cssi/SciSciGPT-SciSciNet huggingface dataset:
Minimum clinically important differences in the Cervical Spine Outcomes Questionnaire: results from a national multicenter study of patients treated with anterior cervical decompression and arthrodesis.

Background: The minimum clinically important difference is a clinically relevant threshold of improvement. A substantial clinical benefit is a threshold of change that correlates with clinically important improvement. The Cervical Spine Outcomes Questionnaire is a disease-specific, patient-reported outcomes instrument that was developed to be sensitive to changes associated with surgical treatment for degenerative cervical disc disease. To determine thresholds for change in these domain scores that are important from the patient's perspective, we estimated the minimum clinically important difference and substantial clinical benefit values for this questionnaire's domain scores. Methods: We evaluated 252 patients from the Cervical Spine Research Society Outcomes Study at their six-month follow-up visits after anterior cervical spine decompression and arthrodesis. Using a receiver operating characteristics curve, with the health transition item of the Short Form-36 as an anchor, we determined that the minimum clinically important difference (the value that maximized sensitivity and specificity to differentiate the “somewhat better” and “much better” responses from others) and the substantial clinical benefit (the value that maximized sensitivity and specificity to differentiate the “much better” response from others) for our questionnaire's domain scores. Responses were scaled between 0 and 1 point; higher scores denoted more severe impairment. Patient and clinical characteristics were tested to determine their influence on score changes. Results: The minimum clinically important difference ranged from 0.13 point (for functional disability) to 0.24 point (for arm/shoulder pain). The substantial clinical benefit score ranged from 0.20 point (for functional disability or physical symptoms other than pain) to 0.30 point (for neck or arm/shoulder pain). Age, sex, and duration of current symptoms were not associated with change in our questionnaire's domain scores. Conclusions: A 0.13-point change in the functional disability domain score indicated a clinically important difference in a self-reported outcome after anterior cervical spine surgery. A 0.30-point change in neck pain after surgery indicated a clinically important clinical benefit. This information, coupled with previous reports of the psychometric stability of the Cervical Spine Outcomes Questionnaire, should increase the clinical utility of this patient-reported outcomes instrument.
Design of a permanent magnet motor with wide temperature range

We present the design of a permanent magnet synchronous motor (PMSM) for wide temperature range applications. The designed motor will operate within a temperature range of −60 °C up to 300 °C, have an output power of 12 kW at 12 krpm rotating speed, and maintain an efficiency greater than 90%. The design calls for good performance over a speed range of 8 krpm to 16 krpm. The stator material in the current design is Hiperco50 and the permanent magnet (PM) material is Samarium Cobalt (SmCo). Special wire insulation is applied to the stator windings. Previously, magneto motive force (MMF) was simply calculated by multiplying the total magnetic field intensity of the air gap by the length of the air gap. This method is not accurate if the designed air gap is large, such as in a PMSM design. In this paper, we have analyzed the mathematical model of the air gap and describe the MMF by an expression in terms of a logarithm function. We have analyzed the effects of temperature variations on the residual flux density, copper loss, core loss, and windage loss, etc.
Effects of Solvent and Enzyme Source on Transesterification Activity

In this paper, the effect of choice of organic solvent on activity of lipase from three sources, namely Candida antarctica, Pseudomonas cepacia, and Thermomyces lanuginosus is examined. In particular, fifteen hydrophobic and hydrophilic solvents from four organic groups are investigated in the methanolysis of waste soybean oil. The yield of biodiesel (fatty acid methyl ester) is correlated with log P (partition coefficient) of the solvent. The results indicate that the choice of solvent can have a huge effect on both the yield, with values ranging from 2.7 to 87%, with the time to attain equilibrium ranging from 4 h to >24 h. Solvents from the alkane group gave the highest biodiesel yields for all three enzymes, with isooctane and n-hexane being the best performers.
Association between C-reactive protein and suicidal behavior in an adult inpatient population

Abstract Objectives To examine the relationship of inflammation and suicidal behavior in hospitalized adult psychiatric patients. Method We retrospectively examined serum high sensitivity C-reactive protein (hsCRP) levels in inpatients at a tertiary-level university hospital (N = 184). The inpatients comprised three cohorts: 1) patients admitted following a suicide attempt, 2) patients with suicidal ideation, and 3) inpatient psychiatric controls. Additionally, we gathered demographic data, clinical data, smoking status, white blood cell count, and fasting lipid panel. Results As CRP level increased, the probability of patients belonging to the suicide attempt group increased as compared to both the probabilities of being in inpatient psychiatric control and or suicide ideation groups [OR = 2.09, CI = (1.29, 3.38) and OR = 1.75, CI = (1.15, 2.66) respectively]. We also observed a significant effect of depression in that depressed patients were more likely to have a suicide attempt when compared to patients with no depression or with mania [OR = 10.38, CI = (1.97, 54.70)]. Conclusions There seems to be an inflammation gradient, measured by CRP levels, from recent suicide attempters, suicidal ideators and psychiatric controls. We replicated the association between a pro-inflammatory state and suicidal behavior in a sample of “real world” severely ill psychiatric inpatients.
Ballistic Missile Threat Assessment Based on AHP-Entropy Mode

