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Mesocarp bruising is an important postharvest problem of avocado fruit. Bruise expression may be influenced by inherent fruit characteristics, and pre- and postharvest handling practices and conditions. In this supply chain focused study, the putative effects on avocado cv. ‘Hass’ bruise expression and severity of fruit maturity, temporal duration before or after impact injury, fruit firmness, and fruit holding temperature were examined. Mesocarp bruising in ripening fruit decreased in a linear fashion with advancing fruit harvest maturity over 20 weeks. Bruise severity increased progressively in fruit kept for up to 5 weeks before impact injury and also for those kept for up to 7 days after injury. Hard green mature stage fruit did not express bruising at ≤100 cm drop height (∼1.36 J energy absorbed). However, softening, firm ripe, and soft ripe stage fruit impacted from 50 cm (∼0.8 J energy absorbed) developed progressively greater levels of bruising. Keeping fruit at temperatures of 2.5 °C and 5 °C as compared with 20 °C at the time of impact resulted in less bruise expression. Similarly, fruit kept at post-impact temperatures of 2.5 °C and 5 °C as compared with 7.5 °C, 10 °C, and 20 °C also resulted in less bruise expression. Fruit kept at 5 °C for the first 8 h after impact and then at 25 °C for 40 h developed less bruising than fruit kept at 25 °C for 8 h after impact and then at 5 °C for 40 h. Overall, it is proposed that harvesting fruit at ≥23% dry matter concentration, passing them quickly through the supply chain such that bruising has less time to express, and keeping the fruit ‘at’ or ‘below’ 5 °C in the supply chain could reduce bruise expression levels in ripening ‘Hass’ avocado fruit.

Perioperative difficult airway management is one of the most challenging tasks encountered by anesthesiologists. Awake intubation is considered the gold standard in securing the anticipated difficult airway. Effective communication between the anesthesiologist and patient is vital during awake intubation. A language barrier can significantly hinder success and jeopardize patient safety. We report a case of a monolingual Arabic-speaking patient with a difficult airway who required awake intubation to undergo surgery. Google Translate, a free and accessible translation software application, was used during his awake intubation-we recommend such an approach to be considered to reduce anxiety and facilitate success by providing concise, real-time instruction in the patient's preferred language.

Purpose: To report a case of septic thrombophlebitis producing bilateral abducens nerve palsy. Observation: A 65 year-old woman with recent sinus surgery experienced the onset of horizontal diplopia during treatment for bacteremia. Computer tomography of head and a neck ultrasonography showed right internal jugular vein occlusion. Ophthalmology examination was consistent with bilateral abducens nerve palsy. She was treated with systemic antibiotics and antiplatelet therapy with resolution of the internal jugular vein occlusion. The diplopia improved over a six-months. Conclusion and importance: Our patient had Lemierre syndrome with an unusual presentation. The patient was treated for septic thrombophlebitis with a resolution of her ocular symptoms. Keywords: Lemierre syndrome, Septic thrombophlebitis, Abducens nerve, Sixth cranial nerve

This article presents original work combining a NURBS-based inverse analysis with both kinematic and constitutive nonlinearities to recover the applied loads and deformations of thin shell structures. The inverse formulation is tackled by gradient-based optimization algorithms based on computed and measured displacements at a number of discrete locations. The proposed method allows accurately recovering the target shape of shell structures such that instabilities due to snapping and buckling are captured. The results obtained show good performance and applicability of the proposed algorithms to computer-aided manufacturing of shell structures.

Magnetic resonance imaging (MRI) is the modality of choice for liver imaging due to its superior contrast resolution in comparison with computer tomography and the ability to provide both morphologic and physiologic information. The physics of MR are complex, and a detailed understanding is not required to appreciate findings on an MRI exam. Here, we attempt to introduce the basic principles of MRI with respect to hepatic imaging focusing on various commonly encountered hepatic diseases. The purpose is to facilitate an appreciation of the various diagnostic capabilities of MR among hepatic oncologists and surgeons and to foster an understanding of when MR studies may be appropriate in the care of their patients.

