cssi/SciSciGPT-SciSciNet huggingface dataset:
Do chronic pain and comorbidities affect brain function in sickle cell patients? A systematic review of neuroimaging and treatment approaches

Sickle cell disease (SCD) is a medical condition in which chronic pain is common and negatively impacts psychosocial function and quality of life. Although the brain mechanisms underlying chronic pain are well studied in other painful conditions, the brain mechanisms underlying chronic pain and the associated psychosocial comorbidities are not well established in SCD. A growing literature demonstrates the effect of treatment of chronic pain, including pharmacological and nonpharmacological treatments, on brain function. The present systematic review aimed to (1) determine the effects of chronic pain and psychosocial comorbidities on brain function of patients with SCD; (2) summarize pharmacological and nonpharmacological approaches to treat these symptoms; and (3) identify areas for further investigation of potential beneficial effects of treatments on brain function. Titles were screened using predefined criteria, including SCD, and abstracts and full texts were reviewed by 2 independent reviewers. A total of 1167 SCD articles were identified, and 86 full articles were included covering 3 sections: chronic pain (4 studies), psychosocial comorbidities (11 studies), and pharmacological and nonpharmacological treatments (71 studies). Neuroimaging evidence demonstrates aberrant neural processing related to chronic pain and psychosocial comorbidities in SCD beyond ischemic stroke and cerebral hemorrhage. Although neuroimaging studies show an important role for psychological factors, pain management is nearly exclusively based on opioids. Behavior therapy seems useful to improve psychological symptoms as well as chronic pain and quality of life. Further investigation is required with larger cohorts, matched controls, and examination of treatment-related neural mechanisms.
Pancreatic cancer treatment costs, including patient liability, by phase of care and treatment modality, 2000-2013.

Objectives Our study provides phase-specific cost estimates for pancreatic cancer based on stage and treatment. We compare treatment costs between the different phases and within the stage and treatment modality subgroups. Methods Our cohort included 20,917 pancreatic cancer patients from the Surveillance, Epidemiology, and End Results (SEER)-Medicare database diagnosed between 2000 and 2011. We allocated costs into four phases of care-staging (or surgery), initial, continuing, and terminal- and calculated the total, cancer-attributable, and patient-liability costs in 2018 US dollars. We fit linear regression models using log transformation to determine whether costs were predicted by age and calendar year. Results Monthly cost estimates were high during the staging and surgery phases, decreased over the initial and continuing phases, and increased during the three-month terminal phase. Overall, the linear regression models showed that cancer-attributable costs either remained stable or increased by year, and either were unaffected by age or decreased with older age; continuing phase costs for stage II patients increased with age. Conclusions Our estimates demonstrate that pancreatic cancer costs can vary widely by stage and treatment received. These cost estimates can serve as an important baseline foundation to guide resource allocation for cancer care and research in the future.
Routinized categorization of suicide risk into actionable strata: Establishing the validity of an existing suicide risk assessment framework in an outpatient sample.

OBJECTIVE The Suicide Risk Assessment and Management Decision Tree (DT) is a clinician-administered assessment that leads to risk categorizations that correspond with actionable strata. This study investigated the construct validity and test-retest reliability of the DT risk categories across two time points. METHOD Outpatients (N = 731) completed a battery of self-report measures. Spearman's correlations were used to examine the relationships between DT suicide risk level and suicidal symptoms, theory-based risk factors, psychiatric correlates, and DT suicide risk level at Timepoint 2. Correlations were analyzed for significant differences to examine the divergent validity of the DT. RESULTS Results, overall, were in line with hypotheses, with the exception of depression and thwarted belongingness. CONCLUSIONS Findings provide evidence for the reliability, convergent validity, and discriminant validity of the DT. This clinician-administered suicide risk assessment may be useful for standardization of the assessment and management of suicide risk in outpatient clinical settings.
Serum Albumin Level Before Kidney Transplant Predicts Post-transplant BK and Possibly Cytomegalovirus Infection

