the sandwich beam under various boundary conditions.
The Mathematical Model

In this chapter we derive the system characterizing the stationary oscillations of thin elastic plates with transverse shear deformation proposed in [56]. We assume that the body forces have a time-harmonic form, which we substitute into the full classical three-dimensional elasticity model to obtain a time-independent system. The so-called kinematic hypothesis is then applied and, by averaging over the thickness of the plate, we arrive at the desired system of equations. The boundary moment–stress operator is also defined.
Complications of Autonomic Dysreflexia

AbstractAutonomic dysreflexia can be a life-threatening problem if not promptly recognized and treated. Since the most common cause is bladder distension it is essential that the urologist be familiar with this syndrome. Several patients with serious complications owing to autonomic dysreflexia, including 1 mortality, are presented. The complications of autonomic dysreflexia result from a sudden marked rise in blood pressure, which may be severe enough to rupture single or multiple cerebral blood vessels or lead to a considerable increase in intracranial pressure. The neurophysiology, clinical features and therapeutic measures are discussed.
Memory Changes with Age. Neurobiological Correlates

Publisher Summary This chapter highlights selected domains of cognition that can be studied across mammalian species and that have known age-related neurobiological underpinnings. Research aimed at understanding the aging process, including the change of learning and memory processes with respect to age, provides the basis for the development of better preventative strategies and treatment strategies for successful ageing (particularly older population). In the general field of aging research, the focus has been on the pathological aging that may be associated with diseases such as Alzheimer's disease (AD). Many people do not develop dementing conditions such as AD with age; instead, most people develop mild memory deficits known as age-associated memory impairment (AAMI).There is a large literature that has examined the impact of aging process on learning and memory function. Tasks in which age-related impairments have been found include classical conditioning, such as eyeblink and heart rate conditioning, conditioned taste aversion, fear conditioning, operant tasks such delayed matching-to-sample and delayed nonmatching-to-sample tasks, and instrumental tasks such as active avoidance, passive avoidance, and maze learning tasks. The studies discussed in the chapter focus on the form of learning and memory that involves the ability of an organism to acquire and retain information that is critical for successful navigation through space. The discussion includes the process of learning and memory with respect to both humans and rodents, the involvement of the hippocampus in spatial learning and memory, and normal brain aging outside the hippocampus.
Wind driven setup in east central Florida's Indian River Lagoon: Forcings and parameterizations

Abstract High resolution hydrodynamic models are computationally expensive to run – especially if ensemble forecasts are desired. This can be problematic within coastal estuaries which are not well resolved by today's operational meteorological forecast models. As an alternative, this paper evaluates the wind forcing for three setup parameterizations (based on the Zuiderzee, modified Zuiderzee, and long wave equations) using a combination of observed setup from in-situ water level gauges and local wind observations. In addition, three methods are explored for developing hourly time series of wind forcing from 5-min observations: top of the hour, hourly mean, and wind run approach. The wind forcings, which are weighted by the length of two lagoon-oriented axes, are used to drive the setup parameterizations. The observed setup is used to tune each of the parameterizations via a least squares approach. The observation spread, linear model residuals, coefficient of determination (R2), and root mean squared error (RMSE) indicate that the wind run out performs the other two methods. In terms of the three parameterizations, the modified Zuiderzee had consistently higher R2 values, lower RMSE, and narrower 95% confidence intervals than the two other methods. This optimized parameterization is currently being used operationally to generate ensemble setup forecasts for the Indian River Lagoon, a restricted estuary on Florida's east-central coast. These simple ensemble forecasts are designed to guide the National Weather Service (NWS) in identifying potentially significant setup events that warrant high resolution hydrodynamic simulations.
Decreased Abundance of Firmicutes in the Gut Microbiota After Consumption of a Diet Containing Milk Fats

Intestinal microbiota play a relevant role in health maintenance and disease prevention. Diet has been shown to influence the intestinal bacterial density, communities, and subsequently their funct...
Modeling thermal contact resistance at the finger-object interface.