Traditional methods of threat assessment only provide qualitative assessment and the results lack sufficient reliability.Therefore a method of quantitative assessment and decision model are proposed.This method builds an analytic hierarchy process(AHP)entropy mode by combining AHP and entropy technology.Weights of indices are defined by using AHP and are revised with entropy technology to generate the threat sequences.The sequences are proved more reliable by testing,thus it may be useful in antimissile battles.
Correlation Study of Estrogen Receptor and IL-10 in Osteoblasts of Skull in Osteoporosis Rats

Objective To observe the correlation of estrogen receptor in osteoblasts and IL-10 expression of skull in osteoporosis rats.Methods 40 SD rats were randomly divided into control group(n=20)and ovariectomized group(n=20,5 weeks 10 rats,7 weeks 10 rats).The bone mineral density was measured by ray absorptiometry,IL-10 expression in the skull were detected by immunohistochemical staining of SABC method and the image analysis techniques;The rat osteoblasts were purified by two-step enzymatic digestion method and successive adherence method.The osteoblasts were observed by calcium alkaline phosphatase cobalt method(ALP)and collagen type Ⅰ immunohistochemical staining method.The estrogen receptors of osteoplasts in SD rats were identified by semi-quantitative western blot.Results The ovariectomized group showed less bone mineral density(P0.01);The IL-10 positive osteoblasts in the trabecula of ovariectomized group was less than that of control group(P0.01),and their staining was lighter than control group;the observable results by ALP and collagen type Ⅰ immunohistochemical method corresponded to the morphology of osteoblast features.The estrogen receptor expression of ovariectomized group was significantly lower than that of control group,that of the 7th week was significantly lower than the 5th week in the ovariectomized group(P0.01).Conclusion Estrogen receptor expression is positively correlated with the expression level of IL-10 in the osteoblasts.
Synthesis, Structure, and Reactivity of the Ethyl Yttrium Metallocene, (C5Me5)2Y(CH2CH3), Including Activation of Methane

(C5Me5)2Y(μ-Ph)2BPh2, 1, reacted with ethyllithium at −15 °C to make (C5Me5)2Y(CH2CH3), 2, which is thermally unstable at room temperature and formed the C–H bond activation product, (C5Me5)2Y(μ-H)(μ-η1:η5-CH2C5Me4)Y(C5Me5), 3, containing a metalated (C5Me5)1– ligand. Spectroscopic evidence for 2 was obtained at low temperature, and trapping experiments with iPrNCNiPr and CO2 gave the Y–CH2CH3 insertion products, (C5Me5)2Y[iPrNC(Et)NiPr-κ2N,N′], 4, and [(C5Me5)2Y(μ-O2CEt)]2, 5. Although 2 is highly reactive, low temperature isolation methods allowed the isolation of single crystals which revealed an 82.6(2)° Y–CH2–CH3 bond angle consistent with an agostic structure in the solid state. Complex 2 reacted with benzene and toluene to make (C5Me5)2YPh, 7, and (C5Me5)2YCH2Ph, 8, respectively. The reaction of 2 with [(C5Me5)2YCl]2 formed (C5Me5)2Y(μ-Cl)(μ-η1:η5-CH2C5Me4)Y(C5Me5) in which a (C5Me5)1– ligand was metalated. C–H bond activation also occurred with methane which reacted with 2 to make [(C5Me5)2YMe]2, 9.
Resonance Raman Scattering as a Probe of Ultrafast Electronic Surface Hopping and Nuclear Vibrational Motion

We present a study of the dynamics and spectroscopy of a model system with two identical, dissociative chromophores using a quantum-mechanical time-dependent wave packet theory. We demonstrate that resonance Raman spectra carry distinct signatures of both the dissociation dynamics in the femtosecond regimes and the non-adiabatic electronic coupling between the two chromophores.
Effects of processing and added ingredients on oil diffusion through cocoa butter using magnetic resonance imaging

This study investigates the diffusion of oil in different blends of cocoa butter with sugar and lecithin, processed under different crystallization conditions (0 and 250 s−1 shearing rate). Magnetic resonance imaging (MRI) was used to quantify the extent of oil migration from a cream filling to the lipid blends. Oil migration was monitored using MRI and liquid oil diffusivity in the samples was evaluated using a short-time approximation to Fick's II law of diffusion. For all the formulations, sheared samples showed distinctively lower oil diffusivity values. Furthermore, the effect of shearing on oil diffusion varied based on the addition of lecithin and/or sugar to cocoa butter. Short-time liquid oil diffusivity decreased by about 91% in sheared samples containing sugar while shear crystallization reduced the migration rate by about 70% and 62% in the binary mixture of cocoa butter and lecithin, and samples containing both sugar and lecithin, respectively.
Model-based micro-grid modeling and optimal PEV charging control