Introduction Opportunistic viral infections cause extensive morbidity and mortality in kidney transplant recipients (KTRs). Low serum albumin levels before and after transplant have been associated with negative outcomes. However, it is uncertain whether serum albumin levels before transplantation are associated with the risk for post-transplantation opportunistic BK polyomavirus (BKV) or cytomegalovirus (CMV). Methods We reviewed all KTRs transplanted at our institution between 1 January 2005 and 31 December 2015 with serum albumin measured within 45 days before transplantation in a retrospective observational cohort study. Selected patients were stratified into 3 groups: normal albuminemia (≥3.5 g/dl), moderate hypoalbuminemia (3.49–2.5 g/dl), and severe hypoalbuminemia ( Results We included 1717 patients in this study; 72.3% had normal serum albumin, 26.3% had moderate hypoalbuminemia, and 1.5% had severe hypoalbuminemia. Moderate and severe hypoalbuminemia incurred a higher risk for BKV compared with normal serum albumin levels in univariable analysis (moderate hypoalbuminemia: hazard ratio [HR] = 1.5; 95% confidence interval [CI], 1.14–1.90; P = .003); severe hypoalbuminemia: HR = 2.15; 95% CI, 1.01–4.56; P = 0.05). Although not significant after multivariable adjustment, there was still 18% increased risk in moderate hypoalbuminemia and 64% in severe hypoalbuminemia for BKV compared with the normal albumin group. Moderate hypoalbuminemia was associated with a higher risk for CMV infection than normal serum albumin levels in multivariable analysis, although it was not statistically significant (HR = 1.15; 95% CI, 0.36–3.64; P = 0.81). Conclusions These findings suggest that pretransplantation hypoalbuminemia is associated with a higher risk for post-transplantation BKV and possibly CMV. More intense screening is warranted for these viruses in recipients with pretransplant hypoalbuminemia.
U-Shaped Association of High-Density Lipoprotein Cholesterol with All-Cause and Cardiovascular Mortality in Hypertensive Population.

Purpose Whether the paradox of high-density lipoprotein cholesterol (HDL-C) and elevated mortality risk extends to hypertensive patients is unclear. We aimed to investigate the association between HDL-C and all-cause and cardiovascular disease mortality in adults with hypertension. Methods In the National Health and Nutrition Examination Surveys, 11,497 hypertensive participants aged ≥18years old and examined at baseline between 1999 and 2014 were followed up until December 2015. We categorized the HDL-C concentration as ≤30, 31-40, 41-50, 51-60 (reference), 61-70, >70 mg/dL and examined their associations with all-cause and cardiovascular mortality, respectively. Multivariate Cox regression was used to calculated hazard ratio (HR) and 95% confidence interval (CI) for mortality risk. Results During follow-up (median: 9.2 ± 3.8 years), 3012 deaths and 713 cardiovascular deaths were observed. In the restrictive cubic curves, associations of HDL-C levels and all-cause and cardiovascular mortality were detected to be U-shaped. After multivariable adjustment, HRs for all-cause mortality were for the lowest HDL-C concentration (≤30 mg/dL) 1.29 (95% CI, 1.07-1.56) and the highest (>70 mg/dL) 1.20 (1.06-1.37), comparing with the reference group. For cardiovascular mortality, HRs were 1.31 (0.83-1.48) and 1.09 (0.83-1.43), respectively. Similar results were obtained in subgroups stratified by age, gender, race, and taking lipid-lowering drugs. The lowest all-cause mortality risk was observed at HDL-C 66 mg/dL (concentration) and 51-60 mg/dL (range). Conclusion Both lower and higher HDL-C concentration appeared to be associated with higher mortality in hypertensive population. Further investigation is warranted to clarify the underlying mechanisms.
Impact of beef carcass size on chilling rate, pH decline, display color, and tenderness of top round subprimals.

Beef carcass weights in the United States have continued to increase over the past 30 yr. As reported by the United States Department of Agriculture, grid-based carcass weight discounts begin when carcasses exceed 408 kg. Despite weight discounts, beef carcass weights continue to increase. At the same time, an increased prevalence of discoloration and color variability in top round subprimals has been observed throughout the industry which may be influenced by the increases in carcass weights. The objectives of this study were to assess the effects of beef carcass size and its relationship to chill time, color, pH, and tenderness of the beef top round. In the current study, eight industry average weight beef carcasses (AW, 341-397 kg) and eight oversized beef carcasses (OW, exceeding 432 kg) were evaluated. Temperatures and pH measurements were observed on both sides of all carcasses for the initial 48 h postharvest at a consistent superficial and deep anatomical location of the respective top rounds. Carcasses were fabricated into subprimals at 48 h and top rounds were aged at 2 °C for an additional 12 d. The superficial location of both AW and OW carcasses cooled at a faster rate (P < 0.01) than the deep locations. The deep location of OW carcasses had a lower pH and a more rapid (P < 0.01) initial pH decline. Quantitative color of steaks from OW carcasses had greater mean L* (lightness; P = 0.01) and initial b* (yellowness; P < 0.01) values. The delayed temperature decline and the accelerated pH decline of the deep location of the top round of OW carcasses occur at different rates than AW carcasses. Delayed rate of cooling leads to irreversible impacts on steak appearance of top round steaks fabricated from OW beef carcasses when compared with AW carcasses.
Influence of Climate and Duration of Stream Water Presence on Rates of Litter Decomposition and Nutrient Dynamics in Temporary Streams and Surrounding Environments of Southwestern USA