ABSTRACTThermal contact resistance at the finger-object interface plays a significant role in our thermal perception and is an important parameter for the design of a myriad of electronics and ther...
CordovaConfig: A Tool for Mobile Hybrid Apps' Configuration

Despite their recentness, hybrid mobile apps have established an increasing share in the mobile apps market. This can be attributed to the fact that these apps offer the balance between providing full functionality at an affordable development cost. Hybrid mobile apps are web apps hosted in a thin native container. Several libraries facilitate building hybrid apps by providing interfaces through which native phone resources can be accessed using Javascript code. Configuring mobile hybrid apps properly is an important but often neglected activity. Coarse-grained configurations and risky default settings result in several privacy and security breaches. Moreover, middleware libraries provide a basic interface to the developers which may drive them off from changing the default settings. We are seeking to provide an automated, interactive, and contextual support for configuring hybrid apps. In this paper, we present a tool prototype, CordovaConfig, which provides fine-grained configurations that are aligned with the app's behavior. We evaluate the potential use and effectiveness of CordovaConfig on 22 students. Our results demonstrate that interactive configuration support can (1) help address this important non-functional requirement early in the development cycle (2) increase programmers awareness in potential risks associated with insecure settings (3) increase developers understanding of configuration items. This is supported by a quantitative and qualitative evaluation. We also uncover common programmers practices and perceptions of hybrid apps security & configurations
Nanostructured Oxides Containing Ga: Materials with Unique Properties for Aqueous-Based Applications

Oxides containing Ga have been studied by various research communities due to their stability under harsh conditions as well as conductivity and luminescence properties. Nanostructured forms of such oxides can be fabricated by a variety of methods. Advances in synthesis approaches have focused on control over size and shape that can permit adaptation in applied interfaces related to medicine, energy, and the environment. Chemical functionalization can enhance the stability of nanostructured oxides containing Ga in aqueous solutions. In this prospective, we summarize progress in making these materials as well as functionalizing them in water solutions. The prospective also identifies future opportunities with these materials in applied and fundamental materials chemistry research.
Valves and actuator integrity and blast load calculations

The mounting kit for a valve consists of a coupling, drive keys, dowel pin, and bolting hardware. The design of a mounting kit should be stress-based or based on previous experience and validation testing. The mounting kit is the most important section for providing valve and actuator integrity, so it should be capable of withstanding loads from actuator, wind, snow, seismic, and blast. Parameters such as type of valve and actuator and orientation, frequency of actuator cycling and speed of operation, coupling connections, adapter fabrication, and material of coupling can affect the strength of the coupling. This paper presents an example where improper machining of the drive shaft jeopardizes the integrity between the valve and actuator. Mismatch between machined parts of the stem inside bracket and coupling makes the stem not to be aligned correctly in the vertical position. Additionally, this paper discusses the integrity between a 6″ × 4″ ball valve in 22Cr duplex material and class 300 and the pneumatic actuator on this valve against longitudinal and shear stresses created by blast and internal pressure. Both shear and longitudinal stresses are less than 90% of the bolting yield stress for 22Cr duplex, so the conclusion is that the connections between the 6″ × 4″ Class 300 ball valve and the pneumatic actuator are strong enough against blast loads.
Management strategies for recurrent acute rhinosinusitis.

Background Management of patients with recurrent acute rhinosinusitis (RARS) is often challenging, and robust data in the literature is scant. The aim of this study is to better characterize the current treatment strategies for RARS used by otolaryngologists. Methods An online survey sent to all members of the American Rhinologic Society in a 1 month period evaluated demographics, practice characteristics, and management strategies for patients with RARS, subdivided into those with (RARSwD) and without (RARSsD) septal deviation. Eighty-eight practicing members responded, of whom 41% were fellowship-trained rhinologists. Results For most cases of RARSsD, 61% of otolaryngologists would primarily use medical management. Most would wait until patients had experienced 4-5 episodes to perform balloon sinuplasty (80%) or formal sinus surgery (79%). The sinus surgery procedure of choice was limited sinus surgery (62%). For RARSwD, 52% primarily chose medical management. Most would wait until patients had experienced 4-5 episodes to perform balloon sinuplasty (80%) or formal sinus surgery (78%). Nearly all fellowship-trained rhinologists (97%) would perform limited sinus surgery with septoplasty for RARSwD, compared to only 70% of other otolaryngologists who would do so and 24% who would perform complete sinus surgery with septoplasty. While 89% of practitioners in private practice would wait to perform balloon sinuplasty until patients had experienced 4-5 episodes, only 68% of those in academia would wait this long and 23% would do so after only 1-3 episodes. Conclusions Treatment of patients with RARS is complex, and the differences in strategies employed between groups of otolaryngologists may reflect their training backgrounds and different patient populations. Level of evidence V.
Characterizing cesium sorption in freshwater settings using fluvial sediments and characteristic water chemistries.

