cssi/SciSciGPT-SciSciNet huggingface dataset:
Dynamic thermal management of high heat flux devices using embedded solid-liquid phase change materials and solid state coolers

Dynamic operation and control is an essential tool for thermal management of a number of next generation electronic devices that suffer from localized hotspots with large heat fluxes. Due to limited cooling resources, the time that high heat flux devices can operate before load mitigation approaches must be employed is limited. To mitigate the spatial and temporal non-uniformities in chip temperature that result from dynamic power maps, the authors have introduced a novel thermal management approach that integrates solid-liquid phase change materials (PCMs) with an embedded heat spreader network directly into the die near the hotspots. This combined PCM-heat spreader network, or Composite Thermal Capacitor (CTC), gives the device a large increase in the local thermal capacitance near the hotspots. A prototype CTC that monolithically integrates micro heaters, PCMs and a Si spreader matrix into a test chip has been fabricated and shown to increase allowable device operating times by over 650% and address heat fluxes of up to ∼395 W/cm2. Coupled to the CTCs are solid state coolers (SSCs) that deliver fast regeneration of the CTCs during throttling events. Experiments that couple thermoelectric coolers to the CTCs, show that system duty cycles of over 50% can be achieved.
Evidence for Oxygen Use in the Hospitalized Patient: Is More Really the Enemy of Good?

Oxygen in arguably one of the most frequently utilized drugs in modern healthcare, but is often administered to patients at caregivers' discretion with scant evidence as to its efficacy or safety. Although oxygen is administered for varied medical conditions in the hospital setting, published literature supports the use of oxygen to reverse hypoxemia, for trauma victims with traumatic brain injury and hemorrhagic shock, for resuscitation during cardiac arrest, and for carbon monoxide poisoning. Oxygen should be titrated to target an S(pO2) of 94-98%, except with carbon monoxide poisoning (100% oxygen), ARDS (88-95%), those at risk for hypercapnia (S(pO2) 88-92%), and premature infants (S(pO2) 88-94%). Evidence for use with other conditions for which oxygen is administered relies on anecdotal experiences, case reports, or small, underpowered studies. Definitive conclusions for oxygen use in these conditions where efficacy and/or safety are uncertain will require large randomized controlled clinical trials.
The effects of vitamin‐E deficiency on the development of the chick

In an investigation of the hatchability of eggs from hens fed on a diet deficient in vitamin E Card found that all embryos from these eggs died during development. Study of these chicks showed that a variety of conditions were responsible for death: During early development the rate of growth and differentiation was definitely slower than under normal conditions, but malformations were rare. Some embryos died during the first two days, due to disintegration of the circulatory system or its failure to become established. At the end of the fourth day there was a definite critical period which few specimens survived and by this time distinet pathological conditions had arisen in extra-embryonic structures. These involved wiping out of the vitelline circulation by establishment of a lethal ring in the blastoderm. This structure was produced by intensive cell proliferation in the mesoderm which resulted in choking out vitelline blood vessels and their subsequent degeneration. It also caused obliteration of the exocoele, with consequent failure of the allantois to expand. In addition, many embryos showed profuse haemorrage into the exocoele. The source of bleeding was most frequently in the atrium of the heart, and at the actual rupture peculiar cells occurred which were probably histiocytic mesenchyme cells. Although death was due directly to causes enumerated above, the ultimate responsibility rests upon conditions set up by them, namely: starvation, asphyxiation, and loss of the medium (blood) by which to carry on metabolic exchange.
Light reflection and transmission by a temperate snow cover

An understanding of the reflection and transmission of light by snow is important for snow thermodynamics, hydrology, ecology and remote sensing. Snow has an intricate microstructure replete with ice/air interfaces that scatter light. Spectral observations of light reflection and transmission, from 400 to 1000 nm, were made in temperate snowpacks, under cold and under melting conditions. The optical observations were made using a dual-detector spectroradiometer. One detector was placed above the snow surface to monitor the incident and reflected solar irradiance, and the second detector was placed at the base of snow cover to measure downwelling irradiance. The optical measurements were supplemented by a physical characterization of the snow, including depth, density and an estimate of grain size. In general, transmitted light levels were low and showed a strong spectral dependence, with maximum values between 450 and 550 nm. For example, a 10 cm thick snow layer reduced visible transmission (500 nm) to about 5% of the incident irradiance, and infrared transmission (800 nm) to less than 1%. Extinction coefficients were in the range 3-30 m -1 , and tended to decrease slightly as the snow aged and increase as snow density increased.
An empirical approach for efficient all-to-all personalized communication on Ethernet switched clusters

All-to-all personalized communication (AAPC) is one of the most commonly used communication patterns in parallel applications. Developing an efficient AAPC routine is difficult since many system parameters can affect the performance of an AAPC algorithm. In this paper, we investigate an empirical approach for automatically generating efficient AAPC routines for Ethernet switched clusters. This approach applies when the application execution environment is decided, and it allows efficient customized AAPC routines to be created. Experimental results show that the empirical approach generates routines that consistently achieve high performance on clusters with different network topologies. In many cases, the automatically generated routines out-perform conventional AAPC implementations to a large degree.
Polyurethane Pad Degradation and Wear Due to Tungsten and Oxide CMP