Ephemeral and intermittent streams are increasing with climate and land use changes, and alteration in stream water presence or flow duration will likely affect litter decomposition and nutrient dynamics in channel and riparian zones more than uplands. To investigate the influence of varying climate and stream flow regimes on rates of decomposition and associated nutrient dynamics, we used a space-for-time substitution design in which we deployed a common leaf litter across a range of ephemeral to seasonally- intermittent stream reaches (10) and landscape positions (channel, riparian, upland) in Arizona, USA over an 18-month period. We also measured soil physio-chemical properties and nutrient dynamics associated with these reaches and positions. Consistent with expectations, rates of litter decomposition (k) decreased significantly in the channels as cumulative percentage (%) of water presence decreased below 40%. Indeed, differences in cumulative duration of water presence as well as channel bed material silt content explained 80% of the variation in k across flow regimes. In contrast, decay rates of the common litter across sites were surprisingly similar in upland and riparian positions despite large differences in climate, specifically precipitation (160-516 mm). Relatively similar litter nitrogen immobilization and soil moisture in upland and riparian environments helped to explain the lack of difference in k and soil nutrient dynamics in these environments. Collectively, our findings indicate that stream water presence may be a more important indicator of ephemeral and intermittent stream function than stream flow alone and that riparian zones in these dryland regions may be less responsive to changes in climate and associated subsidies of stream flow.
Cloud Computing in Education

Abstract As educational technology infuses higher education, many universities are turning to cloud-hosted learning management systems (LMSs) that connect student databases with learning content. Cloud computing is also a viable option for numerical modeling, data storage, and visualization, facilitating collaboration with other scientists. Cloud computing is an affordable resource that enables fast processing, large data-storage capacity, and the sharing of resources. It offers scientists flexibility, ease of data management, research repeatability, and collaboration while minimizing maintenance requirements. The benefits offered by cloud computing far outweigh the challenges introduced by using this emerging technological resource. We demonstrate these benefits through a successful cloud-computing instance achieved in collaboration between Embry–Riddle Aeronautical University and Unidata.
A Web Client Perspective on IP Geolocation Accuracy

Geolocation of Internet addresses is widely used by content providers to tailor services and content to users and to restrict access to content. IP geolocation in practice typically relies on databases that include geographic information about individual addresses or address prefixes. Prior studies have assessed the accuracy of these databases by using a set of addresses with known or estimated locations and comparing them with database-reported locations.In this paper we investigate IP geolocation accuracy from the standpoint of web clients, by exploiting geolocation information embedded in non-standard HTTP response headers and in unencrypted HTTP cookies. We identify a set of 10,476 websites and content providers that include non-standard HTTP headers and unencrypted cookies with geographic information. We launch HTTP requests to each of these sites from 113 client vantage points with known locations distributed across 6 continents and 60 countries and extract available geographic information from the responses using a battery of hand-crafted regular expressions. We find that the country of the client is included in more than 90% of all responses. Moreover, we observe that about 75% of all responses only include the country name or code and that the remaining responses include some combination of geographic information, such as continent, country, city, postcode, region, and coordinates. We observe that accuracy is greatest for the coarsest geographic scope (continent) and least accurate for finer scopes (e.g., coordinate), but that accuracy varies widely across vantage points regardless of the continent or country from which the request is launched.
Projections of algae, eelgrass, and zooplankton ecological interactions in the inner Salish Sea – for future climate, and altered oceanic states

Abstract Future projections based on the IPCC high emissions scenario RCP8.5 have previously shown that the Pacific Northwest coastal waters will be subjected to altered ocean states in the upwelled shelf waters, resulting in higher primary productivity and increased regions of hypoxia and acidification in the inner estuarine waters such as the Salish Sea. However, corresponding effects on the lower trophic levels and submerged aquatic vegetation have not yet been quantified. Supported by new synoptic field data, explicit coupled simulation of algae, zooplankton, and eelgrass biomass was accomplished for the first time in the Salish Sea. We re-applied the improved model to evaluate future ecological response and examined potential algal species shift, but with the effects of zooplankton production, metabolism, and predation-prey interactions included. We also evaluated the role of eelgrass with respect to potential for improvements to dissolved oxygen and pH levels and as a mitigation measure against hypoxia and ocean acidification. The results re-confirm the possibility that there could be a substantial area-days increase (≈52-fold) in exposure of benthic and near-bed pelagic species to hypoxic waters in 2095. The projections for ocean acidification similarly indicate ≈ 20 -114% increase in exposure to lower pH corrosive waters with aragonite saturation state ΩA
Unsteady propulsion and the acoustic signature of undulatory swimmers in and out of ground effect

Propulsive performance and acoustic emission of undulatory swimmers are investigated using an integrated unsteady potential flow and acoustic boundary element solver. Anguilliform and carangiform swimming gaits are modeled by a deforming NACA 0012 airfoil section. The effect of a ground plane on undulatory swimming and associated noise generation is examined as a function of reduced frequency and above plane altitude with the method of images. Ground effect becomes pronounced when swimming within half of a chord length from the ground plane, where the thrust, power, propulsive efficiency, and peak acoustic pressure all increase for both gaits.
Complications and healthcare utilization in commercially-insured osteoporotic vertebral compression fracture patients: a comparison of kyphoplasty versus propensity-matched controls.

