cssi/SciSciGPT-SciSciNet huggingface dataset:
Aldosterone biosynthesis from 4-14C-pregnenolone and 4-14C-progesterone, in the rat and rabbit.

In vitro experiments using 4-14C-pregnenolone and 4-14C-progesterone were performed in order to study the pathways to aldosterone formation in adrenal glands from rats and rabbits. The adrenal steroids were isolated by paper chromatography and quantitated by the double isotope derivative assay method. In both the rat and the rabbit, there seemed to be no distinction between the roles of pregnenolone and progesterone as precursors of adrenal steroids. Corticosterone, 11-dehy-drocorticosterone, and 18-hydroxycorticosterone were possible precursors of aldosterone in the rabbit, whereas in the rat the precursors were corticosterone, 18-hydroxycorticosterone, and 18-hydroxy-11-deoxycorticosterone. The immediate precursor of aldosterone in both species was 18-hydroxycorticosterone.Introduction. The biosynthetic pathway to aldosterone4 has aroused considerable discussion in the past ten years since it was found to be the main mineralocorticoid in several species including man. Pregnenolone, progesterone, 11-deox...
Nonexpansive Mappings in Locally Convex Spaces

Recently Bruck initiated the study of the structure of the fixed-point set of a nonexpansive selfmap T of a Banach space, where T satisfies a conditional fixed point property. We generalize many of his results to a Hausdorff locally convex space X. Also, we generalize a result of Holmes and Narayanaswami and use it, along with a procedure of Kiang, to obtain a fixed point theorem for families of asymptotically nonexpansive mappings in X.
Endothelium-derived relaxing factor modulates renal interstitial cyclic GMP.

The arterial vasodilator activity of endothelium-derived relaxing factor (EDRF) is mediated by activation of the soluble form of guanylate cyclase, causing increased levels of guanosine-3',5'-cyclic monophosphate (cGMP). Because of its extreme lability, the actions of EDRF are local. The ability to monitor changes in renal interstitial fluid cGMP would be of great advantage in clarification of local mechanisms controlling renal function
Surveillance of disinfection quality in different levels of medical institutions in Lanzhou

OBJECTIVE To understand the current status of disinfection quality of difference scales of medical institutions in Lanzhou so as to provide guidance for control of nosocomial infections.METHODS By means of the on site investigation and sampling method,the medical institutions at different scales were monitored.RESULTS A total of 229 medical institutions at different scales were monitored,with 1884 samples involved,the average qualified rate was 89.54%;the qualified rate of the municipal hospitals or private hospitals was 100.00%,the community health service center 81.51%,the county-level hospital 86.41%,the village health center 84.38%,and the private clinic 61.11%.The qualified rate of the disinfection of indoor air was 85.04%,the medical staff's hands 95.31%,the object surfaces 95.19%,the disinfectants in use 100.00%,the sterile supplies 97.06%,and the ultraviolet lamp 80.18%.CONCLUSION There are some problems existing in the disinfection in medical institutions of Lanzhou,it is necessary to enhance the control of nosocomial infections and the disinfection management in grass-roots medical institutions.
Racial-ethnic disparities in the receipt of smoking interventions during prenatal care: analysis of the 2000-2001 Oregon Pregnancy Risk Assessment Monitoring Surveillance System (PRAMS ) data

Background: Maternal smoking during pregnancy has become the most preventable cause of fetal loss and preterm delivery in the United States. Prenatal care (PNC) providers are encouraged to treat tobacco dependency using an evidence-based clinician protocol called the Five A's (Ask, Advice, Assess, Assist, Arrange) which has been shown to increase quit rates by 30-70% among pregnant smokers. However, there is evidence that patients from racial/ethnic minority groups do not receive adequate health promotion counseling, including parts of the Five A's, during PNC as compared to patients from the majority white population. Objective: To determine racial/ethnic disparities in the reported receipt of smoking counseling during prenatal care among pregnant smokers. Methods: This was a cross-sectional analysis of self-reported data from the 2000-2001 Oregon Pregnancy Risk Assessment Monitoring Surveillance System. The PRAMS collects information about whether women received three of the Five A's (Ask, Advice, Assist; Three A's). The unweighted response rate was 72.6% (N= 3,895). Weighted logistic regression models were constructed that included the maternal race/ethnicity variable in each case. Results: There were 594 women who reported smoking during the first trimester of pregnancy. 42.2% of the pregnant smokers reported receiving the Three A's. Over 84% of women reported having been asked about smoking and received advice to quit, but only 53% were offered any assistance to quit. Smoking counseling was not offered uniformly across racial groups. Despite having the highest smoking prevalence, non-Hispanic American Indian/Alaska Natives (AI/AN) were 0.45 times as likely (95% CI: 0.24, 0.85) as non-Hispanic Whites to recall having received the Three A's (in a
Title III of the Jobs Act: Congress Invites Investor Abuse and Leaves the Sec Holding the Bag

In an effort to increase the availability of small business start-up capital, Congress recently created a new type of exempt offering under the Securities Act of 1933, colloquially referred to as “Crowdfunding.” Touting this new equity scheme as a rational modernization of capital formation, both Congress and the Securities and Exchange Commission (SEC) have characterized the new law as striking a fair balance between investor protection and the capital formation requirements of small business entities. However, using a detailed analysis of historical statutory precedent, this paper reveals a strong bias that favors exempt issuers of securities at the expense of investor protections. Through a combination of apparent oversight, ambitious regulatory implementation, and a failure to fully comprehend the nature of modern communications, this new exemption makes wide room for the most vulnerable class of investors to participate in some of the riskiest business ventures imaginable. However, the research also demonstrates that, with very modest changes, this new scheme could easily achieve a balance between the capital needs of small businesses and the protection of investors that more closely aligns with the original intention of the Securities Act.
Commentary: Will Banks Go the Way of Newspapers? Is There a Survival Strategy?

1. John Henry Clippinger 1. is a research scientist at the MIT Media Lab and co-founder and executive director/CEO of ID3 in Boston, MA. (clipman{at}mit.edu) 1. To order reprints of this article, please contact Dewey Palmieri at dpalmieri{at}iijournals.com or 212-224-3675. Just
Prison, Coerced Demand, and the Importance of Incarcerated Bodies in Late Capitalism

Research has done a fine job in noting the utility of mass incarceration for social control and the creation of quiescence, especially in the face of economic precariousness and growing wealth ineq...
Loss of AKAP150 promotes pathological remodelling and heart failure propensity by disrupting calcium cycling and contractile reserve.

Aims Impaired Ca2 + cycling and myocyte contractility are a hallmark of heart failure triggered by pathological stress such as hemodynamic overload. The A-Kinase anchoring protein AKAP150 has been shown to coordinate key aspects of adrenergic regulation of Ca2+ cycling and excitation–contraction in cardiomyocytes. However, the role of the AKAP150 signalling complexes in the pathogenesis of heart failure has not been investigated. Methods and results Here we examined how AKAP150 signalling complexes impact Ca2+ cycling, myocyte contractility, and heart failure susceptibility following pathological stress. We detected a significant reduction of AKAP150 expression in the failing mouse heart induced by pressure overload. Importantly, cardiac-specific AKAP150 knockout mice were predisposed to develop dilated cardiomyopathy with severe cardiac dysfunction and fibrosis after pressure overload. Loss of AKAP150 also promoted pathological remodelling and heart failure progression following myocardial infarction. However, ablation of AKAP150 did not affect calcineurin-nuclear factor of activated T cells signalling in cardiomyocytes or pressure overload- or agonist-induced cardiac hypertrophy. Immunoprecipitation studies showed that AKAP150 was associated with SERCA2, phospholamban, and ryanodine receptor-2, providing a targeted control of sarcoplasmic reticulum Ca2+ regulatory proteins. Mechanistically, loss of AKAP150 led to impaired Ca2+ cycling and reduced myocyte contractility reserve following adrenergic stimulation or pressure overload. Conclusions These findings define a critical role for AKAP150 in regulating Ca2+ cycling and myocardial ionotropy following pathological stress, suggesting the AKAP150 signalling pathway may serve as a novel therapeutic target for heart failure.
Higher Intakes of Vegetables, Vitamin E, Manganese and Zinc Are Associated with a Lower Risk of Non-Hodgkin Lymphoma (NHL): Results from a Case-Control Study

Abstract Background : Reactive oxygen species cause DNA damage and altered immunologic responses, and have been linked to the development of NHL. Diets rich in fruits and vegetables are excellent sources of antioxidants, and vitamins C, E, polyphenols, and carotenoids, along with selected micronutrients such as zinc are thought to be responsible for most of the antioxidant activity in foods. We evaluated the hypothesis that vegetables, fruits and nutrients involved in antioxidant activity would protect against developing NHL. In a secondary analysis, we also assessed heterogeneity of this hypothesis for the most common subtypes of NHL: chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), follicular lymphoma, and diffuse large B cell lymphoma (DLBCL). Methods : We evaluated dietary antioxidant intake and NHL risk in a clinic-based study of 416 newly diagnosed NHL cases and 926 frequency-matched controls enrolled at the Mayo Clinic from 2002–2007. Usual diet two years before diagnosis/enrollment was assessed using a self-administered, 128-item food frequency questionnaire. Dietary intake of antioxidants was estimated using the Food Processor SQL system, further supplemented with data from US Department of Agriculture nutrient databases. Unconditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CI), adjusted for age, sex, residence, and total energy. NHL subtypes were centrally reviewed, and subtype-specific risks were estimated using polychotomous logistic regression. Results : The mean age at diagnosis was 60.8 years for cases and 57% were male; for controls, the mean age at enrollment was 60.8 years and 54% were men. NHL risk was inversely associated with intake of total vegetables (OR for highest compared to lowest quartile, 0.46; 95% CI 0.32–0.68; p-trend Conclusion : Higher intakes of vegetables, particularly green leafy vegetables, vitamin E, manganese, and zinc were associated with lower risk of NHL. These finding extend a growing literature from case-control and cohort studies that support a protective role of foods and nutrients that function in antioxidant related pathways against development of NHL, and therefore may represent one of the few known modifiable risk factors for this cancer.
Comparative outcomes of minimally invasive and robotic-assisted esophagectomy.

167Background: Minimally invasive esophagectomy(MIE) has demonstrated superior outcomes compared to open approaches. The myriad of techniques has precluded the recommendation of a standard approach. The addition of robotics has potential to further improve outcomes. We sought to compare the outcomes of existing techniques for MIE with robotic assisted approaches. Methods: Utilizing a prospective esophagectomy database we identified patients who underwent (MIE) via Ivor Lewis(TT), transhiatal(TH) or robotic assisted Ivor Lewis(RAIL) techniques. Patient demographics, tumor characteristics and complications were analyzed via ANOVA, Chi-Square, and Fisher Exact where appropriate. Results: We identified 302 patients who underwent MIE: TT 95(31.5%), TH 63(20.8%), and RAIL 144(47.7%) with a mean age of 65±9.6. The length of operation was longer in the RAIL: TT(299±87), TH(231±65), RAIL(409±104 minutes), p < 0.001. However the EBL was lower in the RAIL patients: TT(189±188ml), TH(242±380ml), RAIL(155±107ml), p = ...
Selective Feeding of Soybean Looper (Lepidoptera: Noctuidae) on Meridic Diet with Different Concentrations of the Bacillus thuringiensis Cry1Ac Protein

The ability of soybean loopers, Pseudoplusia includens, (Walker), to selectively feed on meridic diet with different concentrations of Cry1Ac was investigated in a choice assay. Neonates selected n...
A transverse local feedback linearization approach to human head movement control

In the mid-nineteenth century, Donders had proposed that for every human head rotating away from the primary pointing direction, the rotational vectors in the direction of the corresponding axes of rotation, is restricted to lie on a surface. Donders’ intuition was that under such a restriction, the head orientation would be a function of its pointing direction. In this paper, we revisit Donders’ Law and show that indeed the proposed intuition is true for a restricted class of head-orientations satisfying a class of quadratic Donders’ surfaces, if the head points to a suitable neighborhood of the frontal pointing direction. Moreover, on a suitably chosen subspace of the 3D rotation group SO(3), we describe a head movement dynamical system with input control signals that are the three external torques on the head provided by muscles. Three output signals are also suitably chosen as follows. Two of the output signals are coordinates of the frontal pointing direction. The third signal measures deviation of the state vector from the Donders’ surface. We claim that the square system is locally feedback linearizable on the subspace chosen, and the linear dynamics is decomposed into parts, transverse and tangential to the Donders’ surface. We demonstrate our approach by synthesizing a tracking and path-following controller. Additionally, for different choices of the Donders’ surface parameters, head gaits are visualized by simulating different movement patterns of the head-top vector, as the head-pointing vector rotates around a circle.
Folate treatment partially reverses gestational low-protein diet-induced glucose intolerance and the magnitude of reversal is age and sex dependent.

Abstract Objectives Gestational low-protein (LP) programming causes glucose intolerance (GI) and insulin resistance (IR) in adult offspring. Folate supplementation has been shown to rescue the offspring from various programming effects. The aim of this study was to investigate whether folate supplementation during pregnancy reverses LP-induced GI and IR. Methods Pregnant rats were fed control (20% protein), isocaloric low-protein (LP, 6%) or LP with 5 mg/kg folate (LPF) diets from gestational day 4 to delivery. The control diet was given during lactation and to pups after weaning. Glucose tolerance test was done at 1, 2, and 3 mo of age followed by euglycemic-hyperinsulinemic clamp at 4 mo. Rats were sacrificed at 4 mo and their gonadal, renal, inguinal, brown fat, and pancreas were weighed and expressed relative to their body weight. Results LP- and LPF-fed dams showed similar weight loss during late pregnancy after decreased feed intake. Both LP and LPF pups were smaller at birth but their weights caught up like that of controls by 3 mo. In males, folate supplementation reduced LP-induced GI at 2 mo (glucose area under the curve [AUC]: 1940 mmol/L × 180 min in LP, 1629 mmol/L × 180 min in LPF, and 1653 mmol/L × 180 min in controls; P Conclusions Folate treatment partially reverses LP-induced GI and the magnitude of reversal is age and sex dependent. Furthermore, folate treatment does not reverse IR in either sex but makes it worse in males at 4 mo. The present study demonstrated that folate treatment is not sufficient to rescue the LP programming effects.
Structural preferences in strong anion–π and halogen-bonded complexes: π- and σ-holes vs. frontier orbitals interaction

X-ray crystallographic and computational analyses of supramolecular associates between the tetracyanopyrazine π-acceptor and halide anions, as well as between brominated electrophiles and pseudohalides, show consistent deviations of the donor/acceptor contacts from the areas of most positive or negative potentials on the surfaces of the interacting species. The geometries of all these anion–π and halogen-bonded complexes suggest bonding overlap of the frontier orbitals of the reactants. In accordance with the experimental data, TD-DFT computations produced intense absorption bands in the UV-Vis spectra of the fully-optimized complexes. Also, their NBO analysis indicated substantial donor/acceptor charge transfer. In contrast, the intensities of the absorption bands and amount of charge transfer calculated for the hypothetical associates in which donor/acceptor contacts occurs at the most positive and negative surface potentials were much lower (if any). Overall, the anion–π and halogen-bonded complexes under study represent an example of supramolecular associates in which electrostatic and molecular-orbital models predict different donor/acceptor arrangements. Their analysis suggests a vital role of orbital interactions in a subtle balance of the intermolecular forces that determine the structural features of these complexes.
Planning Energy Storage and Photovoltaic Panels for Demand Response With Heating Ventilation and Air Conditioning Systems

The objective of this engineering problem is to determine the size of a battery energy storage system and number of photovoltaic (PV) panels to be installed in a building with Heating Ventilation and Air Conditioning systems (HVACs) as the main load. The building is connected to the power grid where electricity price is varying at different hours. This engineering problem is formulated as an optimization problem with a goal to achieve minimum installation cost and operation cost while satisfying room temperature requirements. Stochastic PV outputs are taken into consideration as well. The mathematical problem formulated is a large-scale mixed integer linear programming (MILP) problem. To improve the solving speed, two Benders decomposition strategies are applied to solve this stochastic MILP problem. The optimization problem will lead to the battery energy capacity, power limit, number of PV to be installed, as well as the on / off status of HVACs over 8 h. The contribution of this paper is the implementation of Benders decomposition methods to reduce the computation complexity. Parallel computing structure and maximum feasible subsystem cut generation strategy have been exploited and implemented in this research.
Contrasting the Antarctic and Arctic Atmospheric Responses to Projected Sea Ice Loss in the Late Twenty-First Century

AbstractModels project that Antarctic sea ice area will decline considerably by the end of this century, but the consequences remain largely unexplored. Here, the atmospheric response to future sea...
Trade-induced displacements and local labor market adjustments in the U.S.

Abstract Administrative data from the U.S. Trade Adjustment Assistance (TAA) program reveal that, across locations, one extra TAA trade-displaced worker is associated with the overall employment falling by about two workers amidst muted geographic mobility. This correlation is robust to local import penetration proxies and is corroborated using differences in the exposure of commuting zones to the plausibly exogenous normalization of U.S. trade relations with China in 2000. A Ricardian trade model with endogenous variable markups arising from head-to-head foreign competition can rationalize such a correlation. Following a trade liberalization shock, employment and earnings collapse in the less productive locations since they endogenously exhibit both higher trade-induced job losses and lower job creation, as in the data. When migration is muted in response to the trade shock, inequality increases across locations and induces transitional transfers towards decaying locations, even as employment and welfare rise in the aggregate.
Tobacco and cannabis use in college students are predicted by sex-dimorphic interactions between MAOA genotype and child abuse.

BACKGROUND Postsecondary students in Western countries exhibit a high prevalence of cannabis and tobacco use disorders. The etiology of these problems is contributed by several psychosocial factors, including childhood adversity and trauma; however, the mechanisms whereby these environmental determinants predispose to the use of these substances remain elusive, due to our poor knowledge of genetic and biological moderators. Converging evidence points to the monoamine oxidase A (MAOA) gene as a moderator of the effects of lifetime stress on the initiation of substance use. AIMS Building on these premises, in this study, we analyzed whether MAOA upstream variable number tandem repeat (uVNTR) alleles interact with child maltreatment history to predict for lifetime cannabis and tobacco consumption. MATERIALS AND METHODS Five hundred college students (age: 18-25 years) from a large Midwestern University were surveyed for their child maltreatment history (encompassing emotional, physical, and sexual abuse, as well as emotional and physical neglect) and lifetime consumption of cannabis and tobacco. Saliva samples were obtained to determine the MAOA uVNTR genotype of each participant. RESULTS In female students, lifetime tobacco and cannabis use was predicted by the interaction of physical and emotional abuse with high-activity MAOA allelic variants; conversely, in males, the interaction of low-activity MAOA alleles and physical abuse was associated with lifetime use of tobacco, but not cannabis. DISCUSSION These findings collectively suggest that the vulnerability to smoke tobacco and cannabis is predicted by sex-dimorphic interactions of MAOA gene with childhood abuse. CONCLUSION These biosocial underpinnings of tobacco and cannabis use may prove important in the development of novel personalized preventive strategies for substance use disorders in adolescents.
Atrial delayed enhancement is associated with the severity of diastolic dysfunction in cardiac amyloidosis

Interstitial deposition of amyloid fibrils in the heart causes thickening of atrial and ventricular walls. Although the presence of abnormal late gadolinium enhancement (LGE) in ventricular myocardium is well described, the significance of atrial LGE is less clear. The aim of this study is to describe the prevalence of atrial LGE in cardiac amyloidosis and to investigate potential associations with disease severity. Methods We retrospectively reviewed consecutive patients referred for CMR due to clinically suspected cardiac amyloidosis. The final diagnosis of cardiac amyloidosis was established in the presence of a positive cardiac biopsy and/or a typical pattern of diffuse, predominantly subendocardial left ventricular (LV) LGE. Clinical data (including EKG, pulmonary capillary wedge pressure from cardiac catheterization and brain natriuretic peptide [BNP] serum levels) and subsequent events (death or hospitalization) were recorded. Indexed LV and right ventricular (RV) volumes and ejection fractions, LV mass, LV basal anteroseptal and inferolateral enddiastolic wall thicknesses, and left atrial dimensions were determined from standard cine CMR images. In cardiac amyloid patients, the septal E/E’ ratio, as an index of LV filling pressures, and diastolic function were determined from Doppler echocardiography. Diastolic function was classified as grades 0 (normal), I (impaired relaxation pattern), II (pseudonormal pattern), and III (restrictive pattern). Results We included 125 patients (85 males [68%], age 63±13 years) referred for CMR (59 (47%) at 1.5, 66 (53%) at 3.0 Tesla), of which 51 (40.8%) were diagnosed of cardiac amyloidosis. The prevalence of atrial LGE was markedly higher in those with a diagnosis of cardiac amyloid (86.3% vs 13.5%, p<0.001). Including all 125 patients, atrial LGE was independently associated with the diagnosis of cardiac amyloid in a multivariate analysis including all CMR variables (odds ratio [OR] =26.9, 95% confidence intervals 8.1-88.7, p<0.001). In the group of patients with cardiac amyloidosis, the presence of atrial LGE was associated with age (68 ± 12
Convergence and Stability

Let χ and у be formed spaces and let {T n } be a В[χ, у]-valued sequence (i.e., a sequence of transformations in В [χ, у]). If {T n } converges in the formed space B[χ, у];that is, if there exists T in B [χ, у] such that $$\left\| {{T_n} - T} \right\| \to 0,$$ then we say that {T n } converges uniformly to T. This (unique) T ∈ B[χ, у] is called the uniform limit of {T n }. Notation: \({T_n}\xrightarrow{u}T\). If {T n } does not converge uniformly to T, then we write \({T_n}\mathop {\not \to }\limits^u T\). The у -valued sequence {T n х} converges in у for every x in χ if and only if there exists a (unique) linear transformation T of χ into у such that $$\left\| {({T_n} - T)x} \right\| \to 0 for every x \in \chi .$$
NGOs and international development: A review of thirty-five years of scholarship

Abstract Since 1980, the number of non-governmental organizations (NGOs) in developing countries has exploded. Published research on NGOs has paralleled this growth, yet there exists scant synthesis of the literature. This article presents a synthesis, while also introducing a collaborative research platform, the NGO Knowledge Collective. We ask four questions: first, who studies NGOs, and how do they study them? Second, what issues, sectors and places are studied when NGOs are the focus? Third, what effect do NGO activities have on specific development outcomes? And fourth, what path should the NGO research agenda take? To answer these questions, we conduct a mixed-method systematic review of social science publications on NGOs, which includes computer-assisted content analysis of 3336 English-language journal articles (1980–2014), alongside a close, qualitative analysis of 300 randomly selected articles. We find, first, that interdisciplinary journals dominate NGO publishing, that research on NGOs is more qualitative than quantitative, and that practitioners publish, but Northern academics create most published knowledge. Second, we find the literature is framed around six overarching questions regarding: the nature of NGOs; their emergence and development; how they conduct their work; their impacts; how they relate to other actors; and how they contribute to the (re)production of cultural dynamics. Articles also focus disproportionately on the most populated and/or politically salient countries, and on the governance and health sectors. Third, we find that scholars generally report favorable effects of NGOs on health and governance outcomes. Fourth, we propose a research agenda calling for scholars to: address neglected sectors, geographies, and contextual conditions; increase author representativeness; improve research designs to include counterfactuals or comparison groups; and better share data and findings, including results from additional, focused NGO-related systematic reviews. Implementing this agenda will help reduce bias in decisions by donors, governments, and other development actors, which should improve development outcomes.
Glutaraldehyde inhibits biological treatment of organic additives in hydraulic fracturing produced water.

Abstract Water generated by hydraulic fracturing for the production of oil and gas, commonly termed ‘produced water’, may contain residual organic compounds from the fracturing process or the subsurface formation. Biological treatment is a potential technology to remove residual organic compounds in produced water. Biocides are often added to both fracturing fluids and produced water to limit undesirable microbiological activity, and glutaraldehyde is the most commonly used biocide in hydraulic fracturing. Residual biocides in produced water can limit biological treatment efficiency. We evaluated the effect of glutaraldehyde on the biodegradation of five of the most commonly reported organic compounds in hydraulic fracturing fluids in an engineered biofilm treatment. Our results demonstrated that glutaraldehyde delays biological organic compound removal by introducing a biodegradation lag phase. In addition, the effects of glutaraldehyde were more pronounced for more rapidly degraded compounds. Finally, the presence of glutaraldehyde did not decrease microbial abundance nor drive microbial community structure, suggesting that observed effects were due to altered microbial activity. These results highlight the necessity to consider co-contaminant interactions during treatment of complex waste streams where residual biocide may be present.
The Quest for Precision Medicine: Unmeasured Patient Factors and Mortality After Congenital Heart Surgery

Background Emerging data across many fields suggest that unique patient characteristics can impact disease manifestation and response to therapy, supporting “precision medicine” approaches and more individualized and targeted therapeutic strategies. In children undergoing congenital heart surgery, current risk models primarily focus on the population level, and their utility in understanding precise characteristics that place individual patients at risk for poor outcome remains unclear. Methods We analyzed index surgeries in the Pediatric Cardiac Critical Care Consortium (PC4) registry (August 2014 to May 2016) and utilized a previously constructed model containing patient factors typically included in in-hospital mortality risk models (age, weight, prematurity, chromosomal anomalies/syndromes, preoperative factors, The Society of Thoracic Surgeons–European Association for Cardio-Thoracic Surgery score). Partitioned variances based on a hierarchical generalized linear model were used to estimate the proportion of variation in mortality explained by these factors. Results A total of 8406 operations (22 hospitals) were included. We found that only 30% of the total between-patient variation in mortality in our cohort was explained by the patient factors included in our model. Age, The Society of Thoracic Surgeons–European Association for Cardio-Thoracic Surgery score, and preoperative mechanical ventilation explained the greatest proportion of variation. Of the variation that remained unexplained, 95% was attributable to unmeasured patient factors. In stratified analyses, these results were consistent across patient subgroups. Conclusions Patient factors typically included in congenital heart surgery risk models explain only a small portion of total variation in mortality. A better understanding of other underrecognized factors is critical in further defining risk profiles and in developing more individualized and tailored therapeutic strategies.
Risk factors for Cesarean delivery in pregnancy with small-for-gestational-age fetus undergoing induction of labor.

Objectives To identify risk factors for Cesarean delivery and non-reassuring fetal heart tracing (NRFHT) in pregnancies with a small-for-gestational-age (SGA) fetus undergoing induction of labor and to design and validate a prediction model, combining antenatal and intrapartum variables known at the time of labor induction, to identify pregnancies at increased risk of Cesarean delivery. Methods This was a retrospective cohort study of non-anomalous, singleton gestations with a SGA fetus that underwent induction of labor, delivered in a single tertiary referral center between January 2011 and December 2016. SGA was defined as estimated fetal weight (EFW) Results A total of 594 pregnancies were included. Cesarean delivery was performed in 243 (40.9%) pregnancies. Significant risk factors associated with Cesarean delivery, and included in the final model, were maternal age, gestational age at delivery and initial method of labor induction. The bootstrap estimate of the AUC of the final prediction model for Cesarean delivery was 0.82 (95% CI, 0.78-0.86). The model had sensitivity of 64.2%, specificity of 86.9%, positive likelihood ratio (LR) of 4.9 and negative LR of 0.41. The model had good fit (P = 0.617). NRFHT complicated 117 (19.7%) pregnancies. Significant risk factors for NRFHT included EFW 95th percentile or absent/reversed end-diastolic flow) and gestational age at delivery. The final prediction model for NRFHT had an AUC of 0.69 (95% CI, 0.63-0.75) and specificity of 97.0%. Conclusion We identified several significant risk factors for Cesarean delivery and NRFHT among SGA pregnancies undergoing induction of labor. Clinicians may use these risk factors to guide patient counseling and to help anticipate the potential need for operative delivery. Copyright © 2019 ISUOG. Published by John Wiley & Sons Ltd.
Automated Ultrasound Doppler Angle Estimation Using Deep Learning

Angle estimation is an important step in the Doppler ultrasound clinical workflow to measure blood velocity. It is widely recognized that incorrect angle estimation is a leading cause of error in Doppler-based blood velocity measurements. In this paper, we propose a deep learning-based approach for automated Doppler angle estimation. The approach was developed using 2100 human carotid ultrasound images including image augmentation. Five pre-trained models were used to extract images features, and these features were passed to a custom shallow network for Doppler angle estimation. Independently, measurements were obtained by a human observer reviewing the images for comparison. The mean absolute error (MAE) between the automated and manual angle estimates ranged from 3.9° to 9.4° for the models evaluated. Furthermore, the MAE for the best performing model was less than the acceptable clinical Doppler angle error threshold thus avoiding misclassification of normal velocity values as a stenosis. The results demonstrate potential for applying a deep-learning based technique for automated ultrasound Doppler angle estimation. Such a technique could potentially be implemented within the imaging software on commercial ultrasound scanners.
Notions of Succinctness

Here we consider what it means for one programming system to be more succinct than another. This chapter introduces the various forms of relative succinctness examined in later chapters and establishes some basic facts about these notions.
Optimality of Double Intervals in Persuasion: A Convex Programming Framework

We study information design problems, where the payoff of the information designer is an increasing step function of the posterior mean of the state her signals induce. Settings where the designer employs public signaling mechanisms to persuade multiple receivers (who have (i) finitely many actions that exhibit strategic complementarities, and (ii) best responses that are increasing in the state), and where her payoff is increasing in the receivers’ actions, are special cases. We provide a novel and tractable convex optimization framework for obtaining an optimal signaling mechanism. This mechanism is deterministic and admits a double-interval structure: it pools some “good” and “bad” states, and with each signal realization it associates at most two subintervals of the set of states. Our framework is broadly applicable, and we illustrate this through two very different applications. In the first application, we focus on receivers in a network who take binary actions (that can represent, e.g., adoption of a product of unknown quality), and characterize the optimal mechanism in terms of the network’s cores. Interestingly, as a consequence of the double-interval structure, the set of states for which a receiver takes action 1 is in general nonconvex. We show that in large random networks the designer can obtain asymptotically optimal mechanisms even in the absence of detailed network information, by using only the degree distribution. In our second application, we focus on persuading a single receiver whose type is private. Using a slight modification of our framework, we establish that the optimal mechanism is based on a laminar interval structure – a generalization of the double-interval structure – where the number of subintervals associated with each signal realization increases with the number of types.
Interval-Based Dynamic Discretization Discovery for Solving the Continuous-Time Service Network Design Problem

We introduce an effective and efficient iterative algorithm for solving the continuous-time service network design problem. The algorithm achieves its efficiency by carefully and dynamically refini...
Depression and family arguments: disentangling reciprocal effects for women and men.

Background Depression is a debilitating condition that affects the individual and the family. Objective This study sought to identify potential reciprocal influences between family arguments and depressive symptoms among clinically depressed patients over a 23-year span. Methods The present study employed a longitudinal, observational design with 424 depressed patients. Separate cross-lagged path models examined longitudinal associations for women and men over 23 years while adjusting for age, income, and marital and parental status. Results Among depressed men, more severe baseline depressive symptoms predicted more family arguments 10 years later. Among depressed women, more severe baseline depressive symptoms predicted fewer family arguments 1 year later, while more severe depressive symptoms at 10-year follow-up predicted more family arguments at 23-year follow-up. More family arguments predicted more severe depressive symptoms among women and men, with some variation in the time intervals of these associations. Conclusion These findings suggest that while depressive symptoms may temporarily diminish family arguments among women, such symptoms were associated with more family arguments over longer time intervals. Moreover, family arguments put depressed men and women at risk for more severe depressive symptoms. These results support the use of screening for family arguments and interventions to help depressed individuals develop skills to manage interpersonal conflict.
Control analysis of parallel DC-DC converters in a DC microgrid with constant power loads

Abstract This paper proposes a general methodology for designing hierarchical control schemes for DC microgrids loaded by constant power loads. This paper addresses issues when interfacing sources with a wide voltage range allowing for any general choice for a power source. The control strategy consists of two levels. The lower level consists of droop-based primary controllers. This controller enables current-sharing among paralleled sources and also damps limit cycle oscillations due to constant power loads. The higher level is a secondary controller which compensates for voltage deviations due to primary controller and performs voltage control of the microgrid. It also maintains the current sharing obtained in the primary stage. In the proposed secondary control, high-speed communication links to the primary controllers is implemented. The stability conditions are explained using the equivalent circuit of converters. Using this approach, stability conditions can be derived for microgrids of an arbitrary size and converter topology. The proposed control scheme is shown to be scalable and robust. The results obtained for the three basic DC-DC converter configurations are compared based on a microgrid with a parallel configuration of buck-boost converters. Simulations and experimental results are presented to verify the validity of the proposed control schemes.
Thulium fiber laser utilization in urological surgery: A narrative review

The thulium fiber laser (TFL) is a novel technology under active investigation as an conceivable alternative to the Holmium:yttrium-aluminum-garnet (Ho:YAG) laser, which is currently the gold standard for an array of urologic procedures. The purpose of this review is to discuss the existing literature on the functionality and effectiveness of TFL in urological practice. We conducted a search of the PubMed, Medline, Web of Science Core Collection, SCOPUS, Embase (OVID), and Cochrane Databases for all full articles and systematic reviews on the TFL. We found a total of 35 relevant pieces of literature. The early research findings pertaining to the TFL exhibit numerous potential advantages over the Ho:YAG laser. In vitro and ex vivo studies have highlighted the TFL's ability to utilize smaller laser fibers, obtain faster stone ablation rates, and achieve less retropulsion when tested against the Ho:YAG laser in lithotripsy. Currently, there is limited in vivo research that investigates the utilization of the TFL. The in vivo results that are available, however, look promising both for laser lithotripsy and soft tissue ablation. Indeed, the existing literature suggests that the TFL has great potential and may possess numerous technological advantages over the Ho:YAG laser, especially in laser lithotripsy. Although these early studies are promising, randomized control trials are needed to assess the full applicability of the TFL in urology.
Adsorption of textile industry effluent in a fixed bed column using activated carbon prepared from agro-waste materials