Polyurethane polishing pads are commonly used for chemical-mechanical polishing (CMP) of semiconductor wafers. Structural, chemical, and mechanical property changes of the polishing pads due to CMP are examined. Tungsten and oxide film layers are polished from the wafer surface using the polishing pad and abrasive slurry system. The polishing pad surface is flattened with polishing, and hence, reducing the effective area for slurry transport. The abrasive is used for abrading off the film from the surface. W, Al, I, and K accumulate in the polishing pad after tungsten CMP and Si accumulates after oxide CMP. Material accumulates in the pad pores and grooves. Electron Microprobe X-ray Analysis and Wavelength Dispersive Spectrometry (WDS) were used to examine the changes across the thickness of the pad. Fourier Transform Infrared Spectroscopy (FTIR) was used to determine the changes to the polyurethane isocyanate group. The reduction in the isocyanate group and increase in the hydroxyl group after tungsten CMP indicates that a hydrolysis reaction of the isocyanate to form carboxylic acid occurs.
Computational Analysis of High Throughput Flow Cytometry Data

Introduction: Flow cytometry has been around for over 40 years, but only recently has the opportunity arisen to move into the high-throughput domain. The technology is now available and is highly competitive with imaging tools under the right conditions. Flow cytometry has, however, been a technology that has focused on its unique ability to study single cells and appropriate analytical tools are readily available to handle this traditional role of the technology. Areas covered: Expansion of flow cytometry to a high-throughput (HT) and high-content technology requires both advances in hardware and analytical tools. The historical perspective of flow cytometry operation as well as how the field has changed and what the key changes have been discussed. The authors provide a background and compelling arguments for moving toward HT flow, where there are many innovative opportunities. With alternative approaches now available for flow cytometry, there will be a considerable number of new applications. These op...
High frequency chest wall oscillation plus Mechanical In-Exsufflation in Duchenne muscular dystrophy with respiratory complications related to pandemic Influenza A/H1N1

Two young boys with Duchenne muscular dystrophy, who had contracted 2009 pandemic influenza A/H1N1 (pH1N1), had been treated with antibiotics and steroids without significant improvement. One of them showed severe scoliosis. After hospitalization chest CT scan revealed extensive pulmonary bilateral segmental atelectasis. Their clinical and radiological findings rapidly improved when a sequential respiratory physiotherapy protocol was adopted that consisted of the application of multiple sessions of high-frequency chest wall oscillations, each one followed by mechanically assisted coughing manoeuvres. The protocol was well tolerated, effective, easy to apply and special positioning was not required. Fifteen days after treatment initiation both patients clinically recovered. This treatment can be very helpful for neuromuscular patients, particularly when scoliosis prevents conventional respiratory physiotherapy.
Hawkfish Amblycirrhitus indicus Fowler, 1938: A Junior Synonym of Amblycirrhitus pinos (Mowbray, 1927), the Result of Locality Error

Abstract Evidence is presented that the cirrhitid fish Amblycirrhitus indicus Fowler, 1938, a new name for the preoccupied Cirrhites fasciatus Cuvier, 1829, is the Atlantic Amblycirrhitus pinos (Mowbray, 1927). Cuvier's type locality of India is regarded as a probable error.
Pathogenetics of Disease

Abstract: In this article, the emphasis is on disease. However, we stress the relationship of genetic processes to ordinary developmental mechanisms and maintenance of the healthy body, known as orthogenetics. Precise definition of a disorder, although an important question in its own right, is a luxury that we cannot afford here. For this reason, orthogenetics and pathogenetics are best seen as parts of a single continuous field of inquiry. Understanding the phenotype comes from the interactions among the insights from many disciplines.
Immersive video

Interactive video and television viewers should have the power to control their viewing position. To realize this, we introduce the concept of immersive video, which employs computer vision and computer graphics technologies to provide viewers of live events a sense of total immersion by providing the viewer with a "virtual camera". Immersive video uses multiple videos of an event, captured from different perspectives, to generate a full 3D digital video of that event. While replaying this 3D digital movie, interactive viewers are able to explore the scene continuously from any perspective. This is accomplished by combining an a priori static model with a dynamic model that is created by assimilating dynamic information from each video stream into a comprehensive three dimensional environment model. We formalize the concept of immersive video, describe the architecture of our current implementation, and illustrate immersive video in staged karate demonstrations and basketball games. In its full realization, immersive video will be a paradigm shift in visual communication which will revolutionize television and video media, and will become an integral part of future telepresence and virtual reality systems.
Noise generation by ducted combustion systems

Analysis of the interaction between a zone of nonsteady combustion and its confining duct shows that resonant type oscillations occur with resulting noise intensities far greater than from corresponding unconfined flame zones. The blading action on the flow through the compressor and turbine of an engine generates discrete frequency noise which, it is found, is enhanced by the response of the combustion zone in between. Ducted combustor experiments verify the predicted resonant type noise, the amplitude and frequency of which are strongly influenced by the duct dimensions and end impedance. A convergent exit nozzle results in stronger internal resonant noise oscillations but also generates a higher jet velocity, with the attendant jet noise which exceeds noise from inside the duct at jet Mach numbers near unity.-
Chemistry of hexafluorobicyclo[1.1.0]butane: a computational study.