Abstract BACKGROUND CONTEXT Osteoporotic vertebral fractures (OVFs) can lead to severe pain and reduced function and quality-of-life, but the strength of evidence for treatments remains low, particularly in younger populations. PURPOSE To determine whether patients with OVFs who received kyphoplasty had different patterns of healthcare utilization compared to propensity-matched patients who did not receive vertebral augmentation. DESIGN Observational cohort study. PATIENT SAMPLE We identified patients with OVFs from 2007 to 2018 in the IBM MarketScan Commercial Claims and Encounters Databases who received kyphoplasty and compared them to propensity-matched controls who did not receive vertebral augmentation (either kyphoplasty or vertebroplasty). OUTCOME MEASURES Major medical complications within 30 days, fills of opioids from 1-week through 1-month postaugmentation, and spine-related gross covered payments from 3-days postkyphoplasty through 1-year post-OVF. METHODS We used logistic regression to obtain odds ratios (ORs) and 95% confidence intervals (95% CIs) to compare binary outcomes and median analysis to compare continuous outcomes. RESULTS Of the 15,197 OVF patients identified, 1,969 (13%) received kyphoplasty and 1,928 (98%) of these were propensity matched to nonaugmented controls. We did not observe differences in the odds of major medical complications within 30 days (adjusted OR [95% CI]: 1.0 [0.6, 1.8]) but patients who received kyphoplasty were more likely to have filled opioid medications within 30 days (adjusted OR [95% CI]: 1.3 [1.1, 1.5]) and had greater spine-related gross covered payments (kyphoplasty median [95% CI]: $1,340 [$240, $4,850]; nonaugmented: $7,870 [$7,480, $8,270]; adjusted difference in medians [95% CI]: $260 [$190, $2,050]). CONCLUSIONS In this cohort of patients
Christian Mysticism’s Queer Flame: spirituality in the lives of contemporary gay men: by Michael Bernard Kelley, New York, Routledge, 2019, $48.95 (paperback), ISBN 978-0-3675-8744-4

In Christian Mysticism’s Queer Flame, Michael Bernard Kelly uses the lenses of mysticism (as it is understood mostly in the work of Evelyn Underhill) and faith development theory (as understood in ...
Incorporating antenna detections into abundance estimates of fish

Autonomous passive integrated transponder (PIT) tag antennas are commonly used to detect fish marked with PIT tags but cannot detect unmarked fish, creating challenges for abundance estimation. Her...
A Role for Prior Knowledge in Statistical Classification of the Transition from Mild Cognitive Impairment to Alzheimer’s Disease

BACKGROUND The transition from mild cognitive impairment (MCI) to dementia is of great interest to clinical research on Alzheimer's disease and related dementias. This phenomenon also serves as a valuable data source for quantitative methodological researchers developing new approaches for classification. However, the growth of machine learning (ML) approaches for classification may falsely lead many clinical researchers to underestimate the value of logistic regression (LR), which often demonstrates classification accuracy equivalent or superior to other ML methods. Further, when faced with many potential features that could be used for classifying the transition, clinical researchers are often unaware of the relative value of different approaches for variable selection. OBJECTIVE The present study sought to compare different methods for statistical classification and for automated and theoretically guided feature selection techniques in the context of predicting conversion from MCI to dementia. METHODS We used data from the Alzheimer's Disease Neuroimaging Initiative (ADNI) to evaluate different influences of automated feature preselection on LR and support vector machine (SVM) classification methods, in classifying conversion from MCI to dementia. RESULTS The present findings demonstrate how similar performance can be achieved using user-guided, clinically informed pre-selection versus algorithmic feature selection techniques. CONCLUSION These results show that although SVM and other ML techniques are capable of relatively accurate classification, similar or higher accuracy can often be achieved by LR, mitigating SVM's necessity or value for many clinical researchers.
Agrobacterium-mediated transformation of purple raspberry (Rubus occidentalis × R. idaeus) with the PtFIT (FER-like iron deficiency–induced transcription factor 1) gene

An Agrobacterium-mediated transformation protocol for the purple raspberry (R. occidentalis × R. idaeus) ‘Amethyst’ was developed. Using the system, the FER-like iron deficiency–induced transcription factor 1 gene cloned from Populus tremula (PtFIT) was expressed in transgenic raspberry plants. Effects of four inoculum densities and two co-cultivation times on ‘Amethyst’ transformation were tested in two separate experiments. Results showed that an average transformation frequency of 3.9% was achieved under the conditions of 25 mg L−1 kanamycin selection, 3-d co-cultivation, and OD600 0.3 to 0.55 inoculum density. A total of 12 PtFIT-transgenic lines of ‘Amethyst’ were verified using polymerase chain reaction (PCR) analysis. Expression of the PtFIT gene in transgenic lines was evaluated under the iron deficiency or sufficiency condition using the real-time quantitative PCR (RT-PCR); however, the expression showed an inconsistent response to iron deficiency among different transgenic lines. An established transformation system could provide a research tool used to understand gene functions and trait development in raspberry; therefore, the present research will be beneficial to breeding and germplasm improvement of raspberry or other Rubus species.
Specialized Adjudication in an Administrative Forum: Bridging the Gap between Public and Private Law