Abstract Cesium-137 (137Cs) is a persistent contaminant that poses a significant risk to human health and the environment. Understanding the fate and transport of 137Cs following a contamination incident is necessary for effective containment and remediation. In this study, we performed experiments to investigate how Cs+ sorption processes are affected by sediment type and varying water chemistries to better understand how Cs+ is transported in freshwater settings. Sediment was collected from various river deposits along the Susquehanna River adjacent to the Safety Light Corporation United States Environmental Protection Agency (US EPA) Superfund site (Bloomsburg, PA) and characterized prior to being used in batch reactor experiments with waters characteristic of different regions in the US (Central US and Northeast US) and with three different cation types (Mg2+, Na+, and K+) over a range of ionic strengths. Greater amounts of Cs+ sorption occurred with increasing sediment mud (silt and clay) content, although no major differences in sorption between the Central and Northeast US water types were observed. At an ionic strength (I) of 10 mM, K+ inhibited Cs+ sorption most effectively, followed by Mg2+, with Na+ having little effect on Cs+ sorption over the range of ionic strengths tested (I = 0.1, 1, and 10 mM). Our findings indicate that for the representative freshwater conditions tested here, sediment type (e.g., clay fraction) has a greater influence on Cs+ sorption processes than water chemistry. Additional reactions or processes occurring in relatively fresh water could buffer cation competition for sorption sites. Conducting experiments using site-specific sediment samples and water chemistries is useful for predicting Cs+ sorption and mobility in distinct environmental settings, particularly when the level of Cs+ contamination is high and if the waste or contaminated (or receiving) waters have a relatively high ionic strength.
A novel optimization approach to minimize aggregate-fit-loss for improved breast sizing:

Ready-to-wear clothing is typically based on the body-shape of human fit models that an apparel company hires. The body-shape difference between a consumer and the fit model of their size results i...
External cephalic version of the non-cephalic presenting twin: a systematic review.

Objective: Decreasing the primary cesarean delivery rate and associated maternal and fetal complications is a priority for obstetric care providers. External cephalic version (ECV) is a procedure recommended for women with singleton pregnancies where the fetus is malpresenting to avoid vaginal breech delivery, which is inherently riskier than cesarean delivery. However, little is known about this procedure in the context of twin gestations. Scheduled cesarean delivery is instead recommended for women with twin gestations where the presenting twin is not cephalic. Our aim is to evaluate the safety and efficacy of ECV in the setting of twin pregnancy where the presenting twin is not cephalic. We also present two patients with twin pregnancy at our institution that attempted ECV.Data sources: A systematic review of the following electronic databases was performed, searching from their inception until September 2019: Pubmed, Ovid, Scopus, and clinicaltrials.gov.Study eligibility criteria: All reported cases of ECV for a non-cephalic presenting twin were included. Studies were excluded if patients had contraindications to vaginal delivery and if they described ECV of the second twin only. Maternal demographics, procedure details, and outcomes data were collected.Study appraisal and synthesis methods: The primary outcome was a successful version of the presenting twin to the cephalic presentation following ECV. Statistical analysis involved calculating means, standard deviations, frequencies and percentages as appropriate.Results: Two case reports and one case series, totaling 22 patients, met inclusion criteria. Two additional patients attempted ECV at our institution. One completed ECV (for a total of 23 patients) while the other did not. This patient consented for ECV as Twin A was noted to be breeched upon presentation to labor and delivery but after receiving regional anesthesia, twin A was cephalic. No randomized controlled trials were identified. All were dichorionic pregnancies. Successful ECV of twin A occurred in 57% (13/23) of women and 48% (11/23) had a successful vaginal delivery. The majority were performed using regional anesthesia and a uterine relaxant (20/23). No serious adverse events occurred in any of the reports.Conclusions: ECV is insufficiently studied in twin pregnancy. Based on very limited data, it appears feasible to turn the non-cephalic presenting twin. Additional randomized controlled trials are needed to further evaluate the safety and efficacy of this procedure for a non-cephalic presenting twin.
Self-Supervised Learning from Contrastive Mixtures for Personalized Speech Enhancement.