The successful treatment of a disease via individualized treatment protocols relies on an early and accurate diagnosis. Advances to imaging hardware, such as hybrid PET/MRI scanners, have overcome the inherit disadvantages associated with the individual imaging modality. However, well-designed multimodal contrast agents are essential to optimally exploit hybrid PET/MRI systems. Herein, we show that core-cross-linked azide-functional star polymer nanoparticles can be simultaneously labelled with a radioisotope (radioiodine) and a clinically-used MRI contrast agent (Gd-DOTA) by exploiting an elegant copper-catalyzed one-pot three-component reaction creating an iodotriazole. The nanoparticles have a longitudinal relaxivity of 5.7 mM−1 s−1 at 7 T (as compared to 3.8 mM−1 s−1 for commercially available Gd-DTPA), and a radiochemical yield of 58% was achieved. Furthermore, we show that the radioiodine content can be fine-tuned without affecting the final Gd-DOTA loading. While we have demonstrated the versatility of the approach with 125I, an isotope widely used in biological research, the availability of various radioiodine isotopes enables potential applications in SPECT (123I), PET (124I) and in theranostics by combining radioimmunotherapy (131I) with MRI.

This paper is the result of a crowdsourced effort to surface perspectives on the present and future direction of international finance. The authors are researchers in financial economics who attended the INFINITI 2017 conference in the University of Valencia in June 2017 and who participated in the crowdsourcing via the Overleaf platform. This paper highlights the actual state of scientific knowledge in a multitude of fields in finance and proposes different directions for future research.

Esophageal perforation is a surgical emergency with significant morbidity. Management of this condition is complex and constantly evolving. To our knowledge, this is the first case series describing repair of esophageal perforation with the use of an isoperistaltic gastroesophagostomy tube connected to continuous suction. We present three patients successfully managed using this technique.

Background: Healthy eating and physical activity are effective non-pharmacological approaches to boost immune function and contain the pandemic. We aimed to explore the associations and interactions between physical activity and healthy eating behavior with COVID-19-like symptoms (Slike-CV19S). Methods: A cross-sectional study was conducted on 3947 outpatients, from 14 February to 2 March 2020, at nine health facilities in Vietnam. Data collection included sociodemographic characteristics, healthy eating behavior (using the healthy eating score (HES) questionnaire), physical activity (using the short form international physical activity questionnaire), and Slike-CV19S. The associations and interactions were tested using logistic regression models. Results: Frequent intake of fruits (OR = 0.84, p = 0.016), vegetables (OR = 0.72, p = 0.036), and fish (OR = 0.43, p &lt, 0.001) were associated with a lower Slike-CV19S likelihood, as compared with infrequent intake. Patients with higher HES levels (OR = 0.84, p = 0.033 for medium HES, OR = 0.77, p = 0.006 for high HES) or being physically active (OR = 0.69, 0.001) had a lower Slike-CV19S likelihood, as compared to those with low HES or physical inactivity, respectively. Patients with medium HES who were physically active (OR = 0.69, p = 0.005), or with high HES and physically active (OR = 0.58, 0.001), had a lower Slike-CV19S likelihood, as compared to those with low HES and physical inactivity. Conclusions: Healthy eating behavior and physical activity showed single and combinative impacts on protecting people from Slike-CV19S. Strategic approaches are encouraged to improve healthy behaviors, which may further contribute to containing the pandemic.