=249 3 1 (questioning whether traditional antitrust enforcement is appropriate to respond to developments in today's economy). 2007] SPECIALIZED ADJUDICATION 1647 neither bound by nor create precedent? And does it matter that these arbitrations, hidden from public view, strip the legal system of its opportunity to develop its norms and standards? Employing experts in administrative adjudications provides an answer to these questions and a solution to the dilemma facing the American legal system. Although some may protest the very constitutional basis upon which the administrative state is built, most would agree that it is here to stay. The jurisprudence of even the strictest of separation-of-powers originalists on the Supreme Court-with the exception, maybe, of Justice Thomas235 hasn't challenged the constitutionality of administrative agencies. And although some may protest the extra-judicial methods that administrative courts employ, most would agree that the efficiency advantages that the agencies' disinterested experts offer exceeds anything that can be found in the federal court system. I don't suggest that administrative agencies are the only solution to the expanse separating public from private adjudication. I suggest only that administrative agencies and their adjudicatory mechanisms lend themselves to the sort of complex technicalities that characterize cases today and that have precipitated the schism between private and public law. 235 Whitman v. Am. Trucking Ass'n, 531 U.S. 457, 487 (2001) (commenting that he would "be willing to address the question whether [the] delegation jurisprudence has strayed too far from [the] Founders' understanding of separation of powers). 1648 NOTRE DAME LAW REVIEW [VOL. 82:4
WE-E-BRB-01: Clinical Usage of Knowledge Based Treatment Planning

The knowledge-based treatment planning automation has evolved from academic research from the clinical application with the involvement of the major industry TPS vendors. Previous work proved the concept that IMRT or VMAT plans can be designed without or with minimal human intervention. Recently, the major industry vendors start releasing the automatic planning product such as Philips automatic treatment planning, Varian’s Rapidplan, and RaySearch’s autoplan. Many centers start to evaluate and use the automatic planning products from TPS vendors. It is more and more becoming evident that automatic planning will be routinely used in the clinic. The first presentation will focus on the knowledge modeling for clinical treatment planning. The presenter will introduce the algorithm and theory for developing the dose volume histogram (DVH) model, summarize the results on the validation of the DVH model, and discuss the application of DVH for the automatic treatment planning. The second presenter will focus on the clinical use of the automatic treatment planning. The presenter will give an overview of the several automatic treatment planning tools including the tools developed commercially and in-house, present the early experience of using those tools, and discuss the application of the tools in the routine clinical use and in the quality control of the treatment planning. Learning Objectives: 1. Describe the algorithm and theory behind the knowledge based treatment planning automation. 2. Clinical experience of using automatic planning in clinical trial and patient treatment 3. Early clinical experience of using commercial automatic planning approach 4. The application of automatic planning approach to perform quality assurance of treatment plan. XD obtain the research funding from Varian Medical System, Philips Medical System and Funding support form Sister Institution Network Fund of MD Anderson, XD is also a founder of Global Oncology One
Memories of New Left protest

Collective memory studies generally focus on national commemorations of heroes and heroic events that unify nations. Recent research also examines the contribution of negative collective memories that vilify individuals and organizations, and collective memories that remain in contention. This study examines the contending collective memories that surround the protest cycle of the late 1960s to early 1970s Japan through analysis of three key events: the First Haneda Incident of 8 October 1967; the climactic battle between Zenkyōtō students and riot police on the Tokyo University campus 17–18 January 1969; and the Asama Sansō siege and Rengō Sekigun purge of early 1972. A heavily negative view of the entire period has solidified in public collective memory through commemorative media presentations and films that recycle visual images of the protests into a blur of senseless violence without explanation of its causes. This overwhelmingly negative collective memory reinforces the dominant values of social order while suppressing the underlying issues that sparked the protests. Those who experienced the period as student participants also view the outcomes as negative, but they keep alive more positive memories of their youthful participation in protest events and the issues that motivated them, through nostalgic commemorations and media that circulate within a New Left subculture.
A comparison of structured and unstructured P2P approaches to heterogeneous random peer selection