This work explores how self-supervised learning can be universally used to discover speaker-specific features towards enabling personalized speech enhancement models. We specifically address the few-shot learning scenario where access to cleaning recordings of a test-time speaker is limited to a few seconds, but noisy recordings of the speaker are abundant. We develop a simple contrastive learning procedure which treats the abundant noisy data as makeshift training targets through pairwise noise injection: the model is pretrained to maximize agreement between pairs of differently deformed identical utterances and to minimize agreement between pairs of similarly deformed nonidentical utterances. Our experiments compare the proposed pretraining approach with two baseline alternatives: speaker-agnostic fully-supervised pretraining, and speaker-specific self-supervised pretraining without contrastive loss terms. Of all three approaches, the proposed method using contrastive mixtures is found to be most robust to model compression (using 85% fewer parameters) and reduced clean speech (requiring only 3 seconds).
Greater Acculturation is Associated With Poorer Cardiovascular Health in the Multi‐Ethnic Study of Atherosclerosis

Background Greater acculturation is associated with increased risk of cardiovascular disease. However, little is known about the association between acculturation and ideal cardiovascular health (C...
When and Where Residential Racial Segregation Matters for the Black Self-employment Rate:

Scholars debate whether residential racial segregation associates positively, negatively, or at all with the Black self-employment rate in the United States. This study engages that debate using da...
Luteinizing hormone and the aging nervous system

Abstract From gestation through menopause in women, and andropause in men, fluctuations in luteinizing hormone (LH) release contribute to the development and maintenance of the reproductive system. Of note, increasing evidence also supports extra-gonadal roles for LH within the central nervous system (CNS), particularly as it relates to cognition and plasticity in aging and age-related degenerative diseases such as Alzheimer disease (AD). However, despite increasing reports in the past decade that solidify the role of this hormone in these processes, relating LH function and dysfunction to neuronal function and behavior, the mechanisms underlying LH action within the brain and how they influence cognition and plasticity loss remain poorly understood; in fact they are often in conflict. This chapter aims to provide an up-to-date review of the literature addressing the role of LH signaling in the context of CNS aging and disease. Additionally, we also aim to provide insight from the perspective of LH receptor (LHCGR) signaling and trafficking upon ligand binding that may unify currently conflicting theories regarding the role of LHCGR signaling in CNS function and dysfunction in aging and disease.
Reinforced Concrete Hyperbolic Paraboloid Shells

An experimental study is presented of the behavior of reinforced concrete inverted umbrella hypar shell models loaded with uniform load to failure. Reinforced microconcrete model shells with three different edge member geometries were tested. The shell strength was controlled by the tensile edge members around the periphery of the shell, and was independent of position of edge members with respect to shell midthickness. Ultimate load capacity was about l50 psf (7,l80 N/m2). Shells without compressive ribs had the same strength and only slightly more flexibility than similar shells with compressive ribs. The edge members and a substantial portion of adjacent shell act together in resisting the accumulated membrane shears from the shell. This interaction is defined with an effective width concept based on PVC model results. Direct stresses in the shell differ substantially from membrane theory predictions; the tensile principal stress exceeds the compressive principal stress in all cases. The ratio of bending stress to direct stress is on the order of 1 in the edge members and considerably higher in the shell.
High performance techniques for space mission scheduling

In this paper, we summarize current research at Carnegie Mellon University aimed at development of high performance techniques and tools for space mission scheduling. Similar to prior research in opportunistic scheduling, our approach assumes the use of dynamic analysis of problem constraints as a basis for heuristic focusing of problem solving search. This methodology, however, is grounded in representational assumptions more akin to those adopted in recent temporal planning research, and in a problem solving framework which similarly emphasizes constraint posting in an explicitly maintained solution constraint network. These more general representational assumptions are necessitated by the predominance of state-dependent constraints in space mission planning domains, and the consequent need to integrate resource allocation and plan synthesis processes. First, we review the space mission problems we have considered to date and indicate the results obtained in these application domains. Next, we summarize recent work in constraint posting scheduling procedures, which offer the promise of better future solutions to this class of problems.
Data Reduction Using Multiple Models Integration

