cssi/SciSciGPT-SciSciNet huggingface dataset:
Radiofrequency ablation of small renal cell carcinomas using multitined expandable electrodes: preliminary experience.

PURPOSE Radiofrequency ablation is a minimally invasive, nephron-sparing option for renal cell carcinoma (RCC) in poor surgical candidates. We report our contemporary experience with RCC radiofrequency ablation using multitined expandable electrodes along with an aggressive treatment strategy to displace adjacent viscera away from probe tines. Involution of the treatment zone was assessed over time MATERIALS AND METHODS Over a 36-month period, a quality-assurance database identified 22 patients with 26 sporadic RCC who underwent 43 ablations during 27 radiofrequency ablation sessions. The mean age of the cohort was 71 years (range, 47–89 y). Mean RCC diameter was 2.2 cm (range, 1–4 cm). Twenty-six of radiofrequency ablation sessions were performed using multitined expandable electrodes. All ablations used CT guidance with moderate sedation. Adjunctive techniques used during ablation were recorded, as were instances in which ablation mandated penetration of tines beyond the kidney margin. Post-treatment ablation zones were measured from CT/MR images to evaluate serial involution and treatment response RESULTS Technical success in targeting and ablation was 100%. Follow-up periods ranged from 1 to 31 months (mean, 11.2). During this period, one patient presented with marginal local recurrence and underwent repeat radiofrequency ablation. Adjunctive techniques in four patients included water injection for displacement of the tail of the pancreas ( n = 1) or descending colon ( n = 3). Deliberate penetration of tines beyond the margins of the kidney was performed in 41% of cases; no hemorrhage occurred in these cases. No major complications occurred. Minor complications occurred in 17% of patients, including asymptomatic pneumothorax, perirenal hematomas, subcutaneous hematoma, and subcutaneous abscess. After 6 months, mean involution of the ablation zone was 15% from baseline volume per year CONCLUSION Multitined expandable radiofrequency electrodes produce a high rate of local control for small RCCs with a low complication rate, even when tine penetration of the kidney is required for an adequate tumor treatment margin. Adjacent organs can be protected with adjunctive percutaneous maneuvers
Echocardiographic and functional cardiopulmonary problems 6 months after first-time pulmonary embolism in previously healthy patients.

Aims We hypothesized that first-time submassive pulmonary embolism (PE) can cause persistent, significant cardiopulmonary problems, including right ventricular damage and worsened quality of life in patients with no prior cardiopulmonary disease. Methods and results We prospectively enrolled 205 patients without end-stage comorbidity diagnosed with submassive PE (systolic blood pressure always >100 mmHg). Using explicit criteria, we identified a subgroup of 127 ‘previously healthy’ patients who were free of cardiopulmonary disease or other disabling process. All patients had transthoracic echocardiography (echo) at the time of diagnosis. Six months later, survivors returned for repeat echo, 6 min walk distance (6MWD), and a quality-of-life survey. We defined a significant cardiopulmonary problem as either: (i) abnormal RV on echo (RV dilation or RV hypokinesis); or (ii) NYHA score >II or a 6MWD <330 m at 6 months. Of 127 study patients, five had inadequate echos, nine were lost to follow-up, and four died, leaving 109 with complete data. Of 109 patients, 45 (41%) had cardiopulmonary problems 6 months after PE: 18 of 109 (17%) had only an abnormal RV, 18 of 109 (17%) had only functional limitation, and nine of 109 (8%) had both. Twenty-two patients (20%) indicated at least one index of poor quality-of-life: health status worse, not currently shopping, or perceived need for oxygen at home. Patients with cardiopulmonary problems demonstrated a significant decrease in SaO2% after 6MWD (97 ± 1.3 pre-6MWD vs. 96 ± 1.8% post-6MWD, P = 0.004 by paired t -test). Conclusion Six months after first-time PE, 41% of previously healthy patients had either an abnormal RV on echo, an NYHA score >II or a 6MWD <330 m. Treatment studies of PE should include these persistent cardiopulmonary problems as study endpoints.
Head group-functionalized poly(ethyleneglycol)-lipid (PEG-lipid) surface modification for highly selective analyte extractions on capillary-channeled polymer (C-CP) fibers.

Polypropylene (PP) capillary-channeled polymer (C-CP) fibers were modified by adsorption of a head group-functionalized lipid to generate analyte–specific surfaces for application as a stationary phase in high performance liquid chromatography (HPLC) or solid phase extraction (SPE). The aliphatic moiety of the lipid adsorbs strongly to the hydrophobic PP surface, with the hydrophilic active head groups orienting themselves toward the more polar mobile phase, thus allowing for interactions with the desired solutes. Initial proof-of-concept was achieved by adsorbing a biotin–poly(ethylene glycol)–functionalized lipid to the surface of the PP C-CP fibers. Surface modification and uniformity was evaluated by binding streptavidin labeled with Texas Red (SAv-TR) to the biotin moiety. Isolation of SAv-TR from a mixture in neat buffer and in cleared lysate demonstrated the capability of the modified fibers to extract an analyte of interest from a complex viscous mixture. It is believed that this surface modification approach is generally applicable to a diversity of selective protein immobilization applications, including clinical diagnostics and preparative scale HPLC on C-CP fibers as well as to other hydrophobic supports.
Low cost, chip-last embedded ICs in thin organic cores