Despite its very weak central C−C bond, the yet-unknown hexafluorobicyclobutane is predicted to be quite robust. Unlike the parent hydrocarbon, which undergoes thermal rearrangement to butadiene, the perfluoro compound will yield hexafluorocyclobutene upon heating. The fluorobicyclobutane will react under mild conditions with a variety of reagents, in particular with certain alkenes in a new type of concerted transformation. This “fluorohomoene” reaction is shown to be a pseudopericyclic process, as is condensation of the bicyclobutane with water. Whereas the carbene 3-butenylidene rearranges primarily to butadiene, its perfluoro counterpart is predicted to be an efficient precursor for hexafluorobicyclobutane.
Fearfulness in the Community: Empirical Assessments of Influential Factors.

Fear of crime has been well studied; however, there has yet not been widespread consideration of the potential impact of both individual- and neighborhood-level factors on residents’ level of fear of crime. From a logistic-regression analytical standpoint, the present study empirically explores the contribution of several factors in explaining residents’ propensity for being fearful of crime. Precisely, the study tests the applicability and generalizability of three theoretical perspectives of fear of crime in the Ghanaian context and examines the effects of residents’ attitudes toward the police on their levels of fear of crime. Using large-scale cross-sectional data collected on more than 1,000 residents from 25 neighborhoods in Ghana, the results demonstrate significant predictive effects of both individual- and neighborhood-level factors on citizens’ rate of fearfulness. Findings from this study have both theoretical and practical implications, and provide important insights for the police to reduce l...
Wet-Chemical Passivation of InAs: Toward Surfaces with High Stability and Low Toxicity

In a variety of applications where the electronic and optical characteristics of traditional, siliconbased materials are inadequate, recently researchers have employed semiconductors made from combinations of group III and V elements such as InAs. InAs has a narrow band gap and very high electron mobility in the near-surface region, which makes it an attractive material for high performance transistors, optical applications, and chemical sensing. However, silicon-based materials remain the top semiconductors of choice for biological applications, in part because of their relatively low toxicity. In contrast to silicon, InAs forms an unstable oxide layer under ambient conditions, which can corrode over time and leach toxic indium and arsenic components. To make InAs more attractive for biological applications, researchers have investigated passivation, chemical and electronic stabilization, of the surface by adlayer adsorption. Because of the simplicity, low cost, and flexibility in the type of passivating...
Neurobiology: Wired for sex

Analysis of a sensory neural circuit in the roundworm Caenorhabditis elegans reveals that its wiring is sex-specific, and arises through the elimination of connections that are originally formed in both sexes. See Article p.206
Chemical Structure-Based and Toxicogenomic Models

All pharmaceuticals undergo a comprehensive panel of non-clinical tests to ensure their safety before being approved for use in humans. Genetic toxicity and carcinogenicity testing in whole animal and cell-based assays are a significant component of this testing and the outcome of these studies can significantly impact the marketability of a drug product. Consequently, there is a strong desire for pharmaceutical developers to assess the potential of new drug candidates to cause these effects prior to investing significant resources and in advance of regulatory submission. Early screening of pharmaceutical candidates can be performed through the application of computational methods that evaluate the relationship between chemical structural descriptors and genotoxic and/or carcinogenic outcomes. (Quantitative) structure-activity relationship [(Q)SAR] models represent an entirely virtual assessment that relies only on knowledge of chemical structure to provide a prediction, making them inexpensive and rapid to apply without the need for synthesis of the potential drug candidate. Toxicogenomic-based approaches aim to assess biological functions based on interactions among various parts of biological systems with emphasis on molecular pathways. Toxicogenomics consists of interrogating pathways via studying the genome-wide gene expression changes, and is the most widely explored systems biology methodology in carcinogenicity and genotoxicity risk assessment. It is typically performed at later stages of the drug development process to interpret chemical exposure-induced perturbations of biological pathways by identifying molecular initiating events that can predict downstream genotoxic and carcinogenic consequences, as well as address the question of human relevance of non-clinical safety findings. Although the qualification of toxicogenomic-based approaches for regulatory use is being pursued by industry and regulatory agencies, the application of these methodologies is currently limited to exploratory analyses by pharmaceutical developers. In contrast, in addition to their application to early drug discovery, (Q)SAR models are now being routinely utilized under harmonized regulatory guidance for the late-stage safety assessment of drug substance impurities.
Research on Recognition Technology for Magnetic Flux Leakage of Pipeline Defects and Patches

A recognition method of the magnetic flux leakage of defects and patches in pipeline magnetic flux leakage testing is proposed.The mathematical analysis model for MFL is established,based on Maxwell's equations.A simulation model is established under a finite element theory.It conducts a comparative analysis of the magnetic flue leakage of defects,pathches,the presence of defects and patches at the same time;and through an analysis of the magnetic field of neighboring patches,it obtained the recognition method for recognizing the defects and patches and provided an important theoretical basis for enhancing the precision of magnetic flux leakage.
High Pressure Contactless Viscous Seals

The development of high-pressure equipment is often hindered by the non-availability of seals that can withstand the extreme environment to which they are subjected. Besides containing the high pressure, these seals are often called upon to withstand extremes of high temperature and severe wear.
Dietary supplement use in elderly, long-term cancer survivors: Who are the users? What proportion benefit? What are the costs?