BACKGROUND: Asthma affects millions of people worldwide. Lima, Peru is one of the most polluted cities in the Americas but has insufficient ground PM(2.5) (particulate matter that are 2.5 microns or less in diameter) measurements to conduct epidemiologic studies regarding air pollution. PM(2.5) estimates from a satellite-driven model have recently been made, enabling a study between asthma and PM(2.5). OBJECTIVE: We conducted a daily time-series analysis to determine the association between asthma emergency department (ED) visits and estimated ambient PM(2.5) levels in Lima, Peru from 2010 to 2016. METHODS: We used Poisson generalized linear models to regress aggregated counts of asthma on district-level population weighted PM(2.5). Indicator variables for hospitals, districts, and day of week were included to account for spatial and temporal autocorrelation while assessing same day, previous day, day before previous and average across all 3-day exposures. We also included temperature and humidity to account for meteorology and used dichotomous percent poverty and gender variables to assess effect modification. RESULTS: There were 103,974 cases of asthma ED visits during the study period across 39 districts in Lima. We found a 3.7% (95% CI: 1.7%-5.8%) increase in ED visits for every interquartile range (IQR, 6.02 μg/m(3)) increase in PM(2.5) same day exposure with no age stratification. For the 0 to 18 years age group, we found a 4.5% (95% CI: 2.2%-6.8%) increase in ED visits for every IQR increase in PM(2.5) same day exposure. For the 19 to 64 years age group, we found a 6.0% (95% CI: 1.0%-11.0%) increase in ED visits for every IQR in average 3-day exposure. For the 65 years and up age group, we found a 16.0% (95% CI: 7.0%-24.0%) decrease in ED visits for every IQR increase in PM(2.5) average 3-day exposure, although the number of visits in this age group was low (4,488). We found no effect modification by SES or gender. DISCUSSION: Results from this study provide additional literature on use of satellite-driven exposure estimates in time-series analyses and evidence for the association between PM(2.5) and asthma in a low- and middle-income (LMIC) country

The principal purpose of this work consists in optimizing the support system of a deep tunnel accounting for the uncertainty of the time-dependent behaviour of the surrounding rock, which is described by the rheological Burger law. The stochastic approach is chosen for this aim. On one hand the Quantile Monte Carlo (QMC) simulation is used to determine the optimal design variables (i.e., the thickness of two liners). On the other hand, the well-known Kriging metamodeling technique is undertaken to approximate the limit state function in the augmented reliability space (i.e., the tensor product between the random variable space and the design variable space). The adopted optimization process allows to derive the optimal tunnel support that verifies two failure modes, namely the support capacity criterion and the maximum tunnel convergence.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

Background: We aimed to examine the impacts of digital healthy diet literacy (DDL) and healthy eating behaviors (HES) on fear of COVID-19, changes in mental health, and health-related quality of life (HRQoL) among front-line healthcare workers (HCWs). Methods: An online survey was conducted at 15 hospitals and health centers from 6–19 April 2020. Data of 2299 front-line HCWs were analyzed—including socio-demographics, symptoms like COVID-19, health literacy, eHealth literacy, DDL, HES, fear of COVID-19, changes in mental health, and HRQoL. Regression models were used to examine the associations. Results: HCWs with higher scores of DDL and HES had lower scores of FCoV-19S (regression coefficient, B, −0.04; 95% confidence interval, 95% CI, −0.07, −0.02; p = 0.001; and B, −0.10; 95% CI, −0.15, −0.06; p < 0.001); had a higher likelihood of stable or better mental health status (odds ratio, OR, 1.02; 95% CI, 1.00, 1.05; p = 0.029; and OR, 1.04; 95% CI, 1.00, 1.07; p = 0.043); and HRQoL (OR, 1.02; 95% CI, 1.01, 1.03; p = 0.006; and OR, 1.04; 95% CI, 1.02, 1.06; p = 0.001), respectively. Conclusions: DDL and HES were found as independent predictors of fear of COVID−19, changes in mental health status, and HRQoL in front-line HCWs. Improving DDL and HES should be considered as a strategic approach for hospitals and healthcare systems.

