cssi/SciSciGPT-SciSciNet huggingface dataset:
Advances in Intraoperative Margin Assessment for Breast Cancer

Breast-conserving therapy including partial mastectomy and radiation is commonly performed for patients who are surgical candidates for breast cancer. Although it is as effective as mastectomy for the treatment of early breast cancer, re-excision for positive or close margins is common. This is costly, inconvenient for patients and delays initiation of adjuvant therapies. Commonly used methods for breast tumor localization and optimization of margin assessment include preoperative wire or seed localization, precise specimen orientation, specimen radiography, and cavity shaving. Unfortunately, these techniques do not assess margins on a microscopic scale in real time. Our report reviews the current and experimental techniques of intraoperative microscopic margin assessment including frozen section, cytologic imprint analysis, ultrasound, micro-CT, MarginProbe ® , near-infrared imaging, and spectroscopy.
A novel lysophosphatidylcholine acyl transferase activity is expressed by peroxiredoxin 6

The phospholipase A2(PLA2) activity of peroxiredoxin (Prdx)6 has important physiological roles in the synthesis of lung surfactant and in the repair of peroxidized cell membranes. These functions require the activity of a lysophospholipid acyl transferase as a critical component of the phospholipid remodeling pathway. We now describe a lysophosphatidylcholine acyl transferase (LPCAT) activity for Prdx6 that showed a strong preference for lysophosphatidylcholine (LPC) as the head group and for palmitoyl CoA in the acylation reaction. The calculated kinetic constants for acylation wereKm18 μM andVmax30 nmol/min/mg protein; theVmaxwas increased 25-fold by phosphorylation of the protein whileKmwas unchanged. Study of recombinant protein in vitro and in mouse pulmonary microvascular endothelial cells infected with a lentiviral vector construct indicated that amino acid D31 is crucial for LPCAT activity. A linear incorporation of labeled fatty acyl CoA into dipalmitoyl phosphatidylcholine (PC) indicated that LPC generated by Prdx6 PLA2activity remained bound to the enzyme for the reacylation reaction. Prdx6 is the first LPCAT enzyme with demonstrated cytoplasmic localization. Thus, Prdx6 is a complete enzyme comprising both PLA2and LPCAT activities for the remodeling pathway of PC synthesis or for repair of membrane lipid peroxidation.
Peyronie’s Disease: An Electron Microscopic Study

AbstractAn electron microscopic examination of penile plaques from 20 patients with Peyronie’s disease generally agreed with the light microscopic interpretation for lesions of short duration. Our data additionally show evidence for a reorganization of the interstitial matrix in vascular areas of the tunica albuginea. Penile plaques demonstrated nerve demyelination in 4 patients and the presence of bacteria in 1. Myofibroblast cells were not observed.
Adult Attachment Theory

Adult attachment theory is a dominant framework for understanding behavior, emotion, and cognition in adult close relationships. It is rooted in the assumption that the underlying motivational systems that support parent–child relationships are also influential in adult intimate relationships. Current research in adult attachment examines changes in an individual's approach to close relationships over time and across the lifespan; the enduring influence of early experiences on social behavior; and the association between attachment orientations and health. The current state of knowledge on these topics and directions for future research are discussed. Keywords: attachment; Bowlby, John; lifespan and development; personality; psychology of relationships
A Minimalist Model of the Artificial Autonomous Moral Agent (AAMA)

This paper proposes a model for an artificial autonomous moral agent (AAMA), which is parsimonious in its ontology and minimal in its ethical assumptions. Starting from a set of moral data, this AAMA is able to learn and develop a form of moral competency. It resembles an “optimizing predictive mind,” which uses moral data (describing typical behavior of humans) and a set of dispositional traits to learn how to classify different actions (given a given background knowledge) as morally right, wrong, or neutral. When confronted with a new situation, this AAMA is supposedly able to predict a behavior consistent with the training set. This paper argues that a promising computational tool that fits our model is “neuroevolution,” i.e. evolving artificial neural networks.
Molecular Feminization of Mouse Seminal Vesicle by Prenatal Exposure to Diethylstilbestrol: Altered Expression of Messenger RNA

AbstractExposure to estrogens during critical stages of development has been reported to cause irreversible changes in estrogen target tissues such as the reproductive tract. In fact, recent studies using mice describe prenatal estrogen exposure resulting in the expression of the major estrogen-inducible uterine secretory protein, lactoferrin (LF), by the seminal vesicles of the male offspring. Thus, we have studied the role of estrogens in abnormal and normal gene expression in the developing male reproductive tract using LF and seminal vesicle secretory protein IV (SVS IV), an androgen-regulated murine seminal vesicle secretory protein, as markers. Lactoferrin and SVS IV protein and mRNA expression were studied in histological samples by using the techniques of in situ hybridization (ISH) and immunohistochemistry (IHC). Seminal vesicle secretory protein IV was expressed in all (100%) epithelial cells of the control seminal vesicle, but this protein was decreased by castration. However, LF expression was...
FDA: The Mission and the Message

This is the third article in a six-part series on new radiopharmaceuticals. Upon completion of this article, the nuclear medicine technologist will be able to (1) discuss the history of the FDA, (2) describe the process for new drug approval, (3) list possible causes for delay in new drug approval and the initiatives currently in place to streamline the review process, and (4) understand how the nuclear medicine community can improve its review submissions.
Evaluation of hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program.