This paper presents a novel technology to enable chip embedding in 1 or 2 metal layer substrates using chip-last embedding for its merits. The novel structure is obtained by embedding thin-chips within the core instead of the build-up layers as has been demonstrated previously [1]. To enable the smallest profile embedded die structure, results from the three critical elements of the technology- 1) fine lines and spaces on core, 2) small-diameter fine-pitch area-array through-holes, and 3) thermo-mechanical reliability of small diameter through-holes have been discussed in the paper. Lines and spaces as small as 7μm were demonstrated on core laminate by using build-up type processes. Copper-filled through-holes of 30–60μm diameters were successfully fabricated and shown to pass 1300 thermal cycles from −55°C to 125°C. In addition, through-hole drilling process was optimized to achieve ultra-fine pitches of 70–100μm. Comprehensive analysis of three new materials and associated fabrication processes, carried out to demonstrate the advantages and robustness of this manufacturing-friendly 1–2 metal layer chip-last embedding technology emphasizes that it is a promising technology to achieve ultra-miniaturization for future embedded systems and sub-systems.
Modeling Life-Like Behaviors of An Animated Virtual Tutor

The aim of this study is to understand and model the coordinated verbal and nonverbal behaviors that occur during one-on-one tutoring of students by expert reading tutors, and to develop learning tools in which a virtual tutor—a lifelike 3-D computer character—models these coordinated behaviors, and thus behaves more like an effective and sensitive human tutor. We hypothesize, and test the hypothesis, that virtual tutors that model the contextually appropriate exchange of signals and cues between an expert teacher and a student will produce better user experiences and more effective learning outcomes.
Management of submacular hemorrhage associated with retinal arterial macroaneurysms.

Abstract PURPOSE: Experience is reported with intraoperative pharmacologic lysis of recent submacular hemorrhage with tissue plasminogen activator followed by surgical drainage of the unclotted blood in patients with retinal arterial macroaneurysms. METHODS: Nine eyes (nine patients) with a recent (≤7 days old) submacular hemorrhage involving the center of the fovea secondary to retinal arterial macroaneurysm that were managed with recombinant tissue plasminogen activator–assisted subretinal hemorrhage evacuation, including subretinal injection of tissue plasminogen activator and removal of the liquefied blood. Patients were followed for a mean 18 ± 7 months (range, 7 to 30 months). RESULTS: All nine eyes had improved final corrected visual acuity after surgery, and eight eyes (89%) attained a corrected visual acuity of 20/60 or better (mean, 20/40; range, 20/20 to 20/200). Final corrected visual acuity was limited to 20/200 in one eye. Two eyes developed a cataract that required surgery. CONCLUSIONS: Submacular surgery with tissue plasminogen activator-assisted thrombolysis achieved improved best-corrected visual acuity in eyes with recent submacular hemorrhage involving the center of the fovea associated with retinal arterial macroaneurysm.
The Influence of Gap Size on Sagebrush Cover Estimates With the Use of Line Intercept Technique

Sagebrush cover is often estimated with the use of the line intercept method. However, a lack of standardized protocols may lead to variable estimates of sagebrush canopy cover. Our objectives were to determine the influence of gap size on 1) sagebrush canopy cover estimates, 2) time needed to read a transect, and 3) among-observer variability in sagebrush canopy cover estimates. We utilized 5-, 10-, and 15-cm gaps, and defined a gap as a lack of continuous live or dead shrub canopy. In instances where a segment of dead cover was less than the gap size and adjoined live cover, the dead cover was measured as live. We evaluated canopy cover at 6 Wyoming big sagebrush (Artemisia tridentata Nutt. ssp. Wyomingensis Beetle & A. Young) sites in southeast Oregon. At each site, four 2-person teams measured sagebrush canopy intercept along 50-m transects. Each transect was read by multiple teams to allow for assessment of among-observer variability. Intercept values were converted to percent canopy cover and we used analysis of variance to determine the influence of site and gap size on measurement time and cover estimates. Observer variability was highest at the intermediate gap size (i.e., 10 cm). Transect measurement time was longest with the use of a 5-cm gap (P < 0.001). Total cover estimates were not related to gap size (P = 0.270). Live canopy cover estimates increased (P < 0.001) from 12.1% to 14.5% with increasing gap size, and cover of dead material decreased (P = 0.015) from 4.4% to 3.2%. These differences are small in magnitude and would not likely change a gross assessment of vegetation status. However, use of a standardized gap size will enhance comparability of canopy cover estimates among studies and will decrease between-year sampling error for repeat monitoring.
Project-Based Introduction to an Engineering Design Course Incorporating Microbial Fuel Cells as a Renewable Energy Technology