We report a top-down method for fabricating ultra-high aspect ratio single-crystal silicon nanowires. The fabrication method is based on the standard photolithography technique and anisotropic wet etching of the single-crystal silicon in KOH solution. SiO₂ mask nanolines used for patterning single-crystal silicon nanowires are formed by the undercut etching of thin SiO₂ layer in buffered hydrofluoric solution. The minimum width of the SiO₂ mask nanolines are 50 nm. The length of SiO₂ mask nanolines is 2 cm. The single-crystal silicon nanowires have been successfully transferred from the SiO₂ mask nanolines by KOH anisotropic wet-chemical etching. The minimum width of the silicon nanowire has obtained to be 25 nm. The fabricated single-crystal silicon nanowires have trapezoidal and triangular cross sections, which are useful for applications in nanoelectronic and nanophotonic elements.

Thermoresponsive polymers have recently attracted considerable interest as macromolecular chain transfer agents in RAFT emulsion polymerizations to prepare nanoparticles with tuneable cores, sizes, shapes or surfaces. So far, this synthesis technique requires the use of a conventional surfactant as a stabilizer (e.g., sodium dodecyl sulphate), thus limiting its scope and potential applications. Here, we report the surfactant-free RAFT emulsion polymerization using, for the first time, a biocompatible thermoresponsive polymer as a dual macromolecular chain transfer agent and a macromolecular stabilizer. By randomly incorporating a hydrophilic component with ∼21 ethylene glycol units on the side chain, we synthesized a series of novel thermoresponsive copolymers that can form self-stabilized particles upon heating above their cloud point temperatures. These novel thermoresponsive copolymers have been successfully used to produce nanoparticles with tuneable shapes and cores, paving the way for the high-scale synthesis of biocompatible nanoparticles with complex nanostructures and tailored properties.

Relaxor ferroelectric Pb0.9La0.1(Zr0.52Ti0.48)O3 (PLZT) thin films have been epitaxially grown via pulsed laser deposition on SrRuO3/SrTiO3 single crystal with different orientations. The high recoverable energy-storage density and energy-storage efficiency in the epitaxial PLZT thin films are mainly caused by the coexistence of relaxor and antiferroelectric-like behaviors. The recoverable energy-storage density of 12.03, 12.51 and 12.74 J/cm3 and energy-storage efficiency of 86.50, 88.14 and 88.44%, respectively, for the PLZT(001), PLZT(011) and PLZT(111) thin films measured at 1000 kV/cm. The high energy density and high efficiency indicate that the relaxor epitaxial PLZT(111) thin film is a promising candidate for high pulsed power capacitors.

Constitutive properties for highly cross-linked glassy polymers are currently determined by molecular dynamics (MD) simulations. This avoids the need for ad-hoc experimentation. Constitutive data in functional form, such as yield surfaces, still require identification and correspondence to an existing function. In addition, loss of information occurs with fitting procedures. The present alternative consists in directly defining piecewise-linear yield functions from a set of points obtained by MD simulations. To prevent the algorithmic issues of multisurface plasticity, we propose an alternative to active-set strategies by simultaneously including all yield functions regardless of being active. We smooth the complementarity conditions using the Chen–Mangasarian function. In addition, extrapolation is proposed for slowly-evolving quantities such as the effective plastic strain while fully implicit integration is adopted for rapidly-evolving constitutive quantities. Since polymers exhibit finite-strain behavior, we propose a semi-implicit integration algorithm which allows a small number of steps to be used up to very large strains. Experimentally-observed effects herein considered are: thermal effects on strain (i.e. thermal expansion), Young’s modulus dependence on temperature and the effects of strain rate and temperature on the yield stress. A prototype model is first studied to assess the performance of the integration algorithm, followed by a experimental validation and a fully-featured, thermally-coupled 2D example.