Background The American College of Surgeons National Surgical Quality Improvement Program is well recognized in surgical quality measurement and is used widely in research. Recent calls to make it a platform for national public reporting and pay-for-performance initiatives highlight the importance of understanding which types of hospitals elect to participate in the program. Our objective was to compare characteristics of hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program to characteristics of nonparticipating US hospitals. Methods The 2013 American Hospital Association and Centers for Medicare & Medicaid Services Healthcare Cost Report Information System datasets were used to compare characteristics and operating margins of hospitals participating in the American College of Surgeons National Surgical Quality Improvement Program to those of nonparticipating hospitals. Results Of 3,872 general medical and surgical hospitals performing inpatient surgery in the United States, 475 (12.3%) participated in the American College of Surgeons National Surgical Quality Improvement Program. Participating hospitals performed 29.0% of all operations in the United States. Compared with nonparticipating hospitals, American College of Surgeons National Surgical Quality Improvement Program hospitals had a higher mean annual inpatient surgical case volume (6,426 vs 1,874; P P P P P Conclusion The American College of Surgeons National Surgical Quality Improvement Program hospitals are large teaching hospitals with more quality-related accreditations and financial resources. These findings should be considered when reviewing research studies using the American College of Surgeons National Surgical Quality Improvement Program data, and the findings reinforce that efforts are needed to facilitate participation in surgical quality improvement by all hospital types.
Performance bounds and buffer space requirements for concurrent processors

Scientific programs are typically characterized as floating-point intensive loop-dominated tasks with large amounts of exploitable parallelism. A wide range of concurrent processor architectures have been proposed to capitalize on this parallelism, e.g. vector, multi-threaded, superscalar, and VLIW. Even though these architectures all attempt to exploit the same performance potential, the wide range of hardware structures has to date discouraged a unified performance evaluation technique. This thesis develops and uses application-specific upper bounds on performance to evaluate a wide range of concurrent machines. The method focuses on the bandwidth of critical machine units, abstracting away many details of the underlying architectures. Three machines are evaluated as examples: the RISC DECstation 3100, the superscalar IBM RS/6000, and the Decoupled Access-Execute Astronautics ZS-1. When compared to measured performance, performance bounds reveal the overall efficiency of execution and the effective utilization of the critical machine units. These bounds have proven useful for evaluating specific machines, comparing two or more machines and improving the performance of applications codes on these computers. Achieving high performance on machines with long latency operations demands increased buffer space, usually in the form of registers. The dependence on buffer space for high performance is highlighted by the three example machines mentioned above, each of which uses a fundamentally different structure for its buffer space. A method is presented for calculating minimal buffer space requirements for an application running at its optimum performance as machine latencies are varied. This method allows an architect to examine fundamental consequences of various buffer space and latency design choices. One such issue concerns the number of registers required in a vector machine, versus their length. The results presented here suggest that the historic trend toward longer vector registers as latencies have increased is the wrong approach and that greater resources should be spent on increasing the number of available registers even if their length is greatly reduced.
ASSOCIATION OF TWIN PREGNANCY DIAGNOSIS AND PARTURITION WITH DAYS OPEN, DAYS PREGNANT AT DIAGNOSIS, PARITY, AND MILK PRODUCTION IN DAIRY CATTLE

Association between twin pregnancies diagnosed by either rectal palpation or observation at calving and days open, days in gestation at pregnancy diagnosis, parity, and milk production in the lactation preceding the birth of twins were studied on 5493 cows on 14 California dairies. A total of 196 bicornual (3.57%) and 74 unicornual (1.35%) twin pregnancies were diagnosed, but the actual twinning rate at parturition was 6.86%. The incidence of twins at diagnosis and at calving was dependent on parity and independent of days open. Detection of twins at diagnosis by rectal palpation was dependent on days pregnant at diagnosis. Cows in parities greater than 2 diagnosed with twin pregnancies and calving with twins had higher peak mild production than cows diagnosed with single pregnancies and calving with singles, respectively. However, when data were stratified by dairy, no significant difference occurred in peak milk production between cows diagnosed with singles or twins, and no significant difference occurred between cows calving with singles and twins. The 305 day mature equivalent milk production (ME) did not differ between cows diagnosed or calving with twins and singles. Optimal time for diagnosis of twins was at 51 to 60 day postbreeding.
Comparative histopathology of two strains of Bolivian hemorrhagic fever virus infections in suckling hamsters