AbstractThe National Academy of Engineering has called for the reinvention of engineering education by exposing students to the iterative process of designing, predicting performance, building, and testing; incorporating research into engineering education; and introducing interdisciplinary learning in the undergraduate environment. Here we describe a novel effort to integrate an undergraduate research project into the problem-based design environment of a second-year introduction to engineering design course at Rensselaer Polytechnic Institute, providing a design and research experience early in the curriculum. The project-based environment allows students to learn technical communication (technical writing and oral presentations) and teamwork (including conflict management and team coordination) in parallel. Approximately 600 sophomores from different science, technology, engineering, and mathematics (STEM) disciplines take the course, working in multidisciplinary teams to address a complex challenge fa...
High diffraction efficiency from submicrometer-period plasma gratings in AIGaAs:Te

We describe new measurements of optical diffraction from gratings in carrier density obtained by optical ionization of DX centers in the compound-semiconductor AlGaAs. We report diffraction efficiencies as high as 40% from 390-μm thick-gratings and show that the diffraction efficiency remains above 10% for grating periods as small as 135 nm.
The Really New Jim Crow: Why Bioethicists Must Ally With Undocumented Immigrants

Imagine that you are not allowed to apply for a driver's license. You cannot work “on the books” but only for cash paid “under the table.” Your only health care must be obtained through free clinic...
Communicating in Organizations, Part IV: E-mails and One-on-One Meetings

E-mail messages and face-to-face meetings both are important methods of communication, and each has its own advantages and disadvantages. Conducting informal one-on-one meetings well is important to the success of a leader or manager. However, the follower can also do many things to optimize the success of a one-on-one discussion with his superior.
Ultrafast charge separation and long-lived charge separated state in photocatalytic CdS-Pt nanorod heterostructures.

Colloidal semiconductor–metal nanoheterostructures that combine the light-harvesting ability of semiconductor nanocrystals with the catalytic activity of small metal nanoparticles show promising applications for photocatalysis, including light-driven H2 production. The exciton in the semiconductor domain can be quenched by electron-, hole-, and energy transfer to the metal particle, and the competition between these processes determines the photocatalytic efficiency of these materials. Using ultrafast transient absorption spectroscopy, we show that, in CdS–Pt heterostructures consisting of a CdS nanorod with a Pt nanoparticle at one end, the excitons in the CdS domain dissociate by ultrafast electron transfer (with a half-life of ∼3.4 ps) to the Pt. The charge separated state is surprisingly long-lived (with a half-life of ∼1.2 ± 0.6 μs) due to the trapping of holes in CdS. The asymmetry in the charge separation and recombination times is believed to be the key feature that enables the accumulation of the...
Demonstrating Residential Water Conservation and Reuse in the Sonoran Desert: Casa del Agua and Desert House

Single-family homes are being used to demonstrate and research water conserving and reuse techniques and technologies. These facilities can provide real-world data as well as public information and educational programs. The installation of water-conserving fixtures, rainwater harvesting, and graywater reuse systems and storage can reduce the requirements for potable water by 50 percent. Casa del Agua and Desert House show that the science of conserving resources can be balanced with the art of designing quality desert dwellings.
482 NEUROANATOMICAL CORRELATES OF VISUOSPATIAL ABILITY.

Purpose Although both frontal and parietal cortices, particularly in the right hemisphere, are thought to be associated with visuospatial processing, the specific neuroanatomical sites essential for this ability are not well established. The purpose of this study was to more precisely identify the specific cortical regions that control visuospatial ability. Methods The study included 67 normal control subjects, 33 stroke subjects with left hemisphere damage (LHD) and 24 stroke subjects with right hemisphere damage (RHD). Performance on the Block Design (BD) subtest of the Wechsler Adult Intelligence Scale (WAIS-R) was our measure of spatial ability. MRIs or CT scans were obtained on all stroke subjects and the specific brain area(s) damaged were traced into a computer program. Subjects were separated into six groups depending on whether the LHD or RHD was anterior (ant), posterior (post), or both anterior and posterior (ant-post) to the central sulcus. The areas of damage were overlapped separately depending on whether BD performance was normal or impaired (1 SD below the mean score of control subjects) and the lesion overlaps were compared to identify the specific brain regions most important for BD performance. Results Subjects with ant, post, ant-post RHD or post LHD performed significantly worse than the control group; those with ant-post RHD scored lower than all other subjects in the study. Subjects with BD impairment were more likely to have damage of the left or right dorsolateral prefrontal and left parietal cortices than were subjects with normal BD performance. In contrast, subjects with BD impairment were not more likely to have damage to the right parietal cortex. Conclusions Consistent with previous research highlighting the overall importance of the right hemisphere in spatial processing, we found that subjects with RHD performed worse on BD than those with LHD. Involvement of bilateral dorsolateral prefrontal cortices in BD performance agrees with the known importance of this area for spatial working memory and planning while involvement of the left parietal cortex supports previous work that emphasizes a role for this area in processing spatial details. However, lack of localization of visuospatial skill to the right inferior parietal cortex is inconsistent with the previous literature. This was the first study to couple MRI lesion localization with BD performance, but if replicated, these findings suggest that complex spatial processing is more diffusely controlled within the right hemisphere than the left hemisphere. Further investigation using more advanced imaging techniques, such as voxel-based lesion-symptoms mapping (VSLM), will allow for more precise cortical localization of visuospatial processing.
Amicus Brief in Manuel v. Joliet

A series of Seventh Circuit decisions declares that the Fourth Amendment “falls out of the picture” when an unlawfully arrested person appears in court. This person can recover damages under 42 U.S.C. § 1983 for wrongful detention following his initial appearance only when state remedies for malicious prosecution are inadequate. Nine courts of appeals have rejected the Seventh Circuit’s “vanishing Fourth Amendment” view, and the Supreme Court will address the conflict next Term in Manuel v. Joliet. This brief argues that the Seventh Circuit’s position is inconsistent with the text of the Fourth Amendment, the Framers’ understanding of this amendment, and many Supreme Court decisions.
Salmonellosis associated with abdominal aortic aneurysm and edema of lower extremities: Case report.