Lanthanides are utilized by microbial methanol dehydrogenases, and it has been proposed that lanthanides may be important for other type I alcohol dehydrogenases. A triple mutant strain ( mxaF xoxF1 xoxF2 ; named MDH-3), deficient in the three known methanol dehydrogenases of the model methylotroph Methylobacterium extorquens AM1, is able to grow poorly with methanol if exogenous lanthanides are added to the growth medium. When the gene encoding a putative quinoprotein ethanol dehydrogenase, exaF , was mutated in the MDH-3 background, the quadruple mutant strain could no longer grow on methanol in minimal medium with added lanthanum (La 3+ ). ExaF was purified from cells grown with both calcium (Ca 2+ ) and La 3+ and with Ca 2+ only, and the protein species were studied biochemically. Purified ExaF is a 126-kDa homodimer that preferentially binds La 3+ over Ca 2+ in the active site. UV-visible spectroscopy indicates the presence of pyrroloquinoline quinone (PQQ) as a cofactor. ExaF purified from the Ca 2+ -plus-La 3+ condition readily oxidizes ethanol and has secondary activities with formaldehyde, acetaldehyde, and methanol, whereas ExaF purified from the Ca 2+ -only condition has minimal activity with ethanol as the substrate and activity with methanol is not detectable. The exaF mutant is not affected for growth with ethanol; however, kinetic and in vivo data show that ExaF contributes to ethanol metabolism when La 3+ is present, expanding the role of lanthanides to multicarbon metabolism. IMPORTANCE ExaF is the most efficient PQQ-dependent ethanol dehydrogenase reported to date and, to our knowledge, the first non-XoxF-type alcohol oxidation system reported to use lanthanides as a cofactor, expanding the importance of lanthanides in biochemistry and bacterial metabolism beyond methanol dehydrogenases to multicarbon metabolism. These results support an earlier proposal that an aspartate residue near the catalytic aspartate residue may be an indicator of rare-earth element utilization by type I alcohol dehydrogenases.

For over 50 years, there have been limited options for the management of hyperkalemia, especially among patients with chronic kidney disease (CKD), diabetic nephropathy, hypertension, and heart failure, who were receiving concomitant renin-angiotensin-aldosterone system (RAAS) inhibitor therapy. Hyperkalemia is a potential, life-threatening electrolyte abnormality that frequently challenges clinicians from maximizing the mortality benefit and organ-protective properties of RAAS inhibitors especially in CKD and heart failure populations. Patiromer is a novel nonabsorbed, cation-exchange polymer that binds and exchanges potassium for calcium, predominantly in the gastrointestinal tract. It has demonstrated potassium-lowering effects in normo- or hyperkalemic patients on concomitant RAAS inhibitors with heart failure, diabetic nephropathy, and CKD, in the PEARL-HF, AMETHYST-DN, and OPAL-HK studies, respectively. Across all studies, it appears to be generally effective and well tolerated, with adverse events predominantly gastrointestinal in nature. Additional investigational studies are needed to explore its use for an extended duration of treatment and in larger patient populations, as well as exploring drug-drug interactions. Overall, patiromer demonstrates a promising role in the chronic management of hyperkalemia that will allow optimization of RAAS inhibitor therapy, thus delaying progression of CKD and improving the mortality benefit in heart failure patients.

We present a multiscale model bridging length and time scales from molecular to continuum levels with the objective of predicting the yield behavior of amorphous glassy polyethylene (PE). Constitutive parameters are obtained from molecular dynamics (MD) simulations, decreasing the requirement for ad-hoc experiments. Consequently, we achieve: (1) the identification of multisurface yield functions; (2) the high strain rate involved in MD simulations is upscaled to continuum via quasi-static simulations. Validation demonstrates that the entire multisurface yield functions can be scaled to quasi-static rates where the yield stresses are possibly predicted by a proposed scaling law; (3) a hierarchical multiscale model is constructed to predict temperature and strain rate dependent yield strength of the PE.

This article describes Viet Nam Ministry of Health’s (VMoH) activities to prepare for and respond to the threat Zika virus (ZIKV), including the adaptation of existing surveillance systems to encompass ZIKV surveillance.