B54 The primary aim of this study was to examine dietary supplement-use among older (>65y), long-term survivors (>5 years post-diagnosis) of breast, prostate and colorectal cancer. Specific objectives were to: 1) identify predictors of supplement use; 2) determine associations between supplement use and overall diet quality; and 3) compare expenditures on supplements across strata of income. The sample was comprised of 753 cancer survivors who participated in telephone screening interviews to determine eligibility for a randomized diet and physical activity intervention trial entitled RENEW: Reach-out to ENhancE Wellness in Cancer Survivors. Telephone surveys were conducted through 2005-2007 by the Diet Assessment Center at Pennsylvania State University and included two 24-hour dietary recalls and items regarding dietary supplement use (type, dose, frequency and duration). >Nutrient intakes for 13 vitamins and minerals were determined from diet alone and from diet combined with supplemental intake and compared to the Estimated Average Requirements (EARs) and the Tolerable Upper Intake Levels (ULs). Diet quality was assessed using the revised Healthy Eating Index (HEI). Descriptive statistics were primarily used for this exploratory cross-sectional study with student’s t-tests used for continuous variables and chi-square tests for categorical variables. Multivariate logistic regression was employed to determine demographic, disease and health-related predictors of supplement use. >A majority of survivors (74%) reported taking dietary supplements, ranging from 70% among survivors of colorectal cancer to 80% among breast cancer survivors. A wide variety of supplements were taken, though multivitamins (60%), calcium/vitamin D combinations (37%), antioxidant combinations (30%) and fatty acids/oils (21%) were the most prevalent. Results suggest that supplement users had significantly higher mean HEI scores and nutrient intakes for 12 of the 13 vitamins and minerals investigated (all P 70 years), higher levels of education, female gender, non-smoking status and higher HEI scores. Overall, dietary supplements may considerably increase the prevalence of nutrient adequacy among older cancer survivors, but also may contribute to risk of excessive intakes for certain nutrients, especially vitamin A. Future studies investigating long-term use of supplements are warranted to evaluate if intended benefits are achieved while risks of excessive intakes are minimized.
Economic Evaluations of First-Line Chemotherapy Regimens for Pancreatic Cancer: A Critical Review.

Effect sizes of efficacy of first-line treatments for (metastatic) pancreas cancer are constrained, underscoring the need for evaluations of the efficacy-to-cost relationship. We critically review economic evaluations of first-line chemotherapy regimens for pancreatic cancer since the 1997 introduction of gemcitabine. We searched PubMed/MEDLINE and EMBASE (1997–2015), and the websites of health technology assessment agencies. Two authors independently reviewed economic studies for eligibility in this review; evaluated peer-reviewed, journal-published studies in terms of the Drummond Checklist; and critiqued the technical and scientific merit of all studies. Sixteen pharmacoeconomic evaluations were included: ten published in nine peer-reviewed journals and six on three websites. Six were on single-agent therapies and ten on combination therapies. Analyses conducted included cost-effectiveness (three studies), cost-utility (one study), or combined cost-effectiveness and cost-utility (12 studies). Studies diverged in results, mainly because of different assumptions, methods, inputs, and country-specific guidelines. The two most recent regimens, nanoparticle albumin-bound paclitaxel plus gemcitabine (NAB-P + GEM) and the combination of fluorouracil, oxaliplatin, leucovorin, and irinotecan (FOLFIRINOX), were evaluated in an indirect comparison, yielding a statistically similar benefit in overall survival but superior progression-free survival for FOLFIRINOX. NAB-P + GEM showed greater economic benefit over FOLFIRINOX. In conclusion, the divergence in results observed across studies is attributable to economic drivers that are specific to countries and their healthcare (financing) systems. No recommendations regarding the relative economic benefit of treatment regimens, general or country-specific, are made as the purpose of pharmacoeconomic analysis is to inform policy decision-making and clinical practice, not set policy or define clinical practice.
Biomarkers for Predicting Improved Outcomes With Renal Artery Stenting.