The incidence of infected aortic aneurysms with rupture can be expected to increase with the concomitant steady rise in the occurrence of both arteriosclerosis and salmonellosis.Although large elastic arteries are extremely resistant to infection, pathologic changes in a vessel's wall may produce a suitable site for bacterial infection.The authors report a case of salmonellosis associated with infection in an abdominal aortic aneurysm that, preceding rupture, apparently had produced the rare complication of obstruction of the inferior vena cava and subsequent edema of the lower extremities.They also review the literature on salmonellosis, arteriosclerotic aneurysms, infection of aneurysms, and their complications.
Income Statement Reporting Discretion Allowed by FIN 48: Interest and Penalty Expense Classification

ABSTRACT: Financial Accounting Standards Board Interpretation No. 48 (FIN 48, FASB 2006) allows discretion regarding the income statement classification of interest and penalty expenses for unrecog...
A Structured Approach

Is it possible to create a learning object with minimal modification(s) and still be truly usable in multiple contexts? As an example, the endeavors of sailing and flying are both similar and dissimilar. The obvious point where they are dissimilar is the media in which they are performed (water vs. air). However, they are similar in how they traverse their respective media along with the similar laws of physics that govern this travel. One of the critical aspects of flying that a student pilot must understand is angle of attack. Angle of attack refers to the angle between the wing and the oncoming air also known as the relative wind. As the pilot gradually pulls back on the control column to make the aircraft climb, the angle will increase. When the pilot pushes the column forward to make the aircraft descend, the angle will decrease. When the angle of attack increases to the point where the flow of air cannot continue to flow smoothly over the surface of the wing, it will stop generating sufficient lift and is said to have stalled. In sailing, a student sailor must understand that a sail can also stall. When the wind is coming from the rear or either side, there is sufficient angle between the wind direction and the boat’s direction of travel. However, as the angle decreases when the wind direction and the boat direction start to converge, the sail will stop creating a sufficient amount of low pressure and stall or “luff”.
A multicenter phase I study of cabazitaxel, mitoxantrone, and prednisone for chemotherapy-naive patients with metastatic castration-resistant prostate cancer.

202 Background: Cabazitaxel and prednisone (Cbz/pred) extend survival in mCRPC patients (pts) following docetaxel and first-line studies comparing Cbz to docetaxel are ongoing. Mito/pred also has anti-tumor activity in mCRPC and a non-overlapping mechanism of action and toxicity profile with Cbz. A multicenter phase 1 trial was initiated to establish the maximally tolerated dose (MTD) and recommended phase 2 dose (RP2D) of the combination of Cbz, Mito, and Pred(CAMP). Methods: Chemotherapy (chemo)-naive pts with mCRPC were enrolled in an accelerated titration design. The primary objective was to determine the MTD and RP2D of CAMP; secondary objectives included PSA response rate and duration of response. Cbz 20 and 25 mg/m2 were evaluated in combination with escalating doses of Mito (starting dose 4 mg/m2), both administered on day 1 of a 21-day cycle. Pred 5 mg BID and pegfilgrastim were given with each cycle. Results: 23 pts were enrolled. The median age was 66 (range 51-78) and the median baseline PSA w...
Microstructural investigation of glass fiber reinforced polymer bars

Abstract Microstructural characteristics are crucial in understanding and predicting the behavior of glass fiber reinforced polymer (GFRP) bars used for concrete reinforcement. Considering the lack of extensive GFRP microstructural knowledge, the main purpose of this study is to provide a documentation of GFRP microstructure and demonstrate its contribution in the durability of GFRP bars. Scanning electron microscopy (SEM) imaging was performed at different magnification levels on the cross-section of four different commercially available pristine GFRP bars. As a result of differences in the production method by pultrusion, each pristine bar presented a unique microstructural pattern including voids, defects, and fiber distribution. Two of the bars which demonstrated the most different patterns were exposed to accelerated conditioning in alkaline solution. The horizontal shear test was performed and the results were compared with the pristine bars. The difference in microstructural patterns was found to significantly contribute to GFRP durability. These results can be used as a benchmark for the microstructure of commercially available pristine GFRP bars and serve as a base for monitoring possible changes after any conditioning or testing.
The Economics of an Admissions Holding Unit