Abstract Activated carbon prepared from agro-waste material i.e. green coconut shell and bamboo using ZnCl2 as an activation agent in an adsorption column (fixed bed) was studied for the treatment of textile industry effluent. The experiment with the fixed-bed column was performed by different process parameters such as 200, 400 and 600 mg/L as different initial concentration of dye, at different bed heights of 100 mm, 200 mm, and 300 mm, and 10, 15, and 20 mL/min as different flow rates. The findings demonstrated that both breakthrough and exhaust times increase, with the height of the bed being increased, but decrease with the concentration of the dye inlet. The breakthrough point was found to depend upon the bed height and flow rate. The maximum uptake capacity was obtained when a 200 mm bed depth was used at an inlet concentration of dye 200 mg/L with a flow rate of 15 mL/minute. It was observed that the bamboo activated carbon BAC has high carbon content, and has a high potential for dyes removal and may become capable substitutes for costly activated carbon. The adsorption capacities of BAC, GCSAC are at par with respect to each other, the overall process scheme may become economical as these materials are available as wastes and practically free of cost.
The alternative to despair is to build an ark

Between 1936 and 1938, H. G. Wells delivered a series of lectures first published under the title World Brain in 1938. The standard reading of that text over the past few decades has framed Wells as the utopian futurist projecting from microfilm, radio, and telephone a world encyclopedia freely available to all. Predicting, various authors have written, the World Wide Web or Wikipedia, World Brain naively imagined that such a facility would provide the global community with the knowledge base we would need to create world peace. After 5 years of research on propaganda and misinformation, Yochai Benkler reads World Brain very differently.
CHAPTER 40 – Hypophysitis

Publisher Summary Hypophysitis is an inflammation of the pituitary gland that originates directly within the pituitary, primary forms, or from neighboring or systemic diseases, secondary forms. Primary hypophysitis comprises three main histologic types granulomatous, xanthomatous, and lymphocytic. Autoimmune hypophysitis is rare but increasingly recognized. It offers a fascinating model to study the effect of pregnancy on autoimmune diseases and the interactions between nervous, endocrine, and immune systems. Furthermore, the main diagnostic issue with autoimmune hypophysitis is the differentiation between the rare autoimmune hypophysitis and the overwhelmingly more common pituitary tumors. The treatment of autoimmune hypophysitis is, at the moment, only symptomatic. It includes reduction of the pituitary mass and replacement of the defective hormones. Patient management can be improved when a reliable serologic test that identifies the autoimmune nature of the pituitary disease becomes available. Much remains to be learned about the natural history of autoimmune hypophysitis. Establishment of experimental models in mice and of a disease registry in humans can greatly advance the field.
Chapter 3.2 – Glucocorticoid effects on gene expression

Abstract: Glucocorticoids secreted from the adrenal glands have extremely diverse effects on many physiological functions. They exert most of their actions by changing the transcription rates of responsive genes through intracellular glucocorticoid receptor (GR). Glucocorticoid-bound GR interacts with specific DNA sequences called glucocorticoid response elements located in the promoter regions of many responsive genes, directly stimulating or suppressing their transcriptional activities. Glucocorticoid-bound GR also indirectly modulates the transcriptional activity of numerous transcription factors by associating with them via mutual protein–protein interactions. Though these mechanisms of transcriptional regulation, glucocorticoids exert their effects in different, distinct cells, tissues and organs, including the central nervous, metabolic, musculo-skeletal, connective tissue and cardiovascular systems.
Access Control and the Internet of Things

Where and how should access control be exercised over cyber-physical systems? Here, Vint Cerf deliberates a possible way to secure such systems.
Pharmacokinetics and Pharmacodynamics of Heparin During Hemodialysis: Interpatient and Intrapatient Variability

Heparin pharmacokinetics and pharmacodynamics were studied in 17 patients undergoing hemodialysis, once a week for 4 weeks in order to evaluate intrapatient variability over time. A single bolus injection of heparin was administered directly into the circulation immediately prior to the start of hemodialysis in doses ranging from 3000 to 12,000 U. Blood samples were obtained to determine activated coagulation times (ACT) and heparin concentrations (HC). Combined zero- and first-order elimination was seen in each of the 4 weeks. The half-life of heparin decreased from beginning to end of hemodialysis during each week, with the percentage of decrease from the start of dialysis ranging from 70-74%, indicating concentration-dependent elimination. Since the zero-order component did not appear to be clinically significant, first-order elimination was assumed. A linear decline in ACT over the time of the dialysis period was also seen during each week. A profile of ACT versus HC was generated for each patient as well as for the mean data to assess the relationship of HC to response. An excellent correlation was found for both individual patient data and mean data. In the third week the patients were randomized to receive standard treatment or an individualized dose. They were then crossed over to the opposite group in the fourth week to see if this relationship between ACT and HC would be useful in predicting heparin dose. These profiles were used to individualize the dose during either the third or fourth week of the study. No significant differences were noted between actual and predicted ACT. A significant degree of interpatient variability was demonstrated.(ABSTRACT TRUNCATED AT 250 WORDS)
The US road to 3G: an overview of telecom regulations, carrier strategies, and the consumer market

Building on the transition of the mobile Internet towards true 3G networks, US policy makers and network operators are experiencing a delayed 3G governing policy, incompatible wireless standards, and a lack of available 3G spectrum. However, the experience of the European and Asian regions with 3G implementation bears imperative lessons that the US can significantly benefit from. This article presents an overview of the 3G situation in the US.