Micro-grid systems can support distribution network to avoid insufficient electricity supply by effectively integrating renewable energy sources and energy storage systems. This paper studies the modeling of a micro-grid system using SimPowerSystems in Matlab/Simulink environment. The Micro-grid consists of ten Electric Vehicle Service Equipment (EVSE), a Photovoltaics (PV) farm, an Energy Storage System (ESS), and a commercial building. To minimize charging cost as well as limit the micro-grid peak load, the Non-Integer Generic Algorithm (NIGA) optimization method is used to obtain optimized Plug-in Electric Vehicle (PEV) charging/discharging schedule with time-varying charging rate. The time-of-use (TOU) price and discharge incentive are applied to implement the cost minimization. The simulation results show that the total load is flattened corresponding to TOU price structures. The optimization that considers both discharge incentive and micro-grid load limit can generate a cost-power win-win result.
Induction motor speed estimation using full-order flux observers ensuring system stability

A transparent full-order flux observer design methodology and a model reference adaptive mechanism to estimate the rotor speed of an induction motor are set forth which also ensures system stability in all operability regions. The observer gains are chosen using the Butterworth polynomial and the controller gains of the reference model adaptive speed controller are selected using the concept of the D-decomposition. The overall transfer function between the reference rotor and actual speeds is used to finally determine the controller parameters of the speed loop to enhance the system overall stability in the motoring, regenerative and braking modes of drive operations. The proposed controller and estimator design schemes are validated by computer simulation results for operations in the motoring and regenerating modes
A Preliminary Examination of the Comparative Efficacy of Intravenous vs Oral Acetaminophen in the Treatment of Perioperative Pain

Objective The management of postoperative pain is a major health care issue. While the cost of intravenous acetaminophen (IVA) is significantly greater than its oral acetaminophen (OA) counterpart, less is known regarding comparative effectiveness of these routes. The purpose of this study was to determine whether perioperative IVA is equivalent in reducing postoperative pain compared with perioperative OA for laparoscopic cholecystectomy (LapChole). Design Double-blinded, prospective, randomized placebo-controlled trial. Setting Womack Army Medical Center, Fort Bragg, North Carolina. Subjects Adults (age > 18 years) active duty military, veterans, and beneficiaries receiving a laparoscopic cholecystectomy. Methods This study was conducted at Womack Army Medical Center (WAMC), Fort Bragg, North Carolina, between January 2013 and June 2015. Sixty-seven subjects with symptomatic cholelithiasis were randomly assigned to receive two doses (1,000 mg each) of either IVA or OA. A numerical rating scale (NRS) score of pain was obtained preoperatively and every six hours for 24 hours postoperation. The primary objective was to assess whether treatment groups had significantly different 24-hour postoperative sum of pain intensity differences (SPID24) using an analysis of covariance test. Results Sixty subjects completed the study and were included in the analysis. Treatment groups did not differ in SPID24, even when controlling for age, gender, and preoperative pain levels (F(1,55) = 0.39, P = 0.54, partial η2 = 0.007), nor did 24-hour opioid consumption when controlling for age, gender, and operation time (F(1, 46) = 0.47, P = 0.50, partial η2 = 0.01). Furthermore, treatment groups were equally as likely to report average postoperative NRS scores of 4 or higher (β = 0.24, Exp(B) = 1.28, P = 0.68). Conclusions The results show no evidence of differences between IVA or OA in pain or opioid consumption among a sample of patients undergoing LapChole. Due to low sample size, these descriptive findings warrant larger studies, which may have a significant economic impact.
Westfried, Alex Huxley., REINVENTING THE CULTURE OF WOMANHOOD IN AMERICA AND BRAZIL, AN ANTHROPOLOGICAL PERSPECTIVE: Models for the 21st Century 1964-2001

Westfried, Alex Huxley., REINVENTING THE CULTURE OF WOMANHOOD IN AMERICA AND BRAZIL, AN ANTHROPOLOGICAL PERSPECTIVE: Models for the 21st Century 1964-2001. Lanham, MD: University Press of America, 2002,199 pp. Paperback.While this small text does not quite live up to the expectations of its title, it none-the-less provides the reader with valuable information concerning the women's movement in Brazil which would be difficult to find otherwise. In the Preface, Westfried explains that the book has two objectives: "the description of the Life Histories of Militant Women who were able to overcome the obstacles to their independence in a courageous manner, and the comparison of the cultural and structural features American and Brazilian society (pg. vii)." He goes on to claim that in spite of the more advanced modernization in the United States, that the feminist movement in Brazil has had greater success.We learn from the Acknowledgments, Introduction, and Author Biography that the author is a retired professor of Sociology and Anthropology at Western Connecticut State University, where he taught for 25 years. He began his work and interest in Latin America with his PhD work at Syracuse University. While on a summer fellowship at the University of Florida in 1981, he began his 14 year study of Brazilian women. The project is based on interviews of 30 professional Brazilian women from seven cities. Twelve of the interviews are used in the book. The women who were selected for the case studies are all active feminists with university degrees and professional careers.The first two chapters provide some historical background on gender and work issues, and illustrate them with six of the case study interviews. Even though the details vary, each woman has a similar story. They tend to come from a family that can support their career desires, in which they become very successful. Most of them marry a husband who is initially supportive, though eventual divorce is a common theme. Most of the women also make some career sacrifices in connection with the rearing of their children.Chapter 3 places the women's independence movement within the context of the traditional kinship system. We learn that over time the power of patriarchy has weakened as divorce and demands for sexual equality have become more common. As women break from the extended family they also lose valuable support in child care. Racial discrimination continues, making it very difficult for those of African descent (which make up 65% of the population) to receive the kind of education necessary for professional careers and escape from poverty. …
PMIx: process management for exascale environments

High-Performance Computing (HPC) applications have historically executed in static resource allocations, using programming models that ran independently from the resident system management stack (SMS). Achieving exascale performance that is both cost-effective and fits within site-level environmental constraints will, however, require that the application and SMS collaboratively orchestrate the flow of work to optimize resource utilization and compensate for on-the-fly faults. The Process Management Interface - Exascale (PMIx) community is committed to establishing scalable workflow orchestration by defining an abstract set of interfaces by which not only applications and tools can interact with the resident SMS, but also the various SMS components can interact with each other. This paper presents a high-level overview of the goals and current state of the PMIx standard, and lays out a roadmap for future directions.
A Noninvasive Rhizopus Infection With a Bladder Fungal Ball in a Patient With Poorly Controlled Diabetes Mellitus

Here we present the first reported case of a noninvasive Rhizopus fungal ball confined to the bladder of a patient with poorly controlled diabetes and right flank pain. The patient developed bilateral hydronephrosis after several hospital admissions for urinary tract infections with multiple failed courses of antibiotics. During cystoscopy to replace a ureteral stent, he was found to harbor a fungal ball in the bladder that was removed and grew Rhizopus in culture. Patient received treatment with amphotericin B and transitioned to long-term posaconazole therapy. This case highlights the importance of considering fungal agents in urinary tract infections, especially in persistent or refractory cases, and the role of the clinical microbiology laboratory in correct identification of the infectious source.
Frequency, trends, and antecedents of severe maternal depression after three million U.S. births.

Background Postpartum depression carries adverse consequences for mothers and children, so widespread screening during primary care visits is recommended. However, the rates, timing, and factors associated with significant depressive episodes are incompletely understood. Methods and findings We examined the Healthcare Cost and Utilization Project (HCUP) State Inpatient, Emergency Department, and Ambulatory Surgery and Services Databases from California (2005–2011) and Florida (2005–2012). Within 203 million records, we identified 3,213,111 births and all mothers who had hospital encounters for severe depression within 40 weeks following delivery. We identified 15,806 episodes of postpartum depression after 11,103 deliveries among 10,883 unique women, and calculated an overall rate of 36.7 depression- associated hospital visits per 10,000 deliveries. Upward trends were observed in both states, with combined five-year increases of 34%. First depressive events were most common within 30 days of delivery, but continued for the entire observation period. About half (1,661/3,325) of PPD first episodes occurred within 34 days of delivery, 70% (2,329/3,325) by the end of the second month, and 87% (2,893/3,325) before four-months of the delivery. Women with private insurance were less likely to have hospital encounters for depression than women with public insurance and women with depression were much more likely to have had some kind of hospital encounter at some time during their pregnancies. Rates of depression increased with the number of prenatal hospital encounters in a “dose-dependent” fashion: the rate of depression was 17.2/10,000 for women with no prenatal hospital visits, doubling for women with at least one encounter (34.9/10,000), and increasing 7-fold to 126/10,000 for women with three or more encounters during their pregnancies. Conclusions Our findings suggest that (1) hospital encounters for post-partum depression are increasing, (2) screening should begin very early and continue for the first year after delivery, and (3) added attention should be given to women who had hospital encounters during their pregnancies.
Intramuscular Fat Accumulation and Associations With Body Composition, Strength, and Physical Functioning in Patients With Rheumatoid Arthritis.

Objective Rheumatoid arthritis (RA) is associated with adverse body composition profiles and low muscle density due to the accumulation of intramuscular fat. Linear regression was used to assess differences between RA patients and controls and to determine associations between muscle density, strength, and physical functioning. Methods Patients with RA, ages 18-70 years, and healthy control subjects underwent whole-body dual x-ray absorptiometry and peripheral quantitative computed tomography, in order to quantify the appendicular lean mass index (ALMI) and the fat mass index (FMI), visceral fat area, and muscle density. Dynamometry was used to measure hand grip strength and muscle strength at the knee and lower leg. Disability and physical functioning were measured using the Health Assessment Questionnaire (HAQ) and the Short Physical Performance Battery (SPPB). Linear regression analyses were performed to assess differences related to RA and associations between muscle density, strength, and function. Results The study group included 103 patients with RA (51 men) and 428 healthy control subjects. Among patients with RA, low muscle density was associated with higher disease activity, C-reactive protein and interleukin-6 levels, greater total and visceral fat area, lower ALMI Z scores, physical inactivity, and long-term use of glucocorticoids (>1 year). Patients with low ALMI Z scores had lower muscle density Z scores compared with reference participants with similarly low ALMI scores. Low muscle density was independently associated with lower muscle strength, higher HAQ scores, and lower SPPB scores, after adjustment for ALMI and FMI Z scores. Conclusion The low muscle density observed in patients with RA was associated with low muscle mass, excess adiposity, poor strength, and greater disability. Interventions to address poor muscle quality could potentially affect important functional outcomes.
Imaging the superficial vascular structure for mapping and identification

The human body is comprised of a variety of networks that can be monitored and used as body positioning systems. Furthermore, structural changes observed in these networks have clinical significance as they can aid in disease diagnosis and determining the overall health of an individual. One such network is the superficial vascular structure. As the primary network supplying blood to the body, observing the vein structure gives insight into the cardiovascular health and hydration levels of an individual. Additionally, because of the uniqueness of the network, there is growing interest in using veins as a biometric for identification and mapping. However, because vasculature is difficult to image and existing imaging technology is expensive, the potential for superficial vascular structure to map the body and provide insight into overall health has not been well studied. Furthermore, given the 3D nature of the body, registering and matching corresponding vascular regions proves to be quite challenging. In order to address these needs, we have designed a near-infrared (NIR) imaging system to image the superficial vascular structure. It is compact, easily integrated into any computer system, and cost-effective, thereby having the potential to be used in clinical settings. By carefully designing the image acquisition system and developing registration and matching algorithms, we can robustly image and extract the vascular structure. By extracting the vascular structure from certain limbs, we show the potential for using vasculature as a body map. Additionally, we demonstrate the uniqueness of the vascular structure and its potential to be used as a biometric identifier.
Characterizing and optimizing hotspot parallel garbage collection on multicore systems

The proliferation of applications, frameworks, and services built on Java have led to an ecosystem critically dependent on the underlying runtime system, the Java virtual machine (JVM). However, many applications running on the JVM, e.g., big data analytics, suffer from long garbage collection (GC) time. The long pause time due to GC not only degrades application throughput and causes long latency, but also hurts overall system efficiency and scalability. In this paper, we present an in-depth performance analysis of GC in the widely-adopted HotSpot JVM. Our analysis uncovers a previously unknown performance issue - the design of dynamic GC task assignment, the unfairness of mutex lock acquisition in HotSpot, and the imperfect operating system (OS) load balancing together cause loss of concurrency in Parallel Scavenge, a state-of-the-art and the default garbage collector in HotSpot. To this end, we propose a number of solutions to these issues, including enforcing GC thread affinity to aid multicore load balancing and designing a more efficient work stealing algorithm. Performance evaluation demonstrates that these proposed approaches lead to the improvement of the overall completion time, GC time and application tail latency by as much as 49.6%, 87.1%, 43%, respectively.
Multistability in Josephson Junction Devices

Some of the major features of the bistability reported in the preceeding paper1 were tentatively explained by the interaction of the non-linear elements (the Josephson junctions) with a “cavity” (a length of transmission line). That type of interaction is superficially similiar to one that causes optical bistability, so that it seems interesting to pursue its analysis with similiar theoretical techniques. However, that system has so many variables that a detailed analysis would be rather laborious.
The Modeling of Density-Wave Oscillations in Boiling Water Nuclear Reactors

Density-wave oscillations constitute a potential instability model in Boiling Water Nuclear Reactors (BWR’s). Simplified models using conservative assumptions may lead to unnecessary operating restrictions. This paper presents a state-of-the-art-one-dimensional thermal-hydraulic model which can be used for the linear analysis of BWR stability. The model accounts for phasic slip, heated wall dynamics, distributed spacers, and a detailed model of the loop. The axial heat flux profile is replaced by a stair-case function such that the linearized, Laplace-transformed equations, can be integrated analytically over each node. In its final form, the coupled neutron-kinetics/thermal-hydraulics model constitutes a multi-input/multi-output linear system of a BWR. The model was parametrically evaluated with a digital computer code.
An asymptotically optimal algorithm for the max k-armed bandit problem

We present an asymptotically optimal algorithm for the max variant of the k-armed bandit problem. Given a set of k slot machines, each yielding payoff from a fixed (but unknown) distribution, we wish to allocate trials to the machines so as to maximize the expected maximum payoff received over a series of n trials. Subject to certain distributional assumptions, we show that O(k ln(k/δ) ln(n)2/e2) trials are sufficient to identify, with probability at least 1 - δ, a machine whose expected maximum payoff is within e of optimal. This result leads to a strategy for solving the problem that is asymptotically optimal in the following sense: the gap between the expected maximum payoff obtained by using our strategy for n trials and that obtained by pulling the single best arm for all n trials approaches zero as n → ∞.
Problems of Evolution; Banach Spaces

The laws of classical physics are causal or deterministic, and that leads to the concept of a well-posed initial-value problem. Roughly speaking, a detailed knowledge of the state of a system at time t = t0 enables one to predict the subsequent states for all t > t0. This chapter and the next two are devoted to the study of such problems. Differential equations are usually involved, and one must decide what is physically acceptable as a solution of the equations, and what are the appropriate initial and auxiliary conditions. A physical principle that guides the proper formulation of the problems is that there should be exactly one solution for every initial state, and the solution should depend continuously on the initial state, in a sense to be explained. It will be seen that Banach spaces provide the appropriate abstract setting for these problems. Most of the discussion is for linear problems; non-linear ones, for which the theory is quite fragmentary, are discussed briefly in Chapter 17.
Pathways linking caesarean delivery to early health in a dual burden context: Immune development and the gut microbiome in infants and children from Galápagos, Ecuador.

OBJECTIVES Global increases in caesarean deliveries are exposing more infants to perinatal environments that are evolutionarily novel and potentially increasing their risks for inflammatory conditions. Yet, the pathways linking caesareans to later health outcomes are not well understood, particularly in dual burden contexts. We test two of the hypothesized pathways, altered immune function and gut microbiota, which may link delivery mode to later health outcomes and test whether these associations persist when controlling for postnatal nutritional and pathogenic exposures. METHODS Data come from infants, aged 0 to 2 (n = 41), and young children, aged 2 to 11 (n = 135), from the Galapagos, Ecuador. Differences in morbidity, C-reactive protein (CRP), and gut microbiota by delivery type were tested using linear and logistic regression models adjusted for nutritional and pathogenic exposures and infant age. RESULTS Over half of infants and over 40% of children were delivered by caesarean. Morbidity and CRP did not differ between infants or children born by caesarean or vaginally. Microbial taxa abundance differed by delivery mode. Infants born by caesarean had a higher abundance of Firmicutes and a lower relative abundance of Bacteroidales. Children born by caesarean had a higher abundance of Proteobacteria and Enterobacteriales. These differences remained after adjustment for environmental exposure. CONCLUSIONS Caesarean delivery is associated with differences in gut microbiota across childhood even in this dual burden context. Our results highlight the importance of examining caesarean delivery across diverse contexts to better understand the impact of perinatal interventions on short- and longer-term health outcomes.
Reply to Zhou and Li: Plasticity of the genomic haplotype of Synechococcus elongatus leads to rapid strain adaptation under laboratory conditions

Zhou and Li (1) describe a classic phenomenon in microbiology in which the genotypes of bacteria rapidly evolve to optimize growth under selective conditions. In the original paper describing the fast-growing cyanobacterium Synechococcus elongatus UTEX 2973, Yu et al. (2) described the genome sequence that defines the strain. Since 2015, several colleagues who obtained the strain directly from the original Pakrasi laboratory stock successfully replicated the 2-h doubling time of the strain. Seemingly, specific loci affecting growth rate and light tolerance rapidly interconvert between alternative haplotypes based on the growth conditions. This is confirmed by the sequencing results of Zhou and Li (1) who report that the sample in … [↵][1]1To whom correspondence should be addressed. Email: pakrasi{at}wustl.edu. [1]: #xref-corresp-1-1
Short-term prediction of suicidal thoughts and behaviors in adolescents: Can recent developments in technology and computational science provide a breakthrough?

Abstract Background Suicide is one of the leading causes of death among adolescents, and developing effective methods to improve short-term prediction of suicidal thoughts and behaviors (STBs) is critical. Currently, the most robust predictors of STBs are demographic or clinical indicators that have relatively weak predictive value. However, there is an emerging literature on short-term prediction of suicide risk that has identified a number of promising candidates, including (but not limited to) rapid escalation of: (a) emotional distress, (b) social dysfunction (e.g., bullying, rejection), and (c) sleep disturbance. However, these prior studies are limited in two critical ways. First, they rely almost entirely on self-report. Second, most studies have not focused on assessment of these risk factors using intensive longitudinal assessment techniques that are able to capture the dynamics of changes in risk states at the individual level. Method In this paper we explore how to capitalize on recent developments in real-time monitoring methods and computational analysis in order to address these fundamental problems. Results We now have the capacity to use: (a) smartphone, wearable computing, and smart home technology to conduct intensive longitudinal assessments monitoring of putative risk factors with minimal participant burden and (b) modern computational techniques to develop predictive algorithms for STBs. Current research and theory on short-term risk processes for STBs, combined with the emergent capabilities of new technologies, suggest that this is an important research agenda for the future. Limitations Although these approaches have enormous potential to create new knowledge, the current empirical literature is limited. Moreover, passive monitoring of risk for STBs raises complex ethical issues that will need to be resolved before large scale clinical applications are feasible. Conclusions Smartphone, wearable, and smart home technology may provide one point of access that might facilitate both early identification and intervention implementation, and thus, represents a key area for future STB research.
Robustness evaluation of computer-aided clinical trials for medical devices

Medical cyber-physical systems, such as the implantable cardioverter defibrillator (ICD), require evaluation of safety and efficacy in the context of a patient population in a clinical trial. Advances in computer modeling and simulation allow for generation of a simulated cohort or virtual cohort which mimics a patient population and can be used as a source of prior information. A major obstacle to acceptance of simulation results as a source of prior information is the lack of a framework for explicitly modeling sources of uncertainty in simulation results and quantifying the effect on trial outcomes. In this work, we formulate the Computer-Aided Clinical Trial (CACT) within a Bayesian statistical framework allowing explicit modeling of assumptions and utilization of simulation results at all stages of a clinical trial. To quantify the robustness of the CACT outcome with respect to a simulation assumption, we define δ-robustness as the minimum perturbation of the base prior distribution resulting in a change of the CACT outcome and provide a method to estimate the δ-robustness. We demonstrate the utility of the framework and how the results of δ-robustness evaluation can be utilized at various stages of a clinical trial through an application to the Rhythm ID Goes Head-to-head Trial (RIGHT), which was a comparative evaluation of the safety and efficacy of specific software algorithms across different implantable cardiac devices. Finally, we introduce a hardware interface that allows for direct interaction with the physical device in order to validate and confirm the results of a CACT for implantable cardiac devices.
The curiosity effect: Information seeking in the contemporary news environment:

This research investigates how digital news headlines influence contemporary news information seeking. In two studies (a lab experiment and a field test), we examine how the presentation of news in...
Genetic variation in the apolipoproteins C-II and C-III.

The C group apolipoproteins are primarily associated with triglyceriderich lipoprotein particles (1). They are important in triglyceride metabolism where they act as allosteric affectors of lipoprotein lipase. Apolipoprotein C-II is an activator of lipoprotein lipase while C-III is an inhibitor of both lipoprotein lipase and hepatic lipase. Apolipoprotein C-III may also be involved in the receptor mediated uptake of triglyceriderich lipoproteins. Genetically determined deficiency of C-II is associated with a functional deficiency of lipoprotein lipase and severe hypertriglyceridemia (2). Menzel, et al (3) have reported a protein polymorphism in APO C-II in U.S. Blacks that involved the substitution of glutamine for lysine at residue 55 of the C-II polypeptide chain. They reported a frequency of 12% for this variant in a sample of 50 normolipidemic U.S. Blacks. Sepehrnia, et al (4) confirmed the presence of this polymorphism in U.S. Blacks, demonstrated its presence in Nigerians, and verified an autosomal codominant pattern of segregation in families. Reports of genetic variation in apolipoprotein C-III are restricted to two types of rare families. One having combined apolipoprotein A-I/C-III deficiency due to a sequence inversion involving both the APO A-I and C-III genes (5). Deficient family members have abnormalities of triglyceride metabolism that are corrected by the infusion of normal C-III (6). The second variant is recognized by unusually high levels of unglycosylated APO C-III (APO C-III0) due to the replacement of threonine by alanine at position 74 of the polypetide chain, which prevents 0-glycosylation (7). The latter mutation is not assocociated with gross alteration in lipoprotein levels.
Severe Hypocalcemia After Thyroidectomy: An Analysis of 7366 Patients.

OBJECTIVE The aim of the study was to determine severe hypocalcemia rate following thyroidectomy and factors associated with its occurrence. BACKGROUND Hypocalcemia is the most common complication after thyroidectomy. Severe post-thyroidectomy hypocalcemia can be life-threatening; data on this specific complication are scarce. METHODS Patients who underwent thyroidectomy in the American College of Surgeons-National Surgical Quality Improvement Program thyroidectomy-targeted database (2016-2017) were abstracted. A severe hypocalcemic event was defined as hypocalcemia requiring intravenous calcium, emergent clinic/hospital visit, or a readmission for hypocalcemia. Multivariable regression was used to identify factors independently associated with occurrence of severe hypocalcemia. RESULTS Severe hypocalcemia occurred in 5.8% (n = 428) of 7366 thyroidectomy patients, with 83.2% necessitating intravenous calcium treatment. Rate of severe hypocalcemia varied by diagnosis and procedure (0.5% for subtotal thyroidectomy to 12.5% for thyroidectomy involving neck dissections). Overall, 38.3% of severe hypocalcemic events occurred after discharge; in this subset, 59.1% experienced severe hypocalcemia despite being discharged with calcium and vitamin D. Severe hypocalcemia patients had higher rates of recurrent laryngeal nerve injury (13.4% vs 6.6%), unplanned reoperations (4.4% vs 1.3%), and longer hospital stay (30.4% vs 6.2% ≥3 days (all P < 0.01). After multivariate adjustment, severe hypocalcemia was associated with multiple factors including Graves disease [odds ratio (OR) = 2.06], lateral neck dissections (OR: 3.10), and unexpected reoperations (OR = 3.55); all P values less than 0.01. CONCLUSIONS Severe hypocalcemia and suboptimal hypocalcemia management after thyroidectomy are common. Patients who experienced severe hypocalcemia had higher rates of nerve injury and unexpected reoperations, indicating surgical complexity and provider inexperience. More biochemical surveillance particularly a parathyroid hormone-based protocol, fine-tuned supplementation, and selective referral could reduce occurrence of this morbid complication.
A Deep Learning Approach for Meibomian Gland Atrophy Evaluation in Meibography Images