The histopathology of Machupo virus infection in intracerebrally inoculated suckling hamsters was studied and compared to the histopathology of a virus isolated from a case of hemorrhagic fever from Cochabamba, Bolivia. Both virus isolates were pathogenic for suckling hamsters; however, Machupo virus killed the hamsters earlier than Cochabamba virus. Lesions were most commonly observed in liver and lymphoid and central nervous systems. The lesions varied in incidence, time of occurrence and severity. A nonsuppurative encephalitis which developed in the Cochabamba-virus-infected hamsters was not a consistent finding in the animals inoculated with Machupo virus.
Joint modeling of longitudinal zero-inflated count and time-to-event data: A Bayesian perspective

Longitudinal zero-inflated count data are encountered frequently in substance-use research when assessing the effects of covariates and risk factors on outcomes. Often, both the time to a terminal event such as death or dropout and repeated measure count responses are collected for each subject. In this setting, the longitudinal counts are censored by the terminal event, and the time to the terminal event may depend on the longitudinal outcomes. In the study described herein, we expand the class of joint models for longitudinal and survival data to accommodate zero-inflated counts and time-to-event data by using a Cox proportional hazards model with piecewise constant baseline hazard. We use a Bayesian framework via Markov chain Monte Carlo simulations implemented in the BUGS programming language. Via an extensive simulation study, we apply the joint model and obtain estimates that are more accurate than those of the corresponding independence model. We apply the proposed method to an alpha-tocopherol, beta-carotene lung cancer prevention study.
Japanese Neomercantilism: Continuities and Changes

Although most scholars agree that Japan’s economy is based on neomercantilist rather than neoclassical principles, there are still some who maintain Japan’s markets are free. Not surprisedly, virtually all Japanese official and unofficial spokesmen continue to drumbeat that claim. Typical were the remarks of Nokutoshi Akao, Japan’s then Economic Planning Agency (EPA) head, who told an American audience in August 1989 that the economies of both the United States and Japan “had prospered due to the free enterprise system”, and then made the extraordinary claim that rice is the only product protected by Japanese import barriers.1 Although such rhetoric is easily dismissed, similar claims by noted international scholars must be taken much more seriously. For example, Hugh Patrick “interprets Japanese economic performance as due primarily to the actions and efforts of private individuals and enterprises responding to the opportunities provided in quite free markets for commodities and labor. While the government has been supportive and indeed has done much to create the environment of growth, its role has often been exaggerated”.2 Chen, referring to Japan and the NIEs, declares that “state intervention is largely absent. What the state has provided is a suitable environment for the entrepreneurs to perform their functions”.3
Urban/Rural Contrasts in Vertebrate Fauna From the Southern Atlantic Coastal Plain

A review of archaeological faunal data from urban and rural settings on the southern Atlantic coastal plain indicates that contrasts in these collections reflect the urban or non-urban setting of each site within this natural setting. These contrasts may be seen in the data despite probable differences in socioeconomic status of the sites’ occupants. Apparently, urban households consumed more meat from domestic animals than did rural households, regardless of social status. Rural faunal deposits are more diverse than urban ones and contained large amounts of fish instead of domestic animals. Data for this analysis are taken from 16 archaeological sites excavated at Charleston, South Carolina; Savannah, Georgia; St. Simons Island, Georgia; and elsewhere on the Georgia coast. The combined samples contained 1576 individuals from sites occupied between the mid-18th century and the mid-19th century.
Flint Water Crisis Caused By Interrupted Corrosion Control: Investigating “Ground Zero” Home

Flint, Michigan switched to the Flint River as a temporary drinking water source without implementing corrosion control in April 2014. Ten months later, water samples collected from a Flint residence revealed progressively rising water lead levels (104, 397, and 707 μg/L) coinciding with increasing water discoloration. An intensive follow-up monitoring event at this home investigated patterns of lead release by flow rate–all water samples contained lead above 15 μg/L and several exceeded hazardous waste levels (>5000 μg/L). Forensic evaluation of exhumed service line pipes compared to water contamination “fingerprint” analysis of trace elements, revealed that the immediate cause of the high water lead levels was the destabilization of lead-bearing corrosion rust layers that accumulated over decades on a galvanized iron pipe downstream of a lead pipe. After analysis of blood lead data revealed spiking lead in blood of Flint children in September 2015, a state of emergency was declared and public health int...
Effect of fixed charge group concentration on equilibrium ion sorption in ion exchange membranes