See related article, pp 1145–1152 The CORAL study (Cardiovascular Outcomes With Renal Artery Lesions) was an important, prospective, randomized-controlled trial that conclusively demonstrated the lack of clinical benefit of renal artery stent placement compared with optimal medical therapy alone on both renal and cardiovascular outcomes.1 Yet, is this the case in every patient? However, in this cohort of 931 participants, there might be signals as to which patients might benefit from renal artery stenting. Murphy et al2 provide interesting new data in their article suggesting that a urinary albumin excretion ≤the median value of 22 0.5 mg/g was predictive of significantly better event-free survival from the primary composite outcome of renal and cardiovascular events with stenting as compared with those with levels of microalbuminuria above the median. How can one interpret these results? The authors hypothesize that there is biological plausibility in that elevated levels of microalbuminuria indicate the presence of much more advanced systemic endothelial disease and increased likelihood of adverse cardiovascular outcomes. Thus, although all patients with renal artery disease deserve …
Sustained High Level of Healthcare Worker Adherence With Hand Hygiene Practice Recommendations Using the Patient-as-Observer Approach in the Ambulatory Setting

We report on a quality improvement initiative for hand hygiene adherence using the patient-as-observer method in the ambulatory setting. There were 604,661 observations recorded with improvement of adherence from 88% to 95% or greater; alcohol-based hand sanitizer purchasing correlated with this increase. This sustainable method effectively ensures hand hygiene adherence. Infect Control Hosp Epidemiol 2016;1496-1498.
Do Undiagnosed Suicide Decedents Have Symptoms of a Mental Disorder

Background Psychological autopsy studies consistently report that the rate of detected mental disorders among suicide decedents is below 100%. This implies three possibilities: (a) a subset of suicide decedents did not have a mental disorder at the time of death; (b) all suicide decedents suffered from a mental disorder, but some were undetected due to methodological limitations; and/or (c) suicide decedents with an undetected mental disorder displayed significant and perhaps subclinical features of a mental disorder. Objective In this article, we examined these possibilities by evaluating the differences in symptoms and stressors between suicide decedents who were undiagnosed and those diagnosed with a mental disorder at the time of death. Method We reviewed 130 case studies of community-based suicide decedents originally described in Robins’ (1981) psychological autopsy study. Results Without exception, suicide decedents in Robins’ sample suffered either from a clearly diagnosable mental disorder or displayed features indicative of a significant, even if subclinical, presentation of a mental disorder. Undiagnosed and diagnosed suicide decedents did not significantly differ with regards to demographics, violence of suicide method, suicide attempt history, the number and intensity of stressful life events preceding death, and whether their death was a murder-suicide. Conclusion Although clearly not all who suffer from mental disorders will die by suicide, these findings imply that all who die by suicide appear to exhibit, at minimum, subclinical psychiatric symptoms with the great majority showing prominent clinical symptoms. We conclude with clinical implications and recommendations for future study.
Post-traumatic Arthritis of the Elbow

Post-traumatic arthritis of the elbow is a rare and often debilitating disorder. Stiffness, pain, and loss of range of motion are common presenting symptoms. It is important to get a history of the fracture/dislocation event, along with treatment undertaken and infections and nerve symptoms encountered. Radiographs are often diagnostic with CT occasionally helpful. Non-operative measures can be utilized initially which include nonsteroidal anti-inflammatories, steroid injections, gentle range of motion activities, and activity modification. Surgical options include arthroscopy, ulnohumeral arthroplasty with debridement, interposition arthroplasty, and total elbow arthroplasty with arthrodesis used as a salvage procedure. Total elbow arthroplasty used in patients less than 60 years of age is associated with a high complication failure rate and subsequent reoperation. Isolated arthritis of the radiocapitellar or distal humerus joint can be treated with a variety of surgeries ranging from joint debridement to limited arthroplasty or resection.
E-072 Use of eptifibatide as an alternative to preoperative standard dual antiplatelet therapy load for pipeline intracranial aneurysm flow diversion

Introduction Intracranial aneurysm flow diversion using the Pipeline Embolization Device (PED) has become a common mode of aneurysm treatment. Standard practice involves preoperative loading of a dual antiplatelet (DUAP) regimen that most commonly consists of clopidogrel and aspirin to prevent flow diverter thrombosis. However, preoperative dual antiplatelet treatment can exacerbate procedural hemorrhagic complications, since these agents cannot be easily reversed. By contrast, the antiplatelet effect of the glycoprotein IIb/IIIa agent eptifibatide wears off within 4 to 8 hours following discontinuation. We report the use of eptifibatide in a consecutive series of patients who underwent PED as an alternative to standard DUAP preoperative loading. Methods All patients received an eptifibatide weight-based loading dose of 180 microgram per kilogram upon initial placement of the Pipeline device, with a 12-hour infusion of eptifibatide following completion of the bolus dose at a rate of 2 micrograms/kilogram/minute. All patients were loaded with clopidogrel and aspirin following postoperative clinical assessment, and prior to discontinuation of the eptifibatide 12-hour infusion. Clopidogrel and aspirin platelet inhibition was measured following discharge at least 10 days after discontinuation of epitifibatide to assure therapeutic platelet inhibition: the 10 day delay was utilized to avoid spurious platelet function results from residual traces of serum eptifibatide. Results Seven consecutive patients underwent elective Pipeline flow diversion of unruptured intracranial aneurysms between October 2016 and February 2017. There were six women and one man in this cohort, with ages ranging from 33 to 61 with an average age of 51. All treated aneurysms were located in the intracranial anterior circulation. In one patient, endosaccular aneurysm coil placement was performed along with PED. All patients received a single Pipeline device except for one patient who received two telescoped Pipeline devices. There were no procedural complications in any of the seven PED cases. All patients were discharged home on postoperative day 1 with no evidence of new neurologic deficits or thromboembolic complications. Clopidogrel and aspirin platelet inhibition was measured for 4 of 7 patients two to three weeks after loading with clopidogrel and aspirin utilizing the Verify Now P2y12 and Aspirin Resistance Assay and were found to be therapeutic in all four patients. Conclusion Eptifibatide administration is a safe and effective alternative antiplatelet strategy to preoperative dual antiplatelet loading with clopidogrel and aspirin prior to intracranial aneurysm Pipeline flow diversion. Disclosures: A. Khan: None. R. Ryan: 2; C; Penumbra, Inc. A. Choulakian: None.
Brachial Plexus Neuritis Associated With Anti-Programmed Cell Death-1 Antibodies: Report of 2 Cases.