Random peer selection is used by numerous P2P applications; examples include application-level multicast, unstructured file sharing, and network location mapping. In most of these applications, support for a heterogeneous capacity distribution among nodes is desirable: in other words, nodes with higher capacity should be selected proportionally more often. Random peer selection can be performed over both structured and unstructured graphs. This paper compares these two basic approaches using a candidate example from each approach. For unstructured heterogeneous random peer selection, we use Swaplinks, from our previous work. For the structured approach, we use the Bamboo DHT adapted to heterogeneous selection using our extensions to the item-balancing technique by Karger and Ruhl. Testing the two approaches over graphs of 1000 nodes and a range of network churn levels and heterogeneity distributions, we show that Swaplinks is the superior random selection approach: (i) Swaplinks enables more accurate random selection than does the structured approach in the presence of churn, and (ii) The structured approach is sensitive to a number of hard-to-set tuning knobs that affect performance, whereas Swaplinks is essentially free of such knobs.
Large-Scale geospatial indexing for image-based retrieval and analysis

We describe a method for indexing and retrieving high-resolution image regions in large geospatial data libraries. An automated feature extraction method is used that generates a unique and specific structural description of each segment of a tessellated input image file. These tessellated regions are then merged into similar groups and indexed to provide flexible and varied retrieval in a query-by-example environment.
Addition of exenatide twice daily to basal insulin for the treatment of type 2 diabetes: clinical studies and practical approaches to therapy

Summary Background: Type 2 diabetes is a progressive disease that requires stepwise additions of non-insulin and insulin therapies to meet recommended glycaemic goals. The final stage of intensification may require prandial insulin, adding complexity and increased risks of hypoglycaemia and weight gain. Aims: This review assesses the benefits and risks of adding exenatide twice daily, a glucagon-like peptide 1 receptor agonist, in patients with type 2 diabetes who are currently treated with basal insulin, but have failed to reach their glycaemic goals. Methods and Results: Based on data from published studies, exenatide has a number of actions that complement basal insulin therapy. Exenatide has been shown to increase glucose-dependent insulin production, suppress abnormal plasma glucagon production, slow gastric emptying, enhance liver uptake of glucose and promote satiety. A recently published randomised clinical trial reported that the addition of exenatide twice daily to titrated basal insulin provided greater glycaemic control than titrated basal insulin alone, and did so without an increase in hypoglycaemic events and with modest weight loss. Exenatide use was associated with gastrointestinal side effects. The recent randomised trial confirmed and extended data from a number of prior observational studies that demonstrated the efficacy and safety of insulin/exenatide combination therapy. Practical considerations for adding exenatide twice daily to ongoing basal insulin are discussed.
Does Alibaba's Magic Work Outside China?

Alibaba was an established e-commerce giant in the Chinese online retail industry. In 2014, it recorded the world's largest initial public offering (IPO), raising a total of $25 billion. Alibaba's groundbreaking IPO and continuous growth in China had raised speculation on its imminent and potential expansions into other countries including the United States. On the other hand, Amazon and eBay had been leaders in the e-commerce industry of the United States, arguably the world. This case seeks to weigh the potential success of Alibaba should it choose to expand outside its home country, China, including the United States. This case also helps understand how the Chinese business environment influenced the success of Alibaba, relative to other countries. © 2015 Wiley Periodicals, Inc.
The Clinician's Cultural Countertransference: The Psychodynamics of Culturally Competent Practice

The purpose of this paper is to define the presence of the clinician's cultural countertransference in the cross-cultural therapeutic dyad, and describe its impact on the delivery of culturally competent services. The recognition of the contributing role of the therapist's own subjectivity in psychodynamically oriented practice cannot be more vital than in the treatment of patients whose culture, race, or class markedly differ from that of the therapist. The cultural countertransference is viewed as a matrix of intersecting cognitive and affect-laden beliefs/experiences that exist within the therapist at varying levels of consciousness. Within this matrix lie: the clinician's American life value system; theoretical beliefs and practice orientation; subjective biases about ethnic groups; and subjective biases about their own ethnicity. The author proposes that these countertransference attitudes are often: disavowed by the clinician; exert a powerful influence on the course of treatment; and though unspoken, are frequently perceived by the client.
Femoral artery exposure for endovascular aneurysm repair through oblique incisions.

Purpose:To offer an alternative technique for accessing the femoral artery prior to endovascular grafting.Technique:An oblique incision is made over the medial half of the inguinal ligament and continues to the femoral sheath, which is opened longitudinally. The distal external iliac artery and proximal common femoral artery are isolated. A tiny stab wound is made distal to the primary wound for femoral artery puncture and catheter access.Conclusions:Using an oblique incision at the level of the inguinal ligament optimizes exposure for endograft insertion and may minimize the frequency of serious wound complications.
Effect of data standardization on neural network training

Data transformation is a popular option in training neural networks. This study evaluates the effectiveness of two well-known transformation methods: linear transformation and statistical standardization. These two are referred to as data standardization. A carefully designed experiment is used in which data from two-group classification problems were trained by feedforward networks. Different kinds of classification problems, from relatively simple to hard, were generated. Other experimental factors include network architecture, sample size, and sample proportion of group 1 members. Three performance measurements for the effect of data standardization are employed. The results suggest that networks trained on standardized data yield better results in general, but the advantage diminishes as network and sample size become large. In other words, neural networks exhibit a self-scaling capability. In addition, impact of data standardization on the performance of training algorithm in terms of computation time and number of iterations is evaluated. The results indicate that, overall, data standardization slows down training. Finally, these results are illustrated with a data set obtained from the American Telephone and Telegraph Company.
Detection and classification of undersea objects using multilayer perceptrons

A large number of underwater missions, such as obstacle avoidance, surveying, object recovery, and detection, classification, and recognition of hazards, are simply too dangerous or costly for manned vehicles. Remotely operated vehicles are subject to different limitations, such as communication bandwidth, operator fatigue, and a restricted radius of operation. These considerations make autonomous underwater vehicles (AUV) an increasingly attractive alternative. To be truly autonomous, an underwater vehicle requires scene recognition capabilities. Advances in pattern recognition and the use of increasingly high-resolution underwater sensors hold the promise that such capabilities will be developed in the near future. This paper reports the training and testing of multilayer perceptrons designed to classify specific manmade underwater objects under various environmental conditions, from arbitrary viewing aspects, and in highly cluttered environments. The trained classifiers have been tested against difficult side-scan sonar imagery and appear to work as well as a trained human analyst. Feature sets that account for the sensor response to range and that adapt to environmental variations improve performance and make the design robust. Receiver Operating Curves (ROC) show up to a 96 detection rate for a 2 false alarm rate. The set of multilayer perceptron networks have been demonstrated on special-purpose hardware and run in real time.© (1991) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.
Unusual complications of coronary artery bypass graft surgery

Complications after coronary artery bypass grafting are myriad and are to a certain extent operator dependent. The investigators report 2 unusual cases of inadvertent aortocoronary fistula after coronary artery bypass grafting that escaped routine detection. In conclusion, the development of heart failure led to the detection of this rare complication.
Cost-effective management of gynecomastia.

Abstract Background: Routine endocrine screening of idiopathic gynecomastia has been advocated, but may not be cost effective. We carried out a cost-benefit analysis of this approach. Methods: A retrospective study (1992 to 1997) of 87 adult males with symptomatic gynecomastia was performed. Results: Thirty-four (39%) patients had extrinsic causes; 53 (61%) were considered idiopathic. Forty-five idiopathic cases underwent endocrine testing: β human chorionic gonadotropin alone, 16; and β human chorionic gonadotropin, LH, estradiol, testosterone ± testicular ultrasound, 29. One (2%) occult Leydig cell testicular tumor was detected. Forty-four patients had normal studies and remain well after local excision. Conclusion: Routine endocrine evaluation of idiopathic gynecomastia is rarely productive; such testing is best done selectively.
Behavioral self-regulation and executive function both predict visuomotor skills and early academic achievement

Abstract The present study explored direct and interactive effects between behavioral self-regulation (SR) and two measures of executive function (EF, inhibitory control and working memory), with a fine motor measure tapping visuomotor skills (VMS) in a sample of 127 prekindergarten and kindergarten children. It also examined the relative contribution of behavioral SR, EF, and VMS skills for concurrent academic achievement. Results indicated that a measure of working memory (WJ-Working Memory) and a measure of behavioral SR (Head–Toes–Knees–Shoulders task; HTKS) were directly related to VMS. Differential relations were also examined for prekindergarten and kindergarten children. Results revealed a significant interaction between age and inhibitory control (Day–Night), and an interaction at a trend level between age and working memory suggesting both tasks are more related to VMS skills for younger children. Results also indicated that behavioral SR, EF, and VMS skills were differentially related to the three achievement outcomes. Both behavioral SR and VMS were significantly related to math, behavioral SR, EF, and VMS were significantly related to emergent literacy, and behavioral SR and EF were related to vocabulary scores. Results point to significant relations between behavioral SR and EF with VMS, and how each is related to early academic achievement in preschool and kindergarten.
Combination Resonance of a Centrally Clamped Rotating Circular Disk

The transverse vibrations of a circular disk of uniform thickness rotating about its axis with constant angular velocity are analyzed when the disk is subject to a space-fixed linear spring. Combination resonances are shown to occur at rotational speeds different from the classical critical speeds at which, in the linear analysis, the spinning disk is unable to support arbitrary spatially fixed transverse loads. Using the method of multiple scales, the authors determine a set of eight nonlinear ordinary-differential equations governing the modulation of the amplitudes and phases of four interacting modes. The symmetry of the system and the loading conditions are reflected in the symmetry of the modulation equations. Using convenient variable transformations, the authors obtain an equivalent set of equations, which they use to prove that no single- mode solution is possible for this case. The stability characteristics of the trivial solution for all of the possible interactions among four of the lowest mod...
Discovery and optimization of potent and selective triazolopyridazine series of c-Met inhibitors