Despite their increasing importance in many energy and water purification applications, few systematic studies of ion sorption in ion exchange membranes exist where fixed charge group concentration and water content are varied independently. Such studies are critical for developing fundamental structure/property relations important for rationally tailoring such materials. Here, cation and anion exchange membranes having different fixed charge group concentrations but similar water content were synthesized to investigate the influence of fixed charge group concentration on equilibrium ion sorption in such materials. Co-ion sorption decreased with increasing membrane fixed charge group concentration, as expected, presumably due to enhanced Donnan exclusion. However, the extent to which co-ion sorption was suppressed was different for the cation and anion exchange membranes, despite similar changes in membrane fixed charge group concentration. A thermodynamic model, based on Donnan theory and Manning's counter-ion condensation theory, was used to interpret the data. The model predicted equilibrium co-ion concentrations in the anion exchange membranes with no adjustable parameters. However, good agreement between the model and experimental data for the cation exchange membranes was only obtained by treating the Manning parameter as an adjustable constant, presumably due to phase separation during polymerization, which produced inhomogeneous membranes.
Strain, ethnic competition, and power devaluation: white supremacist protest in the U.S., 1948–1997

AbstractMany Western democracies have seen an increase in extreme right mobilization over the past several decades but extreme right mobilization is not a new phenomenon when we look historically. In this paper, we examine fifty years of white supremacist protest in the United States to help shed light on the factors that explain variation in levels of right-wing mobilization. Using annual time-series analysis, we find that traditional strain explanations do not explain these protests but that threats to the traditional economic, political, and social power of whites were critical. Ethnic competition associated with black population growth and political threats stemming from the political power of northern Democrats, a divided federal government, and civil rights protest stimulated this mobilization. These findings support a broadened ethnic competition/power devaluation model of right-wing mobilization that emphasizes the mobilizing effects of economic and political threats to a relatively advantaged group.
Development of a Competency Model for a State 4-H Camp Counselor Program

EXECUTIVE SUMMARY: Residential camp counselors are responsible for campers 24 hours a day, thus they have a great impact on the camp environment and contribute to the quality of a camp program (Garst, Browne, & Bialeschki, 2011). Nationally and in Ohio, 4-H is known for its use of teens as camp counselors. Ohio 4-H’s continued commitment to a quality camping program led us to consider developing a camp counselor competency model. Competencies are individual knowledge, skills, abilities, and other characteristics associated with high performance. Competency modeling may benefit an organization by supporting better processes for recruitment, selection, training, and performance evaluation. We reviewed competency models developed for camp professionals (American Camp Association, 2010) and youth development professionals (Astroth, Garza, & Taylor, 2004; National Collaboration for Youth, 2004; Starr, Yohalem, & Gannett, 2009). However, there were no models suited to the roles and responsibilities performed by teen camp counselors. Therefore, the purpose of this study was to develop and validate a competency model for Ohio 4-H camp counselors. A mixed-method research design was used, with an emphasis on qualitative approaches. Methods used included a review of literature, interviews, modified nominal group technique, focus groups, and a survey. The process included data gathering, analysis, integration, and peer debriefing in four phases: (a) review of literature, document review, and idea generation; (b) new model development; (c) model validation; and (d) final refinement and confirmation. Roles and responsibilities form the basis for a competency model; there were 16 agreed upon for Oho 4-H camp counselors. After several iterations, 15 competencies met the criteria for inclusion in the final model. Eight competencies were considered essential by half or more of the 4-H professionals who responded to the survey: health, wellness and risk management; supportive relationships; professionalism; role model; teamwork and leadership; child and adolescent development knowledge; thinking and problem solving; and cultural awareness. The remaining competencies received very important as their highest rating: program planning, teaching and facilitating, professional development, personal commitment, communication, self-direction, and understanding the organizational and camp environment. In addition to a definition, three to seven key actions further described each competency. Ohio 4-H professionals have begun to align their county-based training, statewide training, and curriculum development with the model. We discuss implications for research and make recommendations for using the model and applying results. The process reported here could serve as a model for other organizations that might be interested in creating, updating, or refining a competency model. Subscribe to JPRA
Development of Aggressive Pancreatic Ductal Adenocarcinomas Depends on Granulocyte Colony Stimulating Factor Secretion in Carcinoma Cells

The survival rate for pancreatic ductal adenocarcinoma (PDAC) remains low. More therapeutic options to treat this disease are needed, for the current standard of care is ineffective. Using an animal model of aggressive PDAC (Kras/p48TGFβRIIKO), we discovered an effect of TGFβ signaling in regulation of G-CSF secretion in pancreatic epithelium. Elevated concentrations of G-CSF in PDAC promoted differentiation of Ly6G+ cells from progenitors, stimulated IL10 secretion from myeloid cells, and decreased T-cell proliferation via upregulation of Arg, iNOS, VEGF, IL6, and IL1b from CD11b+ cells. Deletion of csf3 in PDAC cells or use of a G-CSF-blocking antibody decreased tumor growth. Anti-G-CSF treatment in combination with the DNA synthesis inhibitor gemcitabine reduced tumor size, increased the number of infiltrating T cells, and decreased the number of Ly6G+ cells more effectively than gemcitabine alone. Human analysis of human datasets from The Cancer Genome Atlas and tissue microarrays correlated with observations from our mouse model experiments, especially in patients with grade 1, stage II disease. We propose that in aggressive PDAC, elevated G-CSF contributes to tumor progression through promoting increases in infiltration of neutrophil-like cells with high immunosuppressive activity. Such a mechanism provides an avenue for a neoadjuvant therapeutic approach for this devastating disease. Cancer Immunol Res; 5(9); 718-29. ©2017 AACR.
Custom Data Mapping for Composable Data Management

Early experiences with OpenMP 4.0, as well as other directive-based offload models, have shown that deep copy is a key challenge to porting complex applications to offload directives. Without a flexible deep-copy mechanism, pointer-based data structures are at best difficult to manage, particularly when shared memory between the host and device cannot be assumed. Despite the importance of the issue, and the considerable effort expended by vendors, standards bodies and users, no solution has emerged as the clear choice. We propose an approach that combines a restricted compiler-assisted (sometimes called “true”) deep copy with a mechanism for users to register their own custom mapping implementations that we call packers. This combination offers the flexibility to address complex cases when necessary while keeping the complexity out of the directives, a balance that serves all cases.
Cantor’s Infinity

Which of these sets is the largest? You might respond that R is the largest because it contains the others. Or you might respond that they all have the same size, namely infinity. Until a little more than a century ago, mathematicians were content with the decision that every infinite set has the same size as every other infinite set. They were not right or wrong - this is simply what they meant by the phrase “same size”.
Incidence, Etiology, and Outcomes of Altered Mental Status in the Perioperative Setting of Liver Transplantation.

Background We examined neurologic consultations for altered mental status in perioperative liver transplant patients to determine the overall incidence, to assess the presumed etiology and the data reviewed to determine that etiology, and to assess outcomes. Methods Retrospective chart review conducted for all 728 adult patients receiving orthotopic liver transplantation (OLT) between January 01, 2010, to June 30, 2014, with identification of 218 receiving neurology consults between 30 days pre-OLT and 90 days post-OLT, with review of all records necessary to determine initial findings and follow-up examination. Results Seventy-three consults for 69 patients were identified, with 27 felt to be altered since a procedure, 20 with sudden-onset altered mentation, and 26 with gradual or waxing-waning course. A single underlying etiology was identified in only 19 cases, with multiple factors involved in all others, with metabolic, toxic, infectious, and structural etiologies most often implicated. There was no statistically significant difference in outcome for those with altered mental status consults versus the total OLT population, though the sudden-onset presentation group did show significantly increased mortality rates. Conclusions This systematic study illustrates the variety of potential causes of altered mentation within the perioperative setting of liver transplantation. Workup including neuroimaging (preferably magnetic resonance imaging), infectious cultures, and expanded metabolic laboratory tests should be undertaken.
Evaluation of a new venous catheter blood draw device and its impact on specimen hemolysis rates.

Abstract Objectives Blood collections from peripheral intravenous catheters offer several benefits to patients, including reduced needle punctures and patient discomfort, but they risk reducing the quality of blood specimens analyzed by the laboratory. In an effort to balance analytical quality of test results with patient-centered care initiatives, a needle-less blood collection device called PIVO™ was evaluated at two institutions. The primary objective of this study was to assess the ability of the PIVO™ device to provide high-quality blood specimens for laboratory testing compared to current blood collection methods. Methods Blood specimens drawn using the PIVO™ device were prospectively flagged. A retrospective review was performed comparing the degree and rate of hemolysis for PIVO™ blood collections to both concurrent and historical hemolysis rates for other collection methods. Results Approximately 7600 PIVO™ blood draws were performed across the two institutions. The hemolysis rates of samples collected with PIVO™ were evaluated using 2380 flagged collections, containing approximately 1200 test orders requiring hemolysis index measurements. The hemolysis rate of PIVO™-flagged samples (1.8%) was statistically superior to the venipuncture and central line blood collection methods (3.3%), reducing the risk of hemolysis during a venous blood draw by 39%. Conclusions PIVO™ collections facilitated improvement in the rate and degree of sample hemolysis when compared to venipuncture and central line blood collections. These findings suggest that PIVO™ is capable of delivering samples that are superior to current blood collection methods in terms of hemolysis rate as well as reducing the number of invasive venipunctures required for laboratory testing.
An Extension of Spatial Dependence Models for Estimating Short-Term Temperature Portfolio Risk

Temperature risk is any adverse financial outcome caused by temperature outcomes. The Chicago Mercantile Exchange lists a series of financial products that link payments to temperature outcomes, an...
Radiation Segmentectomy: Potential Curative Therapy for Early Hepatocellular Carcinoma

Radiation segmentectomy provides local tumor control, prolonged time to progression, and overall survival outcomes comparable to radiofrequency ablation, resection, and transplantation for Barcelona Clinic Liver Cancer stage 0 or A patients. This treatment should be further investigated as a potentially curative treatment in patients not amenable to standard options.
A hunger for hunger: a review of palliative therapies for cancer- associated anorexia

Cancer-associated anorexia, or loss of appetite, is prevalent, distressing to patients and their families, and associated with poorer outcomes in patients with advanced cancer. A well-defined therapeutic strategy remains to be defined. We present here a review of appetite loss in cancer patients with a summary of how best to manage this symptom.
Computing Differential Invariants as Fixed Points

We introduce a fixed-point algorithm for verifying safety properties of hybrid systems with differential equations whose right-hand sides are polynomials in the state variables. In order to verify nontrivial systems without solving their differential equations and without numerical errors, we use differential induction as a continuous generalisation of induction, for which our algorithm computes the required differential invariants. As a means for combining local differential invariants into global system invariants in a sound way, our fixed-point algorithm works with differential dynamic logic as a compositional verification logic for hybrid systems. To improve the verification power, we further introduce a saturation procedure that refines the system dynamics successively by differential cuts with differential invariants until the property becomes provable. By complementing our symbolic verification algorithm with a robust version of numerical falsification, we obtain a fast and sound verification procedure. We verify roundabout manoeuvres in air traffic control and collision avoidance in train control.
The Hydrolyzable Tannins

Publisher Summary This chapter discusses hydrolyzable tannins. Natural tannins are classified as either condensed or hydrolyzable tannins, the latter being esters of a sugar with one or more polyphenolic carboxylic acids. The sugar is usually glucose, but in a few cases, polysaccharides or branched-chain sugars are known to occur. The hydrolyzable tannins are usually further classified as either gallotannins, which give gallic acid on hydrolysis, or ellagitannins, which give ellagic acid. This division, however, is not definite as all of the known ellagitannins also give gallic acid on hydrolysis. These polyphenols, viz., the simple monogalloylglucoses, are breakdown products of, and frequently co-occur with natural tannins. The chemistry of the hydrolyzable tannins is of doubtful value because of the difficulties encountered in the separation of the individual constituents and the lack of reliable methods for determining the purity of the isolated compounds. Two-dimensional paper chromatography, however, provides a rapid, facile criterion of the homogeneity of a tannin constituent. The hydrolyzable tannins give clear, well-defined spots when chromatographed in dilute acetic acid in the first direction, and n-butyl alcohol-acetic acid water in the second direction.
Point-of-Care Ultrasound as Part of a Short-Term Medical Mission to Rural Nicaragua

Objectives The lack of access to diagnostic imaging in resource-limited settings (RLSs) poses a worldwide problem. Advances in ultrasound (US) imaging technology bridge this gap, particularly when examinations are performed by physicians and integrated into the patient encounter, termed point-of-care ultrasound (POCUS). Because the number of physicians participating in short-term medical missions (STMMs) is increasing, the authors sought to characterize how the use of POCUS would affect care delivered as part of a 1-week outreach trip in rural Nicaragua. Methods In February 2017, as part of an ongoing collaboration among the University of South Carolina, the Medical University of South Carolina, and OneWorld Health, the authors conducted an observational prospective study of all of the patients who received a POCUS examination as part of standard clinical practice during an STMM to Sebaco, Nicaragua. The goal was to determine how often POCUS changed medical management. In addition, the number and types of scans performed were recorded to assess the most common reasons for POCUS use. Results More than 1100 patients were seen, and a total of 79 POCUS examinations were performed on 59 patients by 2 physicians with extensive POCUS training. Eighty percent of the patients were women, with an average age of 40.5 years (range 1.6-87 years). The use of US changed management for 35.6% of total patients examined (N = 21), divided among changes in diagnosis, pharmacotherapy, new referral, or referral not needed. The average time to perform a POCUS examination was 6.0 minutes. A wide range of POCUS examinations were performed, with lung, gallbladder, obstetric/gynecologic, and cardiac examinations performed most often. Conclusions Incorporating POCUS by trained physicians in an RLS as part of an STMM was successful and often changed management. As interest in nonemergency and noncritical care POCUS increases and proliferation of low-cost, accurate, handheld US devices continues, it is probable that more physicians traveling to RLSs will use POCUS as part of STMMs, positively affecting patient care.
Sex differences in the association between apolipoprotein E ε4 allele and Alzheimer's disease markers.

Abstract Introduction We determined whether the effect of apolipoprotein E (APOE)-e4 genotype on Alzheimer's disease (AD) markers differs in men and women across AD stages. Methods Among normal control (NC) participants (N = 702) and participants with mild cognitive impairment (N = 576) and AD (N = 305), we examined the associations of sex and APOE-e4 carrier status with cortical amyloid-β (Aβ) burden, hippocampal volume ratio (HpVR; hippocampal volume/intracranial volume × 103), brain glucose metabolism, and verbal memory. Results In NC, APOE-e4 related to greater Aβ burden and poorer verbal memory across sex but to smaller HpVR and hypometabolism in men only. In mild cognitive impairment, APOE-e4 related to smaller HpVR, hypometabolism, greater Aβ burden, and poorer verbal memory across sex. In AD, APOE-e4 related to greater Aβ burden in men only and smaller HpVR across sex and showed no association with hypometabolism or verbal memory. Discussion Sex differences in the association between APOE-e4 and AD markers vary by disease stage.
Peptidomic and glycomic profiling of commercial dairy products: identification, quantification and potential bioactivities

Peptidomics and glycomics are recently established disciplines enabling researchers to characterize functional characteristics of foods at a molecular level. Milk-derived bioactive peptides and oligosaccharides have garnered both scientific and commercial interest because they possess unique functional properties, such as anti-hypertensive, immunomodulatory and prebiotic activities; therefore, the objective of this work was to employ peptidomic and glycomic tools to identify and measure relative and absolute quantities of peptides and oligosaccharides in widely consumed dairy products. Specifically, we identified up to 2117 unique peptides in 10 commercial dairy products, which together represent the most comprehensive peptidomic profiling of dairy milk in the literature to date. The quantity of peptides, measured by ion-exchange chromatography, varied between 60 and 130 mg/L among the same set of dairy products, which the majority originated from caseins, and the remaining from whey proteins. A recently published bioactive peptide database was used to identify 66 unique bioactive peptides in the dataset. In addition, 24 unique oligosaccharide compositions were identified in all the samples by nano LC Chip QTOF. Neutral oligosaccharides were the most abundant class in all samples (66-91.3%), followed by acidic (8.6-33.7%), and fucosylated oligosaccharides (0-4.6%). Variation of total oligosaccharide concentration ranged from a high of 65.78 to a low of 24.82 mg/L. Importantly, characterizing bioactive peptides and oligosaccharides in a wider number of dairy products may lead to innovations that go beyond the traditional vision of dairy components used for nutritional purposes but that will rather focus on improving human health.
The use of liquid and tissue biopsy genomic testing in lung cancer: A single-institution experience.

e20692Background: Liquid biopsy is an evolving minimally invasive technique to detect cell-free DNA (cfDNA) and cfRNA mutations by next generation sequencing (NGS) in plasma. In our Thoracic Oncolo...
Urinary Tract Infection

Urinary tract infection (UTI) refers to a condition in which there is growth of bacteria within the urinary tract. It is one of the most common bacterial diseases in children; 5% of girls and 0.5% of boys will experience at least one infection. Over the past few years, the approach to UTI has dramatically changed and is more focused on host susceptibility to infection, to the characteristics of the pathogens involved (mainly E. coli) and to the relation between UTI and vesicoureteric reflux (VUR) (Gross and Lebowitz 1981; Jodal 1994; Jodal and Lindberg 1999; Hellerstein 1995; Mannhardt et al. 1986; Roberts 1990; Majd et al. 1991). Of special importance is the identification of individuals with complicated UTI, i.e., those with abnormalities of the kidneys, VUR or bladder dysfunction (Ditchfeld et al. 1994a, 1994b). Symptomatic UTI must be differentiated into highertract infection, with lesions of the kidneys — acute pyelonephritis and pyelitis — and lower tract infections — acute cystitis. Upper UTIs usually present clinically with high fever and generalized symptoms, whereas lower UTIs present with voiding symptoms. It is often impossible to differentiate them or even sometimes to properly diagnose UTI (American Academy of Pediatrics 1999). Pathologically, in case of acute pyelonephritis (APN), inflammatory edema and microabscesses develop in the renal parenchyma; inflammatory lesions of the renal pelvic wall are often associated. If left untreated, the lesions evolve toward necrosis of the renal parenchyma, loss of nephrons, and formation of scars (Talner et al. 1994). Long-term complications include reflux nephropathy (RN) (also named “chronic pyelonephritis”), renal hypertension, renal failure, and end-stage renal disease. Risk factors for development of pyelonephritic scars include urinary tract obstruction, VUR with dilatation, low age, uncircumcised neonates, bladder dysfunction, delay of treatment, recurrent attacks even with bacteria of low virulence (Chambers 1997; Van Howe 1998; Ring and Zobel 1988).
Snoring: a source of noise pollution and sleep apnea predictor

Snoring is a highly prevalent condition associated with obstructive sleep apnea (OSA) and sleep disturbance in bed partners. Objective measurements of snoring in the community, however, are limited. The present study was designed to measure sound levels produced by self-reported habitual snorers in a single night. Snorers were excluded if they reported nocturnal gasping or had severe obesity (BMI > 35 kg/m2). Sound was measured by a monitor mounted 65 cm over the head of the bed on an overnight sleep study. Snoring was defined as sound ≥40 dB(A) during flow limited inspirations. The apnea hypopnea index (AHI) and breath-by-breath peak decibel levels were measured. Snore breaths were tallied to determine the frequency and intensity of snoring. Regression models were used to determine the relationship between objective measures of snoring and OSA (AHI ≥ 5 events/h). The area under the curve (AUC) for the receiver operating characteristic (ROC) was used to predict OSA. Snoring intensity exceeded 45 dB(A) in 66% of the 162 participants studied, with 14% surpassing the 53 dB(A) threshold for noise pollution. Snoring intensity and frequency were independent predictors of OSA. AUCs for snoring intensity and frequency were 77% and 81%, respectively, and increased to 87% and 89%, respectively, with the addition of age and sex as predictors. Snoring represents a source of noise pollution in the bedroom and constitutes an important target for mitigating sound and its adverse effects on bed partners. Precise breath-by-breath identification and quantification of snoring also offers a way to risk stratify otherwise healthy snorers for OSA.
CausalConvLSTM: Semi-Supervised Log Anomaly Detection Through Sequence Modeling

Computer systems utilize logging to record events of interest. These logs are a rich source of information, and can be analyzed to detect attacks, failures, and many other issues. Due to the automated generation of logs by computer processes, the volume and throughput of logs can be extremely large, limiting the effectiveness of manual analysis. Rule-based systems were introduced to automatically detect issues based on rules written by experts. However, these systems can only detect known issues for which related rules exist in the rule-set. On the other hand, anomaly detection (AD) approaches can detect unknown issues. This is achieved by looking for unusual behaviors significantly different from the norm. In this paper, we target the problem of semi-supervised log anomaly detection, where the only training data available are normal logs from a baseline period. We propose a novel hybrid model called "CausalConvLSTM" for modeling log sequences that takes advantage of Convolutional Neural Network's (CNN) ability to efficiently extract spatial features in a parallel fashion, and Long Short-Term Memory (LSTM) network's superior ability to capture sequential relationships. Another major challenge faced by anomaly detection systems is concept drift, which is the change in normal system behavior over time. We proposed and evaluated concrete strategies for retraining neural-network (NN) anomaly detection systems to adapt to concept drift.
ANKLE BRACE USE AND RISK OF ACUTE LOWER EXTREMITY INJURY AMONG FEMALE HIGH SCHOOL VOLLEYBALL PLAYERS

Background:Lower extremity injuries (LEIs), particularly ankle sprains, are the most common injury reported among female volleyball players. Many athletes wear ankle braces to help prevent injury; ...
Sarcopenia predicts for long-term survival in patients with thoracoabdominal aortic aneurysms undergoing operative and nonoperative management

Abstract Objective Sarcopenia, defined as a loss of muscle mass or poor muscle quality, is a syndrome associated with poor surgical outcomes. The prognostic value of sarcopenia in patients with thoracoabdominal aortic aneurysms (TAAAs) is unknown. The present study was designed to define sarcopenia in this patient population and assess its impact on survival among patients who had undergone operative and nonoperative management of TAAAs. Methods We retrospectively reviewed all patients with a diagnosis of a TAAA at an academic hospital between 2009 and 2017 who had been selected for operative and nonoperative management. Sarcopenia was identified by measuring the total muscle area on a single axial computed tomography image at the third lumbar vertebra. The muscle areas were normalized by patient height, and cutoff values for sarcopenia were established at the lowest tertile of the normalized total muscle area. Long-term patient survival was assessed using Kaplan-Meier and Cox regression models. Results A total of 295 patients were identified, of whom 199 had undergone operative management and 96 nonoperative management for TAAAs. The patients selected for nonoperative management were more likely to be women and to have chronic kidney disease, coronary artery disease, cerebrovascular disease, a higher modified frailty index, and a larger aortic diameter. The Kaplan-Meier analyses revealed significantly lower long-term survival for the patients with and without sarcopenia in the operative and nonoperative groups. In Cox regression analyses, sarcopenia was a significant predictor of shorter survival for both operative (hazard ratio, 0.96; 95% confidence interval, 0.94-0.99; P = .006) and nonoperative (hazard ratio, 0.95; 95% confidence interval, 0.90-1.00; P = .05) groups after adjusting for age, race, sex, maximum aortic diameter, modified frailty index, chronic kidney disease, and active smoking. Additionally, age was a significant predictor of shorter survival in the operative group, and smoking and aortic diameter were significant in the nonoperative group. Conclusions In our cohort of patients who had received operative and nonoperative management of TAAAs, the patients with sarcopenia had had significantly lower long-term survival, regardless of whether surgery had been performed. These data suggest that sarcopenia could be used as a predictor of survival for patients with TAAAs and might be useful for risk stratification and decision making in the management of TAAAs.