Abstract Recently, guidelines have been outlined for management of immune-related adverse events occurring with immune checkpoint inhibitors in cancer, irrespective of affected organ systems. Increasingly, these complications have been recognized as including diverse neuromuscular presentations, such as demyelinating and axonal length–dependent peripheral neuropathies, vasculitic neuropathy, myasthenia gravis, and myopathy. We present 2 cases of brachial plexopathy developing on anti–programmed cell death-1 checkpoint inhibitor therapies (pembrolizumab, nivolumab). Both cases had stereotypic lower-trunk brachial plexus–predominant onsets, and other clinical features distinguishing them from Parsonage-Turner syndrome (ie, idiopathic plexitis). Each case responded to withholding of anti–programmed cell death-1 therapy, along with initiation of high-dose methylprednisiolone therapy. However, both patients worsened when being weaned from corticosteroids. Discussed are the complexities in the decision to add a second-line immunosuppressant drug, such as infliximab, when dealing with neuritis attacks, for which improvement may be prolonged, given the inherent slow recovery seen with axonal injury. Integrated care with oncology and neurology is emphasized as best practice for affected patients.
Unleashing the Potential of Data-Driven Networking

The last few years have witnessed the coming of age of data-driven paradigm in various aspects of computing (partly) empowered by advances in distributed system research (cloud computing, MapReduce, etc.). In this paper, we observe that the benefits can flow the opposite direction: the design and management of networked systems can be improved by data-driven paradigm. To this end, we present DDN, a new design framework for network protocols based on data-driven paradigm. We argue that DDN has the potential to significantly achieve better performance through harnessing more data than one single flow. Furthermore, we systematize existing instantiations of DDN by creating a unified framework for DDN, and use the framework to shed light on the common challenges and reusable design principles. We believe that by systematizing this paradigm as a broader community, we can unleash the unharnessed potential of DDN.
EXPERIMENTAL STUDIES ON GENETIC TRANSFER IN TRYPANOSOMES

Publisher Summary This chapter presents the experimental studies on genetic transfer in trypanosomes. One study analyzed absence of genetic transfer of drug-resistance in in vitro cultures of Trypanosoma gambiense and in blood stream forms of T. rhodesiense. Because of the technical difficulties attendant to the cultivation in the laboratory of tsetse flies and infecting them with drug-resistant strains of trypanosomes, experiments to check for syngamy among trypanosomes while residing in the arthropod vector were conducted with two strains of Trypanosoma cruzi (Tulahuen), rendered resistant in culture to 80 microgram/ml nitrofurazone and 62 μg/ml primaquine respectively and then fed through membranes as mixed populations to Triatoma infestans and T. protracta. Flagellates recovered from infected reduviid feces were then tested in antibiotic-medicated test tube cultures for resistance to both drugs. In no instance where the two drug-resistant strains could be re-isolated individually, was it possible to demonstrate flagellates resistant to both nitrofurazone and primaquine. Absence of any demonstrable genetic cross transfer by T. cruzi while in Triatoma provides evidence against sexuality in the cold-blooded host.
Communication barrier in family linked to increased risks for food insecurity among deaf people who use American Sign Language.

Objective Food security is defined as being able to access enough food that will help maintain an active, healthy lifestyle for those living in a household. While there are no studies on food security issues among deaf people, research shows that communication barriers early in life are linked to poor physical and mental health outcomes. Childhood communication barriers may also risk later food insecurity. Design/Setting/Subjects A single food security screener question found to have 82 % sensitivity in classifying families who are at risk for food insecurity was taken from the six-item US Household Food Security Survey Module. Questions related to food insecurity screener, depression diagnosis and retrospective communication experience were translated to American Sign Language and then included in an online survey. Over 600 deaf adult signers (18-95 years old) were recruited across the USA. Results After adjusting for covariates, deaf adults who reported being able to understand little to none of what their caregiver said during their formative years were about five times more likely to often experience difficulty with making food last or finding money to buy more food, and were about three times more likely to sometimes experience this difficulty, compared with deaf adults who reported to being able to understand some to all of what their caregiver said. Conclusions Our results have highlighted a marked risk for food insecurity and related outcomes among deaf people. This should raise serious concern among individuals who have the potential to effect change in deaf children's access to communication.
An Investigation of Culture and Contextual Performance in Projects: What is the Role of Project Leader Personal Style Differences?