Introduction: With increasing attention to the actual cost of delivering care, return-on-investment calculations take on new significance. Boarded patients in the emergency department (ED) are harmful to clinical care and have significant financial opportunity costs. We hypothesize that investment in an admissions holding unit for admitted ED patients not only captures opportunity cost but also significantly lowers direct cost of care.Methods: This was a three-phase study at a busy urban teaching center with significant walkout rate. We first determined the true cost of maintaining a staffed ED bed for one patient-hour and compared it to alternative settings. The opportunity cost for patients leaving without being seen was then conservatively estimated. Lastly, a convenience sample of admitted patients boarding in the ED was observed continuously from one hour after decision-to-admit until physical departure from the ED to capture a record of every interaction with a nurse or physician.Results: Personnel costs per patient bed-hour were $58.20 for the ED, $24.80 for an inpatient floor, $19.20 for the inpatient observation unit, and $10.40 for an admissions holding area. An eight-bed holding unit operating at practical capacity would free 57.4 hours of bed space in the ED and allow treatment of 20 additional patients. This could yield increased revenues of $27,796 per day and capture opportunity cost of $6.09 million over 219 days, in return for extra staffing costs of $218,650. Analysis of resources used for boarded patients was determined by continuous observation of a convenience sample of ED-boarded patients, which found near-zero interactions with both nursing and physicians during the boarding interval. Conclusion: Resource expense per ED bed-hour is more than twice that in non-critical care inpatient units. Despite the high cost of available resources, boarded non-critical patients receive virtually no nursing or physician attention. An admissions holding unit is remarkably effective in avoiding the mismatch of the low-needs patients in high-cost care venues. Return on investment is enormous, but this assumes existing clinical space for this unit.
Effect of Pre-strain, Processing Conditions, and Impact Velocity on Energy Dissipation in Silicone Foams and Rubber

Silicone foams and rubber are used in a variety of applications to protect internal components from external shock impact. Understanding how these materials mitigate impact energy is a crucial step in designing more effective shock isolation systems for components. In this study, a Kolsky bar with pre-compression and passive radial confinement capabilities was used to investigate the response of silicone foams and rubber subjected to impact loading at different speeds. Using the preload capability, silicone foam samples were subjected to increasing levels of pre-strain. Frequency-based analyses were carried out on results from silicone foams and rubber to study the effect of both pre-strain and material processing conditions on the mechanism of energy dissipation in the frequency domain. Additionally, effects of impact speed on energy dissipation through silicone foams and rubber were investigated.
Particulate Dimethylsulfoniopropionate Removal and Dimethylsulfide Production by Zooplankton in the Southern Ocean

The influence of Antarctic krill, Euphausia superba, on particulate dimethlysulfoniopropionate (DMSP(p)) and dimethylsulfide (DMS) concentrations in surface waters of the Southern Ocean was investigated by shipboard experiments during austral spring near the Antarctic Peninsula. Chlorophyll concentrations were low in the water column, but substantially higher in sea ice due to the high biomass of ice algae, predominantly pennate diatoms. A comparison of DMSP(p) concentrations and algal accessory pigments indicated that DMSP(p) was associated primarily with diatoms (fucoxanthin) and to a minor extent with Phaeocystis spp. (19’-hexanoyloxyfucoxanthin) in sea ice algae. Maximum DMSP(p) and fucoxanthin concentrations also occurred in the 100-200 μm size fraction. We interpret this to mean that high biomass of diatoms in sea ice contributes significantly to DMSP(p) pools in the Antarctic.
Cord Hemangioma Complicated by Umbilical Vein Rupture; What We Missed on Color Doppler

Umbilical cord hemangiomas are rare tumors of the umbilical cord. Doppler ultrasound has been shown to be useful in the diagnosis of cord hemangioma and evaluation of arterial blood flow through the mass. In this study, we present a 28-year-old pregnant woman with an umbilical cord mass with solid and cystic components. She was followed with weekly umbilical artery (UA) Doppler ultrasound, but the fact that the umbilical vein (UV) ran in the wall of the mass was not noted prospectively. At the time of placental delivery, the cystic component of the mass ruptured tearing the UV causing significant bleeding. The case illustrates the importance of using Doppler ultrasound to both look for UA compromise and to map the UV location through the entirety of the cord.
The Value of Organized Nutritional Support Service in Intensive Care Unit Care

The development of the technique of intravenous feeding in 1968 was a breakthrough in medical care (Wilmore and Dudrick 1968). Since then, the use of specialized nutrition support has become a standard tool in the care of patients. Much has been learned about the appropriate and safe indications, use and administration of enteral and intravenous nutrition. This chapter addresses the safe preparation and administration of intravenous nutrition in critical care medicine so that treatment decisions optimize patient outcome, but do not compromise patient safety.
Abstract 2738: PD-L1/PD-1 checkpoint inhibition in anaplastic thyroid cancer and enhancement of ICAM1-targeted chimeric antigen receptor (CAR)-T cell tumor lysis

Poorly-differentiated thyroid cancer (PDTC) and anaplastic thyroid cancer (ATC) are associated with a rapidly progressive course and poor median survival. Recently we published promising results in a murine model showing efficient clearance of metastatic tumor burden of human ATC cell line 8505c and an anaplastic patient-derived cell line using healthy donor T cells transduced with a third-generation chimeric antigen receptor (CAR) construct targeting intercellular adhesion molecule-1 (ICAM1). However, patient-derived T cells using an identical ICAM1-targeted CAR construct demonstrated slower tumor-killing in vitro. To investigate the role of immune checkpoint proteins PD-L1 and PD-1 in thyroid cancer and as potential inhibitors of ICAM1-CAR T, we stained formalin-fixed paraffin-embedded archived tissue samples for PD-L1 (papillary thyroid cancer, PTC, n = 17; ATC, n = 13) using immunohistochemistry (IHC) and extracted peripheral blood mononuclear cells (PBMCs) from patient blood samples and healthy donors to evaluate PD-1 expression on CD3+/CD8+ T cells using flow cytometry (healthy donor, n = 2; PTC, n = 7; PDTC/ATC, n = 6). Twelve percent of PTC samples were PD-L1+ (threshold >1% positivity) versus 69% of PDTC/ATC samples (Chi-square, p = 0.012); PD-L1 positivity was associated with circumferential ICAM1 staining on IHC (Chi-square, p = 0.003). Similarly, median percentage of PD-1 expression on PBMC9s was higher in PDTC/ATC than PTC (58.1% versus 5.2%, Wilcoxon rank sum test; p = 0.03). Interestingly, expression of elevated PD-1 was seen in PBMC samples from patients in the absence of PD-L1 positivity of the primary tumor (IHC) in 4 of 5 matched tumor samples. This suggests that PD-1 in circulating CD8+ cells may be an important predictor of response to checkpoint inhibitor therapy. Finally, effector:target assays with patient-derived ICAM1-CAR T effector cells (baseline PD-1 expression 96%) against 8505c (PD-L1 100%/ICAM1 68%) and matched patient-derived cell line (PD-L1 >50%/ICAM1 88%) showed enhanced tumor killing in the presence of anti-PD-1, which approached the level of tumor cell death seen with healthy donor ICAM1-CAR T. Our results show that PD-1 is increased in the peripheral blood of patients with poorly differentiated and anaplastic thyroid cancer and is a potential therapeutic target. Furthermore, anti-PD-1 may be used to counter PD-L1+ tumor-induced T cell suppression (or exhaustion) to increase the efficacy of CAR T cells in ATC. Citation Format: Katherine D. Gray, Yogindra Vedvyas, Olivia Kalloo, Enda Shevlin, Theresa Scognamiglio, Marjan Zaman, Andrew Tassler, Moonsoo M. Jin, Rasa Zarnegar, Thomas J. Fahey, Irene M. Min. PD-L1/PD-1 checkpoint inhibition in anaplastic thyroid cancer and enhancement of ICAM1-targeted chimeric antigen receptor (CAR)-T cell tumor lysis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 2738.
Hyperviscosity syndrome in splenic marginal zone lymphoma.

![Figure][1] A 57-year-old man presented with 2 months of weakness, fatigue, gingival bleeding, and cachexia. Examination revealed right mydriasis, bilateral retinal hemorrhages, diffuse lung crackles, a tense abdomen, and normal lymph nodes. Increased blood viscosity prevented laboratory
Viral (aseptic) meningitis: A review

Abstract Viral meningitis is an inflammation of the meninges associated with acute onset of meningeal symptoms and fever, pleocytosis of the cerebrospinal fluid, and no growth on routine bacterial culture. It is sometimes associated with viral encephalitis and meningoencephalitis. Viruses reach the central nervous system (CNS) hematogenously or in a retrograde manner from nerve endings. The viral etiology varies according to age and country. Molecular diagnostics technology has helped improve the rate of pathogen detection reducing unnecessary antibiotic use and length of hospitalization. Most of the viral infections detailed in this article have no specific treatment other than supportive care. Many of the viruses discussed are preventable by vaccination and proper skin protection against transmitting vectors.
The Unruly Emotions of the Execution Crowd and its Critics in Late Nineteenth- and Early Twentieth-Century France

From the 1860s to the 1910s, a host of commentators sounded off on the degraded spectacle of the public execution in France. They had little to say about the violence of capital punishment as such....
Dynamic Dual-Gate Bias Modulation for Linearization of a High-Efficiency Multistage PA

This paper investigates the linearization of high-efficiency multistage PAs through gate bias modulation derived from the envelope of the RF input signal. We show that separate control of the driver- and power-stage gate bias voltages allows for independent linearization of gain and phase. An iterative algorithm determines signal-dependent gate voltage functions that minimize amplitude-to-amplitude (AM/AM) and amplitude-to-phase (AM/PM) distortion, and is demonstrated on a 10-W high-efficiency X-band GaN monolithic microwave integrated circuit (MMIC) PA with a custom-designed hybrid dual-gate bias modulator. The noise power ratio (NPR) of a 5-MHz-wide signal is improved by as much as 9.4 dB compared to the PA with a static bias, without degradation in power-added efficiency (PAE) and gain. The measured average PAE improves from 19.9 % at 9.8-dB backoff by 0.8 points, with a saturated gain increase of 0.2 dB at 9.7 GHz. A long-term evolution (LTE) signal with different envelope statistics and a 10.6-dB peak-to-average power ratio (PAPR) is amplified with an adjacent channel power ratio (ACPR) improvement of up to 7.9 dB.
Assessment of subendocardial vs. subepicardial left ventricular twist using tagged MRI images.

Objective: The objective of this study is to determine the normal value of 3D left ventricular (LV) twist in subendocardial, mid-wall and subepicardial layers, as well as to study the effects of aging on 3D LV twist by tagged MR motion tracking techniques. Three dimensional motion detection based on 3D tagged MR images is robust to out-of-plane motion error; while 2D motion detection is inherently unable to analyze the 3D cardiac motion and may lead to inaccurate results. Methods: The 3D LV volumetric images were acquired in 52 normal adult subjects (aged 21-82) and were analyzed by using 3D HARmonic phase (HARP) technique. HARP technique provided the 3D displacement fields and the displacements were utilized to compute the rotational values. LV twist was defined as apical rotation relative to the basal rotation, in the 3D coordinates. The LV twist values of subendocardial, midwall and subepicardial layers were analyzed separately. The measured parameters in this study were: peak apical rotation, peak basal rotation, and peak LV twist. Result: Looking at the apex, the normal LV maintains a clockwise rotation in the LV basal plane and a counterclockwise rotation in the LV apical plane. In general, the apical and basal rotation values increase during the aging process, leading to an increased value of LV twist. Peak epicardial LV twist is (10.4±2.6 degrees) which is lower than the mid-wall LV twist (11.3±2.2 degrees) and endocardial LV twist (12.1±2.6 degrees) in the young group (21-35 years old). Also, peak epicardial LV twist is (12.2±2.6 degrees) which is lower than the mid-wall LV twist (14.4±2.8 degrees) and endocardial LV twist (14.7±2.5 degrees) in the middle aged group (21-35 years old). In a similar way, peak epicardial LV twist is (14.8±2.9 degrees) which is lower than the mid-wall LV twist (15.7±3.6 degrees) and endocardial LV twist (16.7±3.0 degrees) in the old group (50-65 years old). Regarding the older group (more than 65 years old), peak epicardial LV twist is (15.9±3.1 degrees) which is lower than the mid-wall LV twist (16.2±3.4 degrees) and endocardial LV twist (18.3±3.0 degrees). Conclusions: It is feasible to measure the subepicardial, mid-wall and subendocardial twist in tagged MR images. The twist value gradually increases in the aging process. Outside layers have greater twist values compared to the inside layers.
Antimicrobial Resistance, Gut Microbiota, and Health

The rapid surge of antibiotic resistance has raised serious public health concerns and led to the enforcement of policies to limit the uses of antibiotics in food animal production and human medicine. However, recent scientific breakthroughs present a much more comprehensive picture of antibiotic resistance ecology. The identification of new risk factors in antibiotic resistance development, enrichment, dissemination, and persistence demands innovative strategies for effective mitigation. This chapter discusses important concepts as well as major shifts in research scope and methods based on microbiota instead of individual pathogens. The chapter also discusses corresponding findings on the abundance of antibiotic-resistant bacteria and resistance-encoding genes in the food chain, the major avenues of dissemination of antibiotic-resistant bacteria to hosts through food and feed, mechanisms of antibiotic resistance and persistence, and the impact of antibiotic administration on resistance ecology, gut microbiota, and modern diseases. Discoveries related to foodborne antibiotic-resistant pathogens are illustrated. Specifically, the chapter examines the mainstream practice of oral antibiotic administration in both food animal production and human medicine as a key driver for massive antibiotic resistance in the ecosystem and gut microbiota dysbiosis in animal and human hosts. These breakthroughs in knowledge have laid a solid foundation for targeted controls and opened the doors for innovative and effective mitigation of the major challenges of antibiotic resistance and modern diseases associated with gut microbiota dysbiosis. Future directions for research and paradigm changes in policy and practices in the food chain essential to improve food safety and human health are outlined.
Effect of moisture on the interfacial shear strength: A study using the single fiber fragmentation test

The effect of absorbed moisture on the interfacial strength of a carbon fiber/ epoxy matrix composite has been studied using the single fiber fragmentation test. The absorption of 1.40% moisture produced a reduction less than 20% in the interfacial shear strength. This reduction in interfacial strength may be associated with a reduction in the residual compressive stresses at the fiber/matrix interface associated with the cooldown from the curing temperature, a weakening of the chemical adhesion, or a softening of the matrix giving failure by interphase yielding. These results suggest that long-term durability of carbon fiber/epoxy matrix composites in seawater may not be much affected by absorbed seawater.
Rosai-Dorfman disease: A case report associated with oral papillomatosis and severe lymphopenia

Abstract Rationale We report the case of a child with Rosai-Dorfman disease (RDD) with severe lymphopenia and oral papillomatosis. RDD is a rare, idiopathic disorder characterized by proliferation of histiocytes. This condition is believed to be a reactive process. Immune mediated causes have been postulated, however there is no consistent immunologic defect found. Methods Our patient is a nine year male diagnosed with RDD at nine months of age with initial presentation of massive cervical lymphadenopathy. RDD was confirmed by histiopathologic and immunochemistry findings on a superficial lymph node biopsy. There is no history of recurrent infections. Previous treatment has involved steroid therapy, 6-mercaptopurine, and oral methotrexate with recurrence of symptoms. The patient has been off immunomodulatory therapy for two years. Results Clinical evaluation revealed multiple papular and filliform pale colored lesions on the lips and oral mucosa as well as massive cervical adenopathy. Recent immunologic evaluation revealed decreased CD3 (426 mm3/38%), CD4 (168 mm3/15%), and CD8 (204 mm3/18%) cells, normal B cells, normal lymphocyte proliferation studies, hypergammaglobulinemia and excellent specific antibody responses. HIV serology was negative. Conclusion In summary, we report the case of a child with Rosai-Dorfman disease with a significant T-cell lymphopenia (predominantly CD3/CD4) and oral papillomatosis. To our knowledge, there are no reported cases of RDD associated with significant lymphopenia and papillomatosis.
Better Together: Comparing Vulnerability Prediction Models

Abstract Context Vulnerability Prediction Models (VPMs) are an approach for prioritizing security inspection and testing to find and fix vulnerabilities. VPMs have been created based on a variety of metrics and approaches, yet widespread adoption of VPM usage in practice has not occurred. Knowing which VPMs have strong prediction and which VPMs have low data requirements and resources usage would be useful for practitioners to match VPMs to their project’s needs. The low density of vulnerabilities compared to defects is also an obstacle for practical VPMs. Objective The goal of the paper is to help security practitioners and researchers choose appropriate features for vulnerability prediction through a comparison of Vulnerability Prediction Models. Method We performed replications of VPMs on Mozilla Firefox with 28,750 source code files featuring 271 vulnerabilities using software metrics, text mining, and crash data. We then combined features from each VPM and reran our classifiers. Results We improved the F-score of the best VPM (.20 to 0.28) by combining features from three types of VPMs and using Naive Bayes as the classifier. The strongest features in the combined model were the number of times a file was involved in a crash, the number of outgoing calls from a file, and the string “nullptr”. Conclusion Our results indicate that further work is needed to develop new features for input into classifiers. In addition, new analytic approaches for VPMs are needed for VPMs to be useful in practical situations, due to the low density of vulnerabilities in software (less than 1% for our dataset).
The use of mirabegron in neurogenic bladder: a systematic review

To evaluate the use of mirabegron in patients with neurogenic bladder. A systematic review of the literature was conducted using four databases (Medline via PubMed, Scopus, Cochrane, and EMBASE). Articles evaluating mirabegron in neurogenic bladder patients were collected, and assessment of the drug’s efficacy was reviewed according to clinical and urodynamic parameters. Seven studies were selected and a total of 302 patients with NB were evaluated, ranging from 15 to 66 patients per study. All of the patients had received antimuscarinics as a previous treatment modality. Mirabegron was used as a second-line treatment after antimuscarinics lacked efficacy or caused adverse effects. The duration of the treatments ranged from 4 to 12 weeks. Reported in two studies each, bladder compliance and maximal cystometric capacity were the most commonly improved urodynamic parameters. In the majority of the studies, positive outcomes were reported for clinical scores. Additionally, analysis of the IPSS subscores revealed an improvement of storage symptoms as opposed to voiding symptoms. In all of the studies, mirabegron was well tolerated. Mirabegron appears to be an effective treatment in the management of neurogenic bladder unresponsive to antimuscarinics, particularly in patients presenting with storage symptoms. There is still no evidence concerning the use of mirabegron as a first-line therapy for neurogenic bladder.
Acute Infection Disrupts the Respiratory Microbiome of Lung Transplant Recipients

Purpose Respiratory infections are common after lung transplant and contribute to mortality and allograft failure. Studies suggest that respiratory infections alter the lung microbiome. We hypothesized that respiratory infections would be associated with a pathogenic bacteria dominating the microbiome community with ≥ 30% relative community abundance, and lower alpha diversity. Methods A total of 152 bronchoalveolar lavage (BAL) samples were collected from 88 adult lung transplant recipients (LTR) between January 2017 - June 2018 as part of a single center retrospective study. Samples were categorized as “infected” or “surveillance” based on clinical data and were considered “infected” if 2 or more of the following criteria were met: recent fever, increased sputum, change in sputum appearance, increased shortness of breath, new radiographic infiltrate, or physician concern for infection. DNA was extracted, and bacterial 16S rRNA genes were amplified and sequenced. Sequences were classified taxonomically, and relative abundances were calculated. Comparative statistical analysis was performed using R. Results Of the 152 BAL samples, 19 (13%) were categorized as “infected”. Infected samples were more likely than surveillance samples to be dominated by a single bacterial pathogen at ≥ 30% relative abundance (p=0.025) and ≥ 50% abundance (p=0.004) (Figure). Infected samples had a bacterial pathogen reach ≥ 30% relative abundance in 52% of samples, compared to 25% of the surveillance samples. Using a threshold of ≥ 50% abundance, infected samples had a dominant organism in 37% of samples compared to 10% of surveillance samples. Infected samples had lower mean alpha diversity than surveillance samples (Shannon index 14 vs. 19, p=0.03). Conclusion Bacterial microbiota during respiratory infection was more likely to include a dominant bacterial pathogen than samples obtained in the absence of infection. Microbiota alpha diversity was also found to be reduced during respiratory infection.