Normal-ferroelectric Pb(Zr0.52Ti0.48)O3 (PZT) and relaxor-ferroelectric Pb0.9La0.1(Zr0.52Ti0.48)O3 (PLZT) thin-films are deposited on SrRuO3-covered SrTiO3/Si substrates. An ultrahigh recoverable energy-storage density (Ureco) of 68.2 J/cm3 and energy efficiency (η) of 80.4% are achieved in the PLZT thin-films under a large breakdown strength (EBD) of 3600 kV/cm. These values are much lower in the PZT thin-films (Ureco of 10.3 J/cm3 and η of 62.4% at EBD of 1000 kV/cm). In addition, the remanent polarization (Pr) and dielectric-constant are also investigated to evaluate the breakdown strength in thin-films. Polar nano-regions (PNRs) are created in the PLZT thin-films to enable relaxor behavior and lead to slim polarization loops along with very small Pr. The excellent operating temperature of energy-storage performance and also the breakdown strength obtained in the PLZT thin-films are mainly ascribed to the presence of PNRs. Moreover, both PZT and PLZT thin-films exhibit superior performance up to 1010 times of charge-discharge cycling.

BackgroundIdiopathic pulmonary fibrosis (IPF) pathogenesis involves multiple pathways, and combined antifibrotic therapy is needed for future IPF therapy. Inhaled interferon-γ (IFN-γ) was recently shown to be safe and without systemic effects in patients with IPF.AimTo examine the in vitro effects of individual and combined treatment with IFN-γ and pirfenidone (PFD) on normal and IPF fibroblast activation and extracellular matrix remodeling after TGF-β1 and PDGF-BB stimulation.MethodsIPF and normal human lung fibroblasts (NHLF) were treated with IFN-γ, PFD or a combination of both drugs in the presence of either TGF-β1 or PDGF-BB. The effects of TGF-β1 and PDGF-BB treatment on cell viability, proliferation, differentiation and migration were examined. The expression of collagen 1, matrix metalloproteinases (MMPs) and tissue inhibitors of MMP (TIMPs) was analyzed using qPCR, Western blotting and gelatin zymography. Total collagen content in conditioned media was also measured using a Sircol assay.ResultsCompared to that of PFD, the effect of IFN-γ in downregulating normal and IPF lung fibroblast differentiation to myofibroblasts in response to TGF-β1 was more potent. Importantly, the combination of IFN-γ and PFD had a possibly synergistic/additive effect in inhibiting the TGF-β1- and PDGF-BB-induced proliferation, migration and differentiation of normal and IPF lung fibroblasts. Furthermore, both drugs reversed TGF-β1-induced effects on MMP-1, − 2, − 3, − 7, and − 9, while only PFD promoted TIMP-1 and-2 expression and release.ConclusionsOur findings demonstrate that the antifibrotic effects of IFN-γ and PFD on normal and IPF lung fibroblasts are different and complementary. Combination therapy with inhaled IFN-γ and PFD in IPF is promising and should be further explored in IPF clinical trials.

Zero-valent metal nanoparticles (Cu, Fe and Co) were prepared by the reactive method from their oxide with hydrogen. The energy-rich solutions of metal nanoparticles were used for treatment Maize seeds prior to sowing. The treatment significantly improved the germination rate and early growth. Furthermore, both SOD and APX enzyme activity in leaves were improved, and enhanced the metabolism of superoxide, leading to increased drought resistance. The method was applied to the field over three seasons and greatly improved the harvest. In particular, the implementation of Cu particles at 4 mg/kg increased the productivity of the two Maize species more than 20%.