Large amount of available information does not necessarily imply that induction algorithms must use all this information. Samples often provide the same accuracy with less computational cost. We propose several effective techniques based on the idea of progressive sampling when progressively larger samples are used for training as long as model accuracy improves. Our sampling procedures combine all the models constructed on previously considered data samples. In addition to random sampling, controllable sampling based on the boosting algorithm is proposed, where the models are combined using a weighted voting. To improve model accuracy, an effective pruning technique for inaccurate models is also employed. Finally, a novel sampling procedure for spatial data domains is proposed, where the data examples are drawn not only according to the performance of previous models, but also according to the spatial correlation of data. Experiments performed on several data sets showed that the proposed sampling procedures outperformed standard progressive sampling in both the achieved accuracy and the level of data reduction.
Industrial strategy and rural development in Africa with special reference to Ghana: A review of current trends and suggestions for a plan of action

Abstract Africa is a late comer in the field of industrial development and, today, trails considerably behind even developing Asia and Latin America in the contribution of manufacturing to GDP. At independence, African countries inherited a structural and spatial pattern of industries incapable of contributing to rural development and nationally integrated economies. The principal weaknesses of the structural and spatial patterns of industries are the predominance of first-stage processing and consumption goods industries and the lack of basic capital goods industries, the high degree of metropolitan concentration, the low and sometimes insignificant development of intersectoral and interregional linkages, the high capital-labor ratios, the growing balance of payments' problems caused by the heavy reliance on imported materials and equipment and the monopolistic control of output and markets fostering rising domestic prices. These limitations are discussed and the main ingredients of an alternative industrial allocation pattern outlined. The sustaining thesis is that any African country seeking alternative industrial allocation patterns calibrated to stimulating rural development and the integration of the space economy must initiate critical changes in the inherited structural and spatial patterns.
Are moods cognitive?: A critique of Schmitt on Heidegger

If, as Schmitt suggests, Heidegger bases the claim that moods are cognitive on the philosophical distinction between theoretical and non-theoretical knowing, then much of what Heidegger says in this connection turns out to be either unclear, trivially true, or else false. Yet Schmitt himself only occasionally seems to recognize how dubious this account really is. Moreover, in attempting to help Heidegger say what he means, Schmitt's interpretation in Chapter 5 falters. It falters because
In vivo limb muscle differentiation in the absence of nerves: A quantitative study

Abstract The entire presumptive nervous system of stage 24 Amblystoma maculatum embryos was surgically excised to produce aneurogenic larvae. For controls, embryos of the same age were operated in an identical fashion except that a segment of neural tube (about 1 mm) dorsal to the limb bud anlagen was left intact. The number of peripherally situated muscle nuclei (a measure of myofiber differentiation) peaked at the four-digit stage of aneurogenic limb development. The number of peripheral nuclei in the controls also peaked at the same time but remained at that maximum. With the exception of Day 13, the number of peripheral nuclei was always greater in control than in aneurogenic muscle. The total number of muscle nuclei per limb cross section gradually decreased in aneurogenic muscle to a number significantly lower than in controls at 31 days after the operation and thereafter. The cross-sectional size of aneurogenic muscle nuclei seemed to decrease at a faster rate than control nuclei. Reflecting nuclear density, the myonuclear area per muscle area in aneurogenic limbs was smallest at 21 days after the operation. After 21 days, aneurogenic nuclear densities progressively increased whereas control densities remained at the low, Day-21 value. From Day 13 to 21 the muscle nuclear density in control and aneurogenic limbs was statistically equal. Aneurogenic myofibers in an advanced state of degeneration incorporated more [ 3 H]leucine or [ 3 H]uridine than fibers where cross striations were still visible with the light microscope. With the electron microscope, acid phosphatase-stained lysosomes were found adjacent to disintegrating myofibrillar material in degenerating aneurogenic myofibers. Ruthenium red staining indicated that myofiber basement laminae developed normally in aneurogenic muscle and persisted.