Can individual differences in the personal style of the leader contribute to project culture? How might culture boost behavioral outcomes and success in projects? Drawing on a sample of 189 partici...
Nicotinamide complex of silver(III) with expanded coordination number

In strongly alkaline media ([OH−] ≥ 0.12 M), nicotinamide (nica) forms a complex with square-planar Ag(OH)4− [nica] ≥ 0.05 M. The complex decomposes in seconds to nicotinamide N-oxide. The correlat...
Intrarenal pO2 Measured by EPR Oximetry and the Effects of Bacterial Endotoxin

This study used Electron Paramagnetic Resonance (EPR) oximetry to detect the signal arising from oxygen-sensitive crystals of Lithium phthalocyanine (LiPC) implanted in the cortex and outer medulla of an isolated perfused rat kidney. Kidneys with implanted crystals were placed beneath the surface detector of an L-band spectrometer, and an additional gradient was induced between the poles of the magnet so as to separate the signals arising from each region, allowing simultaneous measurement of the partial pressure of oxygen (pO2) at two locations within the same organ. In control kidneys, the pO2 in the cortex was 96.9±7 and that of the outer medulla 11.0±4 mmHg. We found that perfusion pressure could be increased with little effect on the pO2 of the outer medulla. At a critical point (≈140 mmHg) however, pO2 in this region was markedly increased and was accompanied by a decrease in vascular resistance. When kidneys treated in this way were then given L-NMMA (an inhibitor of nitric oxide synthase), the pO2 in the outer medulla returned to baseline values, presumably by blocking nitric oxide-induced vasodilation. Inclusion of Lipopolysaccharide (LPS) into the perfusion media of control kidneys resulted in a decrease in the pO2 in the cortical region and an increase in the outer medullary region. When L-NMMA was given prior to administration of LPS, the changes in pO2 were prevented. Based on these results, we have developed a model which can account for these observations. It indicates that re-distribution of blood (and hence oxygen) within the kidney may have an important role in altering the solute (and oxygen) gradient early during the septic episode.
Anaerobic biodegradation of BTEX and gasoline in various aquatic sediments.

We examined the extent of biodegradation of benzene, toluene, ethylbenzene and the three isomers of xylene (BTEX) as a mixture and from gasoline in four different sediments: the New York/New Jersey Harbor estuary (polluted); Tuckerton, N.J. (pristine); Onondaga Lake, N.Y. (polluted) and Blue Mtn. Lake, N.Y. (pristine). Enrichment cultures were established with each sediment using denitrifying, sulfidogenic, methanogenic and iron reducing media, as well as site water. BTEX loss, as measured by GC-FID, was extensive in the sediments which had a long history of pollution, with all compounds being utilized within 21–91 days in the most active cultures, and was very slight or non-existent in the pristine sediments. Also, the pattern of loss was different under the various reducing conditions within each sediment and between sediments. For example benzene loss was only observed in sulfidogenic cultures from the NY/NJ Harbor sediments while toluene was degraded under all redox conditions. The loss of BTEX was correlated to the reduction of the various electron acceptors. In cultures amended with gasoline the degradation was much slower and incomplete. These results show that the fate of the different BTEX components in anoxic sediments is dependent on the prevailing redox conditions as well as on the characteristics and pollution history of the sediment.
Oxidative Stress and Systemic Changes in Age-Related Macular Degeneration

Several lines of evidence point to a systemic role for oxidative stress in age-related macular degeneration (AMD). Age and smoking are associated with increasing levels of systemic oxidative stress and oral antioxidant supplements have been shown to slow the progression of the disease. In addition, plasma levels of reactive oxygen species and lipid peroxidation products have been closely associated with AMD, and decreased antioxidant enzyme activity has been reported in AMD patients. Polymorphisms in mitochondrial DNA (mtDNA) and in genes coding for antioxidant enzymes have also been linked to AMD. Oxidative stress and inflammatory mediators have been shown to play a role in AMD, although it is unclear whether inflammation is aggravated by oxidative stress or vice versa. As the interaction between inflammation and oxidative stress may be critical to development and progression of AMD, a combination therapy that reduces systemic changes in redox status and controls local inflammation may be able to prevent or at least slow the development of sight-threatening late-stage disease.
Gaming representation: race, gender, and sexuality in video games

Gaming Representation: Race, Gender, and Sexuality in Video Games, edited by Jennifer Malkowski and TreaAndrea M. Russworm, centers the question of identity and representation within video games an...
Post-Hurricane Vital Statistics Expose Fragility of Puerto Rico\'s Health System