Deregulation of the receptor tyrosine kinase c-Met has been implicated in several human cancers and is an attractive target for small molecule drug discovery. Herein, we report the discovery of a structurally diverse series of carbon-linked quinoline triazolopyridinones, which demonstrates nanomolar inhibition of c-Met kinase activity. This novel series of inhibitors exhibits favorable pharmacokinetics as well as potent inhibition of HGF-mediated c-Met phosphorylation in a mouse liver pharmacodynamic model.
Analysis of random probing hashing

Abstract Random probing and uniform hashing are theoretical models of hashing schemes based on open addressing such as double hashing. Larson provided an asymptotic analysis of random probing hashing with multi-record buckets. His analysis was based on the Poisson approximation to the binomial distribution. The problems of obtaining an exact model and analyzing finite random probing hashing was left open with the mention of the difficulties involved. We address these open problems in this paper. Also, the search performance of full hash tables is analyzed.
African Americans and Reentry: The Threat of Even Greater Challenges

In Salem, ME on October 6, 2013 Thomas Templeton was allegedly beaten by Officer Joseph Freda during his arrest. Templeton has been charged with “reckless conduct, resisting arrest, and disobeying an officer” (Ireland, 2014). Templeton was allegedly driving between 80 mph and 90 mph on the interstate when Freda attempted to stop him for speeding. Templeton pulled of the interstate in an attempt to flee from police and was shortly after found hiding in brush, where he was finally apprehended.Templeton claims that during his arrest he was repeatedly hit with a flashlight on his head, from which he suffered lacerations, and groin area. Then, after being handcuffed Freda allegedly stepped on Templeton's hand while he was sitting on the ground. Templeton is currently being held in a county jail until his trial, while Freda has been charged with two counts of simple assault and has been terminated by the Salem Town Manager (Ireland, 2014).In this case, I believe that it is clear that excessive force by the poli...
Mathematical model to quantify JPEG block artifacts

A method for quantifying the magnitude of block artifacts caused by JPEG type of image compression has been developed. The behavior of block artifacts as a function of compression ratio and edge enhancement operations can now be mathematically tracked. This mathematical technique is found to be useful for development of image compression techniques with regard to eliminating block artifacts.
Mesenchymal stem cells can improve anal pressures after anal sphincter injury.

Abstract Objective. Fecal incontinence reduces the quality of life of many women but has no long-term cure. Research on mesenchymal stem cell (MSC)-based therapies has shown promising results. The primary aim of this study was to evaluate functional recovery after treatment with MSCs in two animal models of anal sphincter injury. Methods. Seventy virgin female rats received a sphincterotomy (SP) to model episiotomy, a pudendal nerve crush (PNC) to model the nerve injuries of childbirth, a sham SP, or a sham PNC. Anal sphincter pressures and electromyography (EMG) were recorded after injury but before treatment and 10 days after injury. Twenty-four hours after injury, each animal received either 0.2 ml saline or 2 million MSCs labelled with green fluorescing protein (GFP) suspended in 0.2 ml saline, either intravenously (IV) into the tail vein or intramuscularly (IM) into the anal sphincter. Results. MSCs delivered IV after SP resulted in a significant increase in resting anal sphincter pressure and peak pressure, as well as anal sphincter EMG amplitude and frequency 10 days after injury. MSCs delivered IM after SP resulted in a significant increase in resting anal sphincter pressure and anal sphincter EMG frequency but not amplitude. There was no improvement in anal sphincter pressure or EMG with in animals receiving MSCs after PNC. GFP-labelled cells were not found near the external anal sphincter in MSC-treated animals after SP. Conclusion. MSC treatment resulted in significant improvement in anal pressures after SP but not after PNC, suggesting that MSCs could be utilized to facilitate recovery after anal sphincter injury.
REFLECTIONS ON SOCIAL NEUROSCIENCE

Social Neuroscience is a useful tool for elucidating both the psychological and neural mechanisms underlying social behavior. The promise of new theoretical insights was one of the most exciting potential benefits of integrating social and biological approaches. Now that social neuroscience research has progressed, evidence of this promise can now be seen. This review highlights some of the ways in which social neuroscience has benefitted our understanding of social processes, while also noting considerations for improving the field's impact.
Erythrocyte destruction in sickle-cell anemia: simultaneous N15-hemin and N15-stercobilin studies.

Summary1. Study of erythrocyte destruction in sickle-cell anemia by analysis of hemin N15 disappearance and fecal stercobilin N15 appearance after a 1 g dose of N15-glycine indicates a completely random destruction of circulating red cells. 2. This individual's cells had a half-life of 11 days indicating a turnover rate of 6.3% per day with a mean survival time of approximately 16 days. 3. There was no evidence of more than one population of cells. 4. Comparison with a similar study by London and coworkers shows a similar clinical condition but a physiological state twice as active, and further suggests still unknown factors involved in the destruction of circulating red cells in this type of hemolytic anemia.