Author(s): Wang, Jiayun; Yeh, Thao N; Chakraborty, Rudrasis; Yu, Stella X; Lin, Meng C | Abstract: PurposeTo develop a deep learning approach to digitally segmenting meibomian gland atrophy area and computing percent atrophy in meibography images.MethodsA total of 706 meibography images with corresponding meiboscores were collected and annotated for each one with eyelid and atrophy regions. The dataset was then divided into the development and evaluation sets. The development set was used to train and tune the deep learning model, while the evaluation set was used to evaluate the performance of the model.ResultsFour hundred ninety-seven meibography images were used for training and tuning the deep learning model while the remaining 209 images were used for evaluations. The algorithm achieves 95.6% meiboscore grading accuracy on average, largely outperforming the lead clinical investigator (LCI) by 16.0% and the clinical team by 40.6%. Our algorithm also achieves 97.6% and 95.4% accuracy for eyelid and atrophy segmentations, respectively, as well as 95.5% and 66.7% mean intersection over union accuracies (mean IU), respectively. The average root-mean-square deviation (RMSD) of the percent atrophy prediction is 6.7%.ConclusionsThe proposed deep learning approach can automatically segment the total eyelid and meibomian gland atrophy regions, as well as compute percent atrophy with high accuracy and consistency. This provides quantitative information of the gland atrophy severity based on meibography images.Translational relevanceBased on deep neural networks, the study presents an accurate and consistent gland atrophy evaluation method for meibography images, and may contribute to improved understanding of meibomian gland dysfunction.
Introduction to the article by Harold Biswell: Prescribed Burning in Georgia and California Compared

Harold Biswell first learned about the benefits of prescribed fire in forest management when he was a Forest Service researcher in Georgia, USA. After he accepted a professorship in the School of Forestry at the University of California, Berkeley, USA, he was surprised to find out that prescribed fire was not an accepted practice in California. He set out to conduct a series of studies to explore the effects of prescribed fire in forests of California and compare those effects to those he observed in Georgia.
Structural models of mammalian mitochondrial transcription factor B2

Mammalian mitochondrial DNA (mtDNA) encodes 13 core proteins of oxidative phosphorylation, 12S and 16S ribosomal RNAs, and 22 transfer RNAs. Mutations and deletions of mtDNA and/or nuclear genes encoding mitochondrial proteins have been implicated in a wide range of diseases. Thus, cell survival and health of the organism require some steady-state level of the mitochondrial genome and its expression. In mammalian systems, the mitochondrial transcription factor B2 (mtTFB2 or TFB2M) is indispensable for transcription initiation. TFB2M along with two other proteins, mitochondrial RNA polymerase (mtRNAP or POLRMT) and mitochondrial transcription factor A (mtTFA or TFAM), are key components of the core mitochondrial transcription apparatus. Structural information for POLRMT and TFAM from humans is available; however, there is no available structure for TFB2M. In the present study, three-dimensional structure of TFB2M from humans was modeled using a combination of homology modeling and small-angle X-ray scattering (SAXS). The TFB2M structural model adds substantively to our understanding of TFB2M function. An explanation for the low or absent RNA methyltransferase activity is provided. A putative nucleic acid-binding site is revealed. The amino and carboxy termini, while likely lacking defined secondary structure, appear to adopt compact, globular conformations, thus "capping" the ends of the protein. Finally, sites of interaction of TFB2M with other factors, protein and/or nucleic acid, are suggested by the identification of species-specific clusters on the surface of the protein.
In vitro response of lymphocytes to phytohemagglutinin (PHA) as studied with antiserum to PHA. II. Cell cycle analyses.

Abstract The cell cycle and phase times of human lymphocytes responding to PHA have been analysed with the percent labelled metaphases (PLM) technique. The range of generation times (13–18 h) and DNA synthesis times (6.5–10.5 h) reported here compare well with previous measurements in the literature. Cycle analyses of the early responding cells of the initial response, selected with partial anti-PHA serum inhibition, and of restimulated cells yield relatively well-defined PLM curves. The short cycle times measured from these curves may reflect the early cycles after stimulation or a subpopulation of responding cells. Analyses at two times during both the initial and restimulation responses suggest that cycles lengthen with time after stimulation. The poor PLM curves of the initial response and the restimulation response of cells released from anti-PHA inhibition indicate considerable intercellular variation in cycle times. Cells in the initial long G 1 phase contribute to this variation. PHA dose does not appear to affect the cycle time.