Abstract BACKGROUND Hurricane Maria made landfall in Puerto Rico on September 20, 2017. As recently as May of this year (2018), the official death count was 64. This figure was criticized for being overly optimistic by groups with access to September and October demographic registry data. However, because the government was not making all post-hurricane mortality counts publicly available, fully understanding the hurricane’s effect was challenging. A study describing a household survey, published on May 29, 2018, reported a much higher death count estimate, as well as evidence of population displacement, extensive loss of services, and a prolonged death rate increase lasting until the end of the survey period. Three days after this report was published, the government released death registry data. Here we use these data as well as data from other states to provide a detailed description of the effects on mortality of hurricane Marfa. We compare these effects to those of other hurricanes. METHODS We fit a statistical model to mortality data that accounts for seasonal and non-hurricane related yearly effects. We then estimated the deviation from the expected death rate as a function of time using natural cubic splines that allowed discontinuities at hurricane landfall dates. We fit this model to 1985-2018 Puerto Rico daily data, which includes the dates of hurricanes Hugo, Georges, and Maria, 2015-2018 Florida daily data, which includes the dates of hurricane Irma, 2002-2004 Louisiana monthly data, which includes the date of hurricane Katrina, and 2000-2016 New Jersey monthly data, which includes the date of hurricane Sandy. RESULTS We estimated death rate increases on the day of the hurricane of 689%, 74%, 33%, 10%, and 2% for Katrina, Maria, Georges, Hugo, and Irma, respectively. No increase was noted for Sandy. We find a prolonged increase in death rate after Maria and Katrina, lasting at least 207 and 125 days, resulting in excess deaths estimates of 3,433 (95% CI, 3,189-3,676), and 1,832 (95% CI, 1,600-2064) respectively, showing that Maria had a more long term damaging impact. Surprisingly, we also find that in 1998, Georges had a comparable impact to Katrina’s with a prolonged increase of 106 days resulting in 1,427 (95% CI, 1,247-1,607) excess deaths. For Hurricane Maria, we find sharp increases in a small number of causes of deaths, including diseases of the circulatory, endocrine and respiratory system, as well as bacterial infections and suicides. CONCLUSIONS Our analysis suggests that since at least 1998, Puerto Rico’s health system has been in a precarious state. Without a substantial intervention, it appears that if hit with another strong hurricane, Puerto Ricans will suffer the unnecessary death of hundreds of its citizens.
Gene Therapy for Nonmalignant Hematology

Hematopoietic stem cell (HSC) gene therapy has effectively become a therapeutic option largely due to the resounding clinical successes in patients with primary immunodeficiencies (PIDs) such as X-linked severe immunodeficiency (SCID-X1), adenosine deaminase deficiency (ADA-SCID), Wiskott-Aldrich syndrome (WAS), and chronic granulomatous disease (CGD). HSC gene therapy is also being investigated in patients with metabolic diseases such as X-linked adrenoleukodystrophy (ALD) and metachromatic leukodystrophy (MLD) and inherited blood disorders such as β-thalassemia and sickle cell disease (SCD) where some therapeutic benefits have been reported more recently. Safer and more efficient self-inactivating (SIN) γ-retroviral and lentiviral vectors have been developed to overcome the genotoxicity imparted by γ-retroviral vectors with intact long terminal repeat (LTR). The discovery and maturation of gene-editing platforms, including zinc-finger nuclease (ZFN), transcription activator-like effector nucleases (TALEN), and clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9, offer exciting prospective strategies for further improving gene therapy by targeting the repair of diseased genes.
A Review of National Insurance Coverage of Post-bariatric Upper Body Lift.

Recent years have seen an increased utilisation of upper body lift following massive weight loss. Although it is typically considered cosmetic, the recurrent skin conditions and decline in quality of life may warrant medical necessity. We evaluated current insurance coverage and characterised policy criteria for upper body lift in the post-bariatric population. We defined upper body lift as a combination of mastopexy and upper back excision (UBE) and conducted a cross-sectional analysis of US insurance policies. Insurance companies were selected based on their enrolment data and market share. A web-based search and telephone interviews were conducted to identify the policy. Criteria were abstracted from the publicly available policies that offered coverage. Of the 56 insurance companies assessed, 5% would consider coverage of both procedures. Although fewer companies held established policies for UBE than mastopexy in the post-bariatric population (79% vs 96%, p = 0.0081), there were significantly more policies that offered pre-approval for UBE than for mastopexy (30% vs 5%, p = 0.0017). Three medical necessity criteria were common to both procedures: evidence of functional impairment, secondary skin conditions, and medical photographs. Policy criteria for coverage of mastopexy or UBE differ greatly between companies. Further evaluation of medical necessity criteria for post-bariatric mastopexy and UBE with the establishment of a standardised guideline is needed. We propose a comprehensive list of reporting recommendations to help optimise authorisation of upper body lift in the post-bariatric population, and we urge plastic surgeons to challenge current definition of “cosmetic” by insurance companies. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .