cssi/SciSciGPT-SciSciNet huggingface dataset:
Fiscal Decentralization in Indonesia: A New Approach to an Old Idea

Abstract The system for financing and delivering local public services in Indonesia, as in many developing countries, is highly centralized. Growing awareness of the weaknesses of the present system has recently generated much interest in decentralization and numerous government policies and programs toward that end. In spite of these efforts, the role and capacity of local governments remain weak. In this paper, we outline the most critical obstacles to decentralization and examine a strategy to reduce their significance. Instead of centering our analysis on the definition of a normatively desirable decentralization outcome, we focus on the development of a process through which genuinely feasible outcomes could be defined and implemented, in this case an interministerial and intergovernmental process for evaluating local governments.
Political Economy of Epidemic Kidney Disease in Sri Lanka

The Chronic Kidney Disease (CKD), taking the lives of thousands in poor farming communities in Sri Lanka, is commonly seen as a problem peculiar to the island’s north central dry zone agricultural region. The prevailing bio-medical focus is on identifying one or more “environmental nephrotoxins.” While delineating important controversies on the etiology of the disease, this article seeks to broaden the discourse on the hitherto neglected political economy of CKD in Sri Lanka. In so doing, it seeks to bring together the bio-medical debate on the impact of widespread and unregulated use of agrochemicals on public health and kidney disease with broader global interdisciplinary perspectives on the industrialization of agriculture and the consolidation of food production by transnational agribusiness corporations. The article concludes pointing out environmentally sustainable and socially equitable development and organic agriculture as the long-term solutions to CKD in Sri Lanka and elsewhere.
Bevacizumab for Advanced Breast Cancer: All Tied Up With a RIBBON?

conducting correlative studies in large clinical trials. It is likely that novel drugs for cancer coming to market will continue to have stratospheric price tags. It is also likely that novel agents will achieve, at best, incremental improvements in PFS that often will not translate into improvements in overall survival. We will serve our patients best by designing trials that permit us to identify which patients have the highest likelihood of deriving a meaningful survival benefit from a novel agent. Correlative science for effective patient selection may be the key to cost-effective treatment of cancer in the biologic therapy era.
Serial positive patterning: Implications for “occasion setting”

Rats received positive patterning training in which a serial light-tone compound was reinforced with food and the elements were separately nonreinforced. Conditioned responding of a form characteristic of auditory conditioned stimuli emerged to the tone within the serial compound. Separate presentations of the elements evoked little conditioned behavior. Discrimination performance was better when the light-tone interval was 20 sec than when it was 5 sec. These data suggested that the light acquired a conditional cue or occasion-setting function such that the light signaled when a tone-food relation was in effect. Comparisons with data from previous experiments involving serial feature-positive discriminations indicated that the light’s ability to serve as an occasion setter was relatively independent of its response-evoking capacity.
Milton's Conception of Time in the Christian Doctrine

In the argument preceding Book I of Paradise Lost, Milton chooses to emphasize at the outset one aspect of his conception of time. He summarizes Satan's report to the fallen angels, and adds “for that Angels were long before the visible Creation, was the opinion of many ancient Fathers.” Nowhere else in these prefatory “arguments” does he feel it necessary to make any explanatory statements about the cosmology of the poem. Here, however, he calls attention to a belief that was in conflict with the prevailing Christian view. But, as Milton realized, the reader must grasp this heterodox belief of his in order to understand the whole design of the poem.
Merocyanine 540 as a fluorescent probe of membranes: Selective staining of leukemic and immature hemopoietic cells

We have reported (Easton, Valinsky and Reich, 1978) that merocyanine 540 (MC 540) specifically stains a variety of living excitable cells, but not nonexcitable cells. This paper describes the exceptional permeability to MC 540 of leukemic leukocytes and immature hemopoietic precursor cells. We have used fluorescence microscopy and uptake of radioactive dye to study MC 540 staining of peripheral blood leukocytes from 80 leukemic and 34 normal individuals; leukemic leukocytes stain, whereas normal leukcytes do not. The leukocyte staining reaction differs from that previously described for excitable cells since it is independent of the ionic composition of the staining medium, kinetically complex, enhanced by light, enhanced by oxygen and essentially irreversible. Virtually all circulating nucleated cells from leukemic individuals are stained to approximately the same extent, and there is no qualitative or quantitative distinction between the various forms of leukemia. We have also found that MC 540 interacts with granulopoietic colony-forming cells (CFU-C) and with spleen colony-forming cells derived from mouse bone marrow (CFU-S). We cannot as yet identify a specific property of leukocyte plasma membranes that determines MC 540 permeability; since changes in MC 540 uptake appear to be correlated with cellular maturation during normal hemopoiesis, the retention of staining by leukemic cells, some of which appear morphologically normal, may indicate of failure in membrane maturation during leukemic blood cell development.
Vanishing or Phantom Tumor of the Lung; Localized Interlobar Effusion in Congestive Heart Failure

Because of the rapid growth of our geriatric population and consequent increase in congestive heart failure, a rise in the incidence of vanishing tumors of the lung can be expected. An instructive case and a brief review of the pathophysiology are presented.
GiardiaDB and TrichDB: integrated genomic resources for the eukaryotic protist pathogens Giardia lamblia and Trichomonas vaginalis

GiardiaDB (http://GiardiaDB.org) and TrichDB (http://TrichDB.org) house the genome databases for Giardia lamblia and Trichomonas vaginalis, respectively, and represent the latest additions to the EuPathDB (http://EuPathDB.org) family of functional genomic databases. GiardiaDB and TrichDB employ the same framework as other EuPathDB sites (CryptoDB, PlasmoDB and ToxoDB), supporting fully integrated and searchable databases. Genomic-scale data available via these resources may be queried based on BLAST searches, annotation keywords and gene ID searches, GO terms, sequence motifs and other protein characteristics. Functional queries may also be formulated, based on transcript and protein expression data from a variety of platforms. Phylogenetic relationships may also be interrogated. The ability to combine the results from independent queries, and to store queries and query results for future use facilitates complex, genome-wide mining of functional genomic data.
What's Love Got To Do With It? Equality, Equity, Commitment and Women's Marital Quality

The companionate theory of marriage suggests that egalitarianism in practice and belief leads to higher marital quality for wives and higher levels of positive emotion work on the part of husbands. Our analysis of women's marital quality and men's marital emotion work provides little evidence in support of this theory. Rather, in examining women's marital quality and men's emotional investments in marriage, we find that dyadic commitment to institutional ideals about marriage and women's contentment with the division of household tasks are more critical. We also show that men's marital emotion work is a very important determinant of women's marital quality. We conclude by noting that "her" marriage is happiest when it combines elements of the new and old: that is, gender equity and normative commitment to the institution of marriage.
Moment tensor inversion of very long period seismic signals from Strombolian eruptions of Erebus Volcano

article i nfo Strombolian eruptions from the long-lived lava lake of Erebus volcano, Ross Island, Antarctica, generate repeating Very Long Period (VLP) signals, containing energy between approximately 30 and 5 s, that persist for several minutes and through the post-eruptive refilling of the lava lake. The initial approximately 10 s of this signal is moderately variable, particularly with respect to its initial polarity, while the following VLP coda has been observed to be stable since the earliest VLP observations were made (1996). To estimate forces and force couples consistent with the Erebus VLP signature, we perform moment tensor inversions for point sources using high signal-to-noise data stacks from the six-station, 18-component broadband seismographic network and Green's function forward calculations that incorporate topography. We infer a shallow (approximate depth of less than 400 m below the lava lake surface) source centroid that underlies the center to the northwestern rim of the main crater, east and north of the lava lake. Integrated Mii functions over the predominant (180 s) signal duration of VLP events show that the net scalar moments for these events are on the order of 4×10 13 N m (corresponding to a moment magnitude mw ≈3) for typical sized VLP events. Moment rate tensors which characterize force couple components are dominated (85-97% of variance) by dilatational components. Approximately 25% of the data variance is attributable to single forces that are attributable to oscillatory reaction forces caused by fluid transport, however, the relative contributions of vertical forces and couples with this sparse network is poorly resolved for these shallow sources. The generally high degree of repeatability in the VLP signal across thousands of eruptions over the past decade indicates that the response of the conduit system to gas slug ascent and subsequent gravitational disequilibrium is stable, consistent with the generally unchanging surface manifestation of the convecting lava lake system, and arguing for a thermally and dynamically stable conduit system beneath the lava lake.
Biomass Allocation and Resprouting Ability of Princess Tree (Paulownia Tomentosa: Scrophulariaceae) across a Light Gradient

Abstract Acclimation to low light may interfere with the ability of woody plants to resprout. We examined the patterns of biomass allocation and resprout ability of seedlings of Paulownia tomentosa, a heliophytic r-selected species. Plants were grown in shade houses in a common garden with two replicates of three light treatments: full ambient light, artificial edge and shade. The shade treatments were similar to light patterns and levels typical of a deciduous forest understory. The artificial edge treatment provided an intermediate light regime since it received only direct morning sun and was shaded in the afternoon. The experimentally browsed treatment consisted of clipping 10 tree seedlings to ground level in each replicate light treatment four times over the growing season. In all light treatments, whole plants were harvested on each clipping date. Plants in all treatments allocated more to belowground biomass in the first weeks of the experiment and then shifted allocation to aboveground biomass. P...
Optimization of oral anticoagulation: solved and unsolved problems with mechanical heart valve prostheses

Due to the introduction of artificial surfaces and unphysiologic transprosthetic flow conditions, heart valve substitutes and especially mechanical prostheses are throm-bogenic. It is accepted that life-long anticoagulation is necessary for patients with such devices to prevent intracardiac thrombosis and consequent embolic events (1, 4, 10, 18). However, the intensity of anticoagulation therapy was arbitrarily choosen in the early years of valve replacement surgery and never submitted to controlled clinical trials. The striking importance of the prosthesis itself for the postoperatively persistant thrombembolic hazard in the early years of valve replacement surgery has resulted in an underestimation of non-device related factors for intracardiac thrombosis and cardioembolism. Indeed, it is still impossible to decide whether a given embolic or thrombotic event is related to the artificial device or to the cardiac morphology or function. Most likely, both factors are involved to a varying degree (16). Apart from non-standardized follow up techniques, this is the major reason why, thus far, the thrombogenicity of a given prosthetic device can not be determined directly and a consequent device-specific anticoagulation has not been established (3,6,16).
Measuring Ignition Temperature and the Rate of Energy Generation From Canola Methyl Ester and Soy Methyl Ester in Oxygen-Nitrogen Mixtures on Platinum-Rhodium

A heated plug flow reactor was used to study the reactions of nonflammable mixtures of canola methyl ester-oxygen and soybean methyl ester-oxygen diluted with nitrogen over a coiled 90%:10% platinum:rhodium wire catalyst. The temperature the catalyst needed to reach to initiate surface reactions (ignition temperature) and the subsequent rate of energy generation were determined. The absolute volume fraction of fuel was varied from 0.238% to 0.445% and the relative fuel-oxygen equivalence ratio, φ, was varied between 0.4 and 1.0. The 127 micrometer diameter Pt-Rh wire was coiled and suspended crosswise in the quartz tube of the reactor. Evaporated biodiesel was delivered by heated nitrogen into the apparatus and blended with oxygen in a mixing nozzle. The wire catalyst was electrically heated and acted as a resistance thermometer to measure its average temperature. Ignition temperatures increased with increasing equivalence ratio and volumetric fuel vapor percentage, thus indicating initial fuel coverage of the catalyst surface. Temperatures as low as 912 K at φ = 0.4 for 0.268% Soy Methyl Ester (SME) and as high as 991 K at φ = 1.0 for 0.445% Canola Methyl Ester (CME) were recorded. The rate of energy generated due to surface reactions for both biodiesels decreased with increasing equivalence ratio and generated less energy as fuel percentages decreased. The lowest and highest rates of energy generation were both obtained from experiments with CME with 6.9 W/cm2 at φ = 1 for 0.268% fuel and 25.3 W/cm2 at φ = 0.4 for 0.445% fuel. The extremes of the rate of heat generated from SME reactions were 5.1 W/cm2 and 28.6 W/cm2 , both at φ = 0.4, with 0.238% and 0.417% fuel, respectively. Another outcome of this work was achieving steady evaporation of microliter/hour heavy fuel vapor flow rates. This was aided by thermogravimetric analysis (TGA) to determine thin-film vaporization temperatures. CME and SME had the lowest evaporation temperatures of 188 K and 186 K, respectively.Copyright © 2011 by ASME
Abstract B83: The prevalence of colorectal cancer risk factors in the United States, 1999-2008

Background: Despite that an estimated 39-71% of colon cancer cases could be avoided through lifestyle modifications, colorectal cancer remains the third most commonly diagnosed cancer and the third leading cause of cancer death. Targeting the most prevalent lifestyle risk factors is a complementary strategy to screening in men and women 50+ years old, and should be the primary prevention strategy in younger people to reduce the incidence of and mortality from colorectal cancer. To prioritize targets for prevention, we, thus, evaluated the prevalence of modifiable risk factors for colorectal cancer in the U.S. Methods: We used nationally representative data for non-Hispanic white (NHW), non-Hispanic black (NHB), and Mexican-American (MA) men and women (non-pregnant) 20-69 years old from the National Health and Nutrition Examination Survey (NHANES) conducted in 1999-2000, 2001-2002, 2003-2004, 2005-2006, and 2007-2008. We included lifestyle risk factors for which the evidence is convincing (WCRF/AICR, Surgeon General9s Report): physical inactivity ( Results: At each time point, the most prevalent risk factor was physical inactivity (∼60%), followed by obesity (∼30%), red meat intake (∼30%) and smoking (∼25%). The prevalence of the risk factors did not decline over the 10 years and the ordering of their prevalences was stable. Overall, only 13% of adults had none of the risk factors, whereas 17% had 3 and 5% had 4-6 risk factors. Men (3: 20%, 4-6: 6%), who have higher colorectal cancer incidence and mortality rates, had more risk factors than women (3: 15%, 4-6: 4%; p=0.004). NHB adults (3: 20%, 4-6: 7%), who have the highest rates, had the most risk factors followed by NHW (3: 17%, 4-6: 5%), and MA (3: 14%, 4-6: 3%; p=0.06), who have the lowest rates of the three racial/ethnic groups. The number of risk factors did not differ among people aged 20-34 years (3: 16%, 4-6: 5%); 35-49 years (3: 18%, 4-6: 5%) or 50-69 years (3: 17%, 4-6: 4%; p=0.67), although which of the risk factors were the most prevalent differed slightly among the three age groups. Conclusions: Eighty-seven percent of American adults have at least one colorectal cancer risk factor. The most prevalent risk factors are also risk factors for other common chronic diseases. Over the past 10 years, the prevalence of these risk factors has not declined. This constellation of risk factors should be targeted for intervention to reduce the burden of colorectal cancer and all other major chronic diseases. Funding: Dr. Joshu was supported by NCI T32 CA009314. Citation Information: Cancer Prev Res 2010;3(12 Suppl):B83.
Solvents' Critical Role in Nonaqueous Lithium-Oxygen Battery Electrochemistry.

Among the many important challenges facing the development of Li–air batteries, understanding the electrolyte’s role in producing the appropriate reversible electrochemistry (i.e., 2Li+ + O2 + 2e– ↔ Li2O2) is critical. Quantitative differential electrochemical mass spectrometry (DEMS), coupled with isotopic labeling of oxygen gas, was used to study Li–O2 electrochemistry in various solvents, including carbonates (typical Li ion battery solvents) and dimethoxyethane (DME). In conjunction with the gas-phase DEMS analysis, electrodeposits formed during discharge on Li–O2 cell cathodes were characterized using ex situ analytical techniques, such as X-ray diffraction and Raman spectroscopy. Carbonate-based solvents were found to irreversibly decompose upon cell discharge. DME-based cells, however, produced mainly lithium peroxide on discharge. Upon cell charge, the lithium peroxide both decomposed to evolve oxygen and oxidized DME at high potentials. Our results lead to two conclusions; (1) coulometry has to b...
Gracilis Myocutaneous and Muscle Flaps

Surgical techniques for the elevation of gracilis myocutaneous and muscle flaps are outlined and a versatile range of clinical applications discussed. Even greater future diversity is foreseen for this donor unit.
Electrophysiologic auditory tests

Auditory stimulation elicits a complex series of electric signals in the ear and nervous system which can be used for hearing assessment, audiologic and neurologic diagnosis, intraoperative monitoring, and neurophysiologic research. The earliest components comprise the electrocochleogram. The cochlear microphonic arises from receptor potentials from cochlear hair cells, and is used to assess hair cell function in patients with auditory neuropathy. The summating potential becomes larger in Meniere's disease. The eighth-nerve compound action potential is useful for objective audiometry. Brainstem auditory evoked potentials, a series of components generated in the eighth nerve and the brainstem auditory pathways, can be used for diagnostic assessment and intraoperative monitoring of the ears and of the auditory pathways up through the mesencephalon. They are relatively easy to record, highly consistent in normal subjects, and little unaffected by surgical anesthesia. Middle-latency and long-latency auditory evoked potentials are generated in multiple areas of cerebral cortex that are activated by auditory stimulation. Anesthetic effects limit their utility for intraoperative monitoring, and substantial intersubject variability limits their utility as a diagnostic test in individual patients, but they are important research tools for the study of memory processes and the way in which the brain analyzes auditory stimuli.
How nerve-sparing technique has been applied to radiotherapy?

The introduction of nerve-sparing technique is one of the most significant advances in the surgical treatment of prostate cancer and heralded a shift from a curing cancer at all-cost model to a curing cancer and preserving quality of life model. In a recent article published in Lancet Oncology in May, Lee et al. reviewed the concept of vessel-sparing and functional anatomy-based radiotherapy as well as outcomes with respect to erectile dysfunction, bringing to light a conceptual shift in the management of localized prostate cancer with radiotherapy, which parallels the shift in the surgical management of prostate cancer with the introduction of nerve-sparing technique. The hypothesis is that utilization of vessel-sparing and functional anatomy-based radiotherapy may result in a more personalized approach to this modality based on a patient's specific anatomy, therefore improving patient outcomes.
The Political Ethics of Constitutional Professionalism

This chapter discusses how the elimination of abusive administrative practices in bureaucratic governance requires a comprehensive institutional approach to restore the balance between bureaucratic authority and the liberty and equality of citizens. This chapter advocates career public servants’ acting as constitutional professionals and outlines the elements of constitutional professionalism, including the use of external controls provided by representative political institutions such as grand juries. This chapter also argues for strengthening the constitutional system of checks and balances in bureaucratic governance by encouraging more rigorous legislative oversight and greater diversification of democratic public service through the adoption of the norms of representative bureaucracy and consultative administrative practices. The chapter concludes with guidelines on how career public servants may behave as constitutional professionals in their day-to-day operations.
A study of aerosol properties based on observations of particulate matter from the U.S. Embassy in Beijing, China

The United States Embassy in Beijing, China, released publicly a record of mass concentrations of particulate matter 2.5 µm and smaller in aerodynamic diameter (PM2.5) from April 2008 to the present measured with a Beta Attenuation Monitor (BAM). We compare these measurements with observations of particulate matter recorded at the Beijing Institute of Atmospheric Physics and observations of visibility recorded at the Beijing Capital International Airport (BCIA) to assess their value as a record of air quality in the greater Beijing metropolitan area. We find that the PM2.5 observations correlate well with the other observations of PM over the period January 1st to February 1st 2013 using a Tapered Element Oscillating Microbalance and an Aerosol Mass Spectrometer (AMS), and they exhibit a clear inverse correlation with visibility measured at BCIA. Using inverse visibility as a proxy of radiation extinction, we determine a dry mass extinction efficiency and a dependence of radiation extinction to relative humidity that is consistent with other studies of polluted urban environments. We deduce a strong degree of homogeneity of particulate pollution across the Beijing metropolitan region and conclude that the U.S. Embassy measurements are a reliable sample of this particulate pollution during periods of photochemical smog. The U.S. Embassy observations of PM2.5 appear to remain consistent throughout the available record and can serve as a useful dataset for studying future trends in particulate matter as China implements ambitious measures to improve air quality in the region.
Effect of Patient Age on Outcomes in Breast Reconstruction: Results from a Multicenter Prospective Study

Background Although >40% of new breast cancer diagnoses in the US are in older women, few studies have assessed the outcomes of post-mastectomy reconstruction in this population. Our objective was to evaluate age effects on postoperative complications and patient-reported outcomes in women undergoing breast reconstruction, and to investigate whether age effects differ between reconstructive procedure types. Study Design Eligible patients in the Mastectomy Reconstruction Outcomes Consortium study from 11 institutions (57 providers) in North America were analyzed. Two-year complications and patient-reported outcomes via BREAST-Q domains were compared across younger (younger than 45 years), middle-aged (45 to 60 years), and older (older than 60 years) women. Mixed-effects regression models were used, controlling for a range of demographic and clinical covariates. Results A total of 1,531 patients were studied: 494 younger, 803 middle-aged, and 234 older. Age was not a significant predictor of complications. For sexual well-being 2 years post-reconstruction, older women reported 4.25 (p = 0.04) higher mean scores with implant procedures, and 10.39 (p Conclusions Age did not significantly affect complication rates. Older women demonstrated higher sexual well-being for both procedures, and better satisfaction and physical and psychosocial well-being than younger women with autologous procedures. Post-mastectomy reconstruction is a viable option for older patients, with risks and benefits comparable with those in younger women.
A Novel Subset of CD8+, CD62L-High Tumor Infiltrating Lymphocytes (TIL) Exhibits Regulatory Function

Abstract Tumor infiltrating lymphocytes (TIL) have demonstrated therapeutic effects in adoptive cell therapy of melanoma, and there is great interest in optimizing this response. However, the role of lymphocytes during tumor initiation and progression is complex and evolves over time. We have identified two distinct subsets of TIL that have divergent effector vs. regulatory function in murine tumor models. These subsets can be efficiently segregated in vitro based on differential expression of L-selectin (CD62L). Although initially present in small numbers, they can be activated in vitro with anti-CD3 mAb and expanded with a combination of IL-2 and IL-7 to provide sufficient numbers for adoptive transfer into secondary hosts with advanced tumors. Our initial studies demonstrated that the TIL CD62L-low subset is a mixture of CD4 and CD8 cells that individually or in combination mediate tumor-specific regression. By contrast, the CD62L-high subset, which is exclusively CD8+, does not have therapeutic efficacy. Moreover, when CD62Lhigh TIL are co-transferred with CD62L-low effector cells they abrogate their therapeutic efficacy, thus they have suppressor function. Because L-selectin is involved in lymphocyte homing to secondary lymphoid tissues, we hypothesized that the CD62L-high TIL cells might preferentially re-circulate into lymph nodes and inhibit primary sensitization of naive T cells to tumor antigens. Tumor cells were inoculated subcutaneously, alone or with either CD62L-high TIL or CD62L-low TIL. The CD62L-high TIL actually enhanced the growth of subcutaneous tumors whereas the CD62L-low cells prevented tumor growth. More importantly, tumor-draining lymph nodes were harvested twelve days later and activated in vitro with anti-CD3 and IL-2/IL-7 for adoptive cell transfer to secondary tumor-bearing hosts. The presence of TIL suppressor cells during sensitization of tumor-draining lymph node cells partially inhibited the development of tumor-reactive effector cells. This inhibition was not tumor-antigen specific because TIL suppressor cells derived from the MCA205 fibrosarcoma were able to inhibit sensitization of B16/F10 draining lymph node effector cells. These data suggest that tumors acquire a population of CD8 CD62L-high T cells that can inhibit other effector T cells. The suppressor TIL cells also appear to modulate the tumor stroma to promote tumor growth and modulate antigen-presenting cells that migrate to draining lymph nodes thereby dampening the development of effector cells. Studies are ongoing to determine the mechanism of suppressor function.
EXPERIMENTAL STUDIES OF MINERAL ENERGETICS

The energetics of mineral reactions can be studied by a variety of high temperature techniques. Studies of phase equilibria, vapor pressure, and oxidation-reduction reactions give values of free energies and activity composition relations. Calorimetric studies at high temperature, both by oxide-melt solution calorimetry and drop calorimetry, determine heats of formation, mixing, melting, phase transitions, and order-disorder processes. Application of thermochemical measurements is made to atmospheric and high pressure phases in the system MgO-SiO2, with emphasis on the aspects of structure and bonding which stabilize olivine, pyroxene, spinelloid, spinel, garnet, ilmenite, and perovskite structures.
Totally implantable venous access device use in pancreatic cancer: A national analysis.

e15188 Background: Totally implantable venous access devices (ports) can be used in pancreatic cancer treatment. Long-term device placement facilitates agent infusion and reduces discomfort from re...
Thoracic and Esophageal Procedures, Lung Transplant in Cirrhotic Patients: Safety and Limiting Factors

Cirrhotic patients may suffer from comorbid thoracic or esophageal conditions, which often necessitate surgical treatment such as cancer resection or lung transplantation. Currently, there are limited data and few protocols to guide surgical decision making for these patients. This chapter discusses the indications and outcomes for the surgical treatment of lung cancer, gastrointestinal reflux disease, esophageal cancer, lung transplantation, and combined liver–lung transplantation in cirrhotic patients. Recognizing when it is safe to operate cirrhotic patients and when it is contraindicated is critical for the safety of these patients.
Fluorescence Image-Guided Robotic Surgery

Fluorescence image-guided surgery (FIGS) is a surgical modality that employs the fluorescence optical detection and tracking system to identify fluorescence-labeled tissue structures in real time to guide a surgical procedure. Near-infrared fluorescence (NIRF) imaging with fluorophore indocyanine green (ICG) has been integrated into the robotic surgery platform, allowing FIGS to be used in robot-assisted minimally invasive procedures. Fluorescence image-guided robotic surgery is in its infancy. In urology, this technology has been tested in robotic partial nephrectomy for tumor margin identification and super-selective arterial clamping and in urinary tract reconstructions for tissue perfusion assessment, as well as in prostatectomy for sentinel lymph node mapping. Early experiences with this technology have demonstrated that ICG-NIRF image-guided robotic surgeries are feasible and safe and have the potential to improve the qualities and outcomes for certain major urologic procedures. Convincing data demonstrating the effectiveness in terms of improving the quality and outcome of surgery with reasonable costs or with decreased costs of overall care are still needed. The key advancement in fluorescence image-guided robotic surgery will rely on future engineering of robotic surgery imaging systems and developing tissue- or cell-type-specific fluorescence labeling contrasts suitable for clinical use.
Abstract 147: Weighted Insurance Reimbursement Strategies For Cardiac Imaging Based On Appropriateness Criteria

Rising use of medical imaging has been a major driver in escalating health care costs. As reimbursement for imaging has declined, it is likely that some effort to expand volume into lower risk populations has occurred. Consequently, insurance payouts based on pre-test likelihood of disease can be restructured to promote effective use in intermediate risk populations where uncertainty about disease presence is highest (50%). Objective: to analyze the incidence of normal result imaging over 5 years and to construct insurance payout schemes that will result in a net reduction in cost while simultaneously promoting the effective use of imaging. Methods .This is a retrospective study of patients (pts) who underwent stress nuclear perfusion scans to detect coronary artery disease (CAD). The study is in 2 parts. Part 1: Specific years were randomly sampled: 2006 (n=2894), 2008 (n= 2843) and 2010 (n=2550) as to whether results were normal or had some abnormality in perfusion suggesting CAD. Part 2: The years 2010 and 2011 (n=2486) were then combined to fit different models of reimbursement based on the pre-test likelihood of CAD. All patients without known CAD referred for imaging were included. A risk score derived from combination of clinical risk factors known to be associated with CAD and available to all clinicians was calculated for each patient. This score was further weighted by the resting ECG status and the presence or absence of symptoms. Three appropriateness classifications were assigned based on this score (1=inappropriate (1-10% risk),2=probably appropriate (10-40% risk and more than 60%) and 3= appropriate (40-60% risk) derived from a national expert panel of physicians. The cost of imaging was set at $2000, which is an approximate national median charge Results: There was a significant increase in the incidence of normal imaging results with time: 2006=66%, 2008=69%, 2010=76%, p Conclusion: This approach, based on established pretest criteria, is highly flexible and produces immediate savings. More importantly, it provides incentive to reshape ordering behavior in the future but may need to be complemented with tort reform.
Scalable data structure to compress next-generation sequencing files and its application to compressive genomics

It is now possible to compress and decompress large-scale Next-Generation Sequencing files taking advantage of high-performance computing techniques. To this end, we have recently introduced a scalable hybrid parallel algorithm, called phyNGSC, which allows fast compression as well as decompression of big FASTQ datasets using distributed and shared memory programming models via MPI and OpenMP. In this paper we present the design and implementation of a novel parallel data structure which lessens the dependency on decompression and facilitates the handling of DNA sequences in their compressed state using fine-grained decompression in a technique that is identified as in compresso data processing. Using our data structure compression and decompression throughputs of up to 8.71 GB/s and 10.12 GB/s were observed. Our proposed structure and methodology brings us one step closer to compressive genomics and sublinear analysis of big NGS datasets. The code for this implementation is available at https://github.com/pcdslab/PHYNGSD
Monolithically Integrated Virtual Balanced ACP-OPLL for PM RF Photonic Links

We present the analysis, design, fabrication, and measurement of the attenuating counter-propagating optical phase locked loop (ACP-OPLL) photonic integrated circuit with a virtual balanced device structure for high dynamic range RF photonic links. The virtual balanced design not only significantly reduces fabrication complexity, but also improves the optical loss performance. The virtual balanced ACP-OPLL demonstrated the best linear phase demodulation performance among the OPLL photonic integrated circuits.
Additive Manufacturing and size-dependent mechanical properties of three-dimensional microarchitected, high-temperature ceramic metamaterials

3D microarchitected metamaterials exhibit unique, desirable properties influenced by their small length scales and architected layout, unachievable by their solid counterparts and random cellular configurations. However, few of them can be used in high-temperature applications, which could benefit significantly from their ultra-lightweight, ultrastiff properties. Existing high-temperature ceramic materials are often heavy and difficult to process into complex, microscale features. Inspired by this limitation, we fabricated polymer-derived ceramic metamaterials with controlled solid strut size varying from 10-µm scale to a few millimeters with relative densities ranging from as low as 1 to 22%. We found that these high-temperature architected ceramics of identical 3D topologies exhibit size-dependent strength influenced by both strut diameter and strut length. Weibull theory is utilized to map this dependency with varying single strut volumes. These observations demonstrate the structural benefits of increasing feature resolution in additive manufacturing of ceramic materials. Through capitalizing upon the reduction of unit strut volumes within the architecture, high-temperature ceramics could achieve high specific strength with only fraction of the weight of their solid counterparts.
Superdense coding for quantum networking environments

Quantum networks provide a versatile infrastructure for communication, computing, and sensing with quantum information. Novel sources and detectors for transmitting and receiving quantum states are critical elements in the development and eventual deployment of robust quantum networks. Alongside performance, the compatibility of quantum network devices with modern networking infrastructure is an important requirement for deployment. We present results on the integration of quantum communication using superdense coding transmitted over optical fiber links into network environments. Our approach takes advantage of a novel complete Bell-state measurement setup that relies on hyper-entanglement in the temporal and polarization degrees of freedom for a two-photon state emitted from a quantum light source. Using linear optics and common single-photon detectors, we record a single-qubit channel capacity of 1.665±0.018. We then demonstrate a full experimental implementation of hybrid, quantum-classical communication protocol for image transfer applications. Our devices integrate with existing fiber optical network and software-defined transmitters and receivers as part of a modular design to provide an extensible quantum communication system that can adapt to future quantum technology goals.
CONTAMINANT TRANSPORT MODELING IN SURFACE WATERS

A current major environmental concern is the release of toxic chemicals to water or the land surface, and their subsequent impacts on aquatic biota and humans. Many toxic contaminants are persistent and undergo complex interactions in the environment. Mathematical models, supported by coordinated laboratory and field measurements, can integrate many of the complex mechanisms controlling contaminant transport and fate in the environment into a single framework. This paper discusses these mechanisms, contaminant transport computer codes for surface waters, and several case studies.
Role of NF-κB Inhibitors in HIV-Related Malignancies

NF-κB is essential for B-cell development and crucial for the survival of B-cell lymphoma. Not surprisingly then NF-κB and other members in this pathway have been developed as anti-cancer drug targets. At the same time, NF-κB is essential for the maintenance and replication of human tumor viruses such as Epstein–Barr virus (EBV) and Kaposi’s sarcoma associated herpesvirus (KSHV). The high association of HIV lymphomas with these viruses provides an opportunity to approach these malignancies using strategies that target NF-κB.
Enzyme therapy XI: immunologic considerations for replacement therapy with unentrapped, erythrocyte- and liposome-entrapped enzymes.

Critical review of animal and human trials of enzyme therapy has identified the major obstacles which must be overcome before replacement therapy can become an effective therapeutic modality for selected inherited lysosomal storage diseases (1). A prime requisite is the development of entrapment strategies for enzyme administration which afford maximal protection to the exogenous enzyme from potential physiologic and immunologic inactivation; in addition, the enzyme carriers used must be non-immunogenic and biodegradable.
Don't be jelly: Exploring effective jellyfish locomotion

Jellyfish have been called one of the most energy-efficient animals in the world due to the ease in which they move through their fluid environment, by product of their morphological, muscular, and material properties. We investigated jellyfish locomotion by conducting \textit{in silico} comparative studies and explored swimming performance across different fluid scales (e.g., Reynolds Number), bell contraction frequencies, and contraction phase kinematics for a jellyfish with a fineness ratio of 1 (ratio of bell height to bell diameter). To study these relationships, an open source implementation of the immersed boundary method was used (\textit{IB2d}) to solve the fully coupled fluid-structure interaction problem of a flexible jellyfish bell in a viscous fluid. Thorough 2D parameter subspace explorations illustrated optimal parameter combinations in which give rise to enhanced swimming performance. All performance metrics indicated a higher sensitivity to bell actuation frequency than fluid scale or contraction phase kinematics, via Sobol sensitivity analysis, on a high performance parameter subspace. Moreover, Pareto-like fronts were identified in the overall performance space involving the cost of transport and forward swimming speed. Patterns emerged within these performance spaces when highlighting different parameter regions, which complemented the global sensitivity results. Lastly, an open source computational model for jellyfish locomotion is offered to the science community that can be used as a starting place for future numerical experimentation.
Physiological and behavioral responses to anthropogenic stressors in a human-tolerant mammal

As humans continue to alter natural habitats, many wild animals are facing novel suites of environmental stimuli. These changes, including increased human–wildlife interactions, may exert sublethal impacts on wildlife such as alterations in stress physiology and behavior. California ground squirrels (Otospermophilus beecheyi) occur in human-modified as well as more pristine environments, where they face a variety of anthropogenic and naturally occurring threats. This makes this species a valuable model for examining the effects of diverse challenges on the physiology and behavior of free-living mammals. To explore potential sublethal effects of habitat modification on O. beecheyi, we compared body masses, behaviors, and fecal glucocorticoid metabolite (FGM) levels for free-living squirrels in human-disturbed versus undisturbed habitats. Prior to these analyses, we validated the use of FGMs in this species by exposing captive O. beecheyi to pharmacological and handling challenges; both challenges produced significant increases in FGMs in the study animals. While FGM responses were repeatable within captive individuals, responses by free-living animals were more variable, perhaps reflecting a greater range of life-history traits and environmental conditions within natural populations of squirrels. Animals from our human-disturbed study site had significantly higher FGMs, significantly lower body masses, and were significantly less behaviorally reactive to humans than those from our more pristine study site. Thus, despite frequent exposure of California ground squirrels to human impacts, anthropogenic stressors appear to influence stress physiology and other phenotypic traits in this species. These findings suggest that even human-tolerant mammalian species may experience important sublethal consequences due to human modifications of natural habitats.
No Difference in Force Required for Intraprosthetic Dislocation of Mixed Manufacturer vs Same Manufacturer Dual Mobility Articulations.

Abstract Background To avoid the morbidity of removing well-fixed implants during revision surgery, the off-label practice of mixing femoral heads with dual mobility (DM) polyethylene liners from different manufacturers is commonly performed. The resistance to intraprosthetic dislocation, when the inner prosthetic head disengages from the polyethylene bearing, between mixed and same manufacturer constructs remains unknown. Methods Between January 2010 and July 2018, 168 DM liners were retrieved. Specimens were excluded for catastrophic wear (n = 14), previously levered-out (n = 17), and cases in legal proceedings (n = 8). Using a validated setup, 129 specimens were uniaxially loaded 100 mm from the femoral head until lever-out failure of the head from the liner. The difference in maximum lever-out force (LOF) was compared for same and mixed manufacturer retrievals (Student t-test). Multivariable regression analysis evaluated the influence of potential confounders (length of implantation, head size, head material, presence of skirt) on LOF. Results Ninety-seven same and 32 mixed manufacturer DM constructs were tested. The average LOF for same (272.6 ± 68.7 N) and mixed (299.2 ± 89.0 N) manufacturer specimens was not significantly different (P = .08). An inner head size of 22.2 mm was associated with 184.4-N increase in LOF (P Conclusion We found no difference in the force required to lever-out same and mixed manufacturer inner heads from DM liners, suggesting that mixing manufacturers when placing DM articulations on well-fixed femoral stems should not increase the risk of intraprosthetic instability.
The Mir-99b/Let-7e/Mir-125a cluster Is Associated with Platelet Count and Mean Platelet Volume and Regulates Megakaryocyte Proplatelet Formation

Platelet count (PC) and mean platelet volume (MPV) are critical measurements when considering the role of platelets in hemostasis and thrombosis, abnormalities in PC and MPV have been shown to be predictors of ischemic cardiovascular disease. Ischemic vascular disease has a known genetic component, and we and others have shown high heritability for both PC and MPV. Many inherited, and most immune, thrombocytopenias show an inverse relationship between PC and MPV, and such a relationship has also been reported in healthy subjects. Although genome-wide association studies have identified numerous single nucleotide variants in protein-coding genes associated with PC and MPV (Geiger Nat Genet 2011), non-coding genes have had rather little consideration. The goal of our studies was to identify microRNAs (miRs) regulating PC and MPV and to begin to understand the molecular mechanisms of this inverse platelet number-volume relationship. Initially, we queried our Platelet RNA and Expression-1 data set and observed that PC and MPV are inversely correlated in these 154 healthy subjects (r=-0.45, p=3.98E-09). We next determined which of the 734 platelet-expressed miRs were significantly (p To begin to address the potential functionality of this miR cluster, we overexpressed and knocked down their expression in megakaryocytes (MKs), since MK proplatelet formation (PPF) is a necessary step in the generation of peripheral blood platelets. We utilized human umbilical cord blood derived CD34-positive hematopoietic stem and progenitor cells differentiated along the MK lineage with thrombopoietin. Quantification of miR levels with qPCR demonstrated all 3 miRs in the cluster progressively increased from culture day 6 to day 9 to day 13 (the time during which MKs mature in culture). Compared to a scrambled control, when miR activity was knocked down with locked nucleic acids (LNAs), we observed a 61% reduction in PPF for miR-125a-5p (p Download : Download high-res image (1MB) Download : Download full-size image Disclosures No relevant conflicts of interest to declare.