BACKGROUND The use of massive transfusion protocols (MTPs) in the resuscitation of hemorrhaging trauma patients ensures rapid delivery of blood products to improve outcomes, where the decision to trigger MTPs early is important. Scores and tools to predict the need for MTP activation have been developed for use to aid with clinical judgment. We performed a systematic review to assess (1) the scores and tools available to predict MTP in trauma patients, (2) their clinical value and diagnostic accuracies, and (3) additional predictors of MTP. METHODS MEDLINE, EMBASE, and CENTRAL were searched from inception to June 2017. All studies that utilized scores or predictors of MTP activation in adult (age, ≥18 years) trauma patients were included. Data collection for scores and tools included reported sensitivities and specificities and accuracy as defined by the area under the curve of the receiver operating characteristic. RESULTS Forty-five articles were eligible for analysis, with 11 validated and four unvalidated scores and tools assessed. Of four scores using clinical assessment, laboratory values, and ultrasound assessment the modified Traumatic Bleeding Severity Score had the best performance. Of those scores, the Trauma Associated Severe Hemorrhage score is most well validated and has higher area under the curve of the receiver operating characteristic than the Assessment of Blood Consumption and Prince of Wales scores. Without laboratory results, the Assessment of Blood Consumption score balances accuracy with ease of use. Without ultrasound use, the Vandromme and Schreiber scores have the highest accuracy and sensitivity respectively. The Shock Index uses clinical assessment only with fair performance. Other clinical variables, laboratory values, and use of point-of-care testing results were identified predictors of MTP activation. CONCLUSION The use of scores or tools to predict MTP need to be individualized to hospital resources and skill set to aid clinical judgment. Future studies for triggering nontrauma MTP activations are needed. LEVEL OF EVIDENCE Systematic review, level III.

In many modern image-classification applications, understanding the cause of model's prediction can be as critical as the prediction's accuracy itself. Various feature-based local explanations generation methods have been designed to give us more insights on the decision of complex classifiers. Nevertheless, there is no consensus on evaluating the quality of different explanations. In response to this lack of comprehensive evaluation, we introduce the c-Eval metric and its corresponding framework to quantify the feature-based local explanation's quality. Given a classifier's prediction and the corresponding explanation on that prediction, c-Eval is the minimum-distortion perturbation that successfully alters the prediction while keeping the explanation's features unchanged. We then demonstrate how c-Eval can be computed using some modifications on existing adversarial generation libraries. To show that c-Eval captures the importance of input's features, we establish the connection between c-Eval and the features returned by explainers in affine and nearly-affine classifiers. We then introduce the c-Eval plot, which not only displays a strong connection between c-Eval and explainers' quality, but also helps automatically determine explainer's parameters. Since the generation of c-Eval relies on adversarial generation, we provide a demo of c-Eval on adversarial-robust models and show that the metric is applicable in those models. Finally, extensive experiments of explainers on different datasets are conducted to support the adoption of c-Eval in evaluating explainers' performance.

Coronary artery to superior vena cava (SVC) fistula is a very rare congenital anomaly of the heart. It typically follows the course of sinoatrial-nodal branch. It can originate from the right coronary or circumflex artery. In the majority of cases, it terminates in the SVC close to the right atrium junction. Only five cases were treated in literature successfully through a transcatheter approach. We present a case with a symptomatic right coronary artery to SVC fistula treated with a unique percutaneous embolization using a guidewire loop/balloon occlusion technique. Controlled access and embolization of the fistula was achieved by through-and-through guidewire access across the coronary fistula from the arterial groin access to the venous groin access with balloon occlusion of the coronary artery fistula while detachable coils were positioned.

Lanthanide elements have been recently recognized as “new life metals” for diverse environmental microorganisms including Gram-negative methylotrophic bacteria and strains ofPseudomonasandBradyrhizobium. Yet much remains unknown regarding lanthanide acquisition and homeostasis. InMethylorubrum extorquensAM1, the periplasmic lanthanide-dependent methanol dehydrogenase XoxF1 produces formaldehyde, which is lethal if allowed to accumulate. This property enabled a transposon mutagenesis study to expand knowledge of the metabolic network required for methanol oxidation when lanthanides are available. Growth studies were conducted to detail the involvement of novel gene products that impact the ability of XoxF-type enzymes to oxidize methanol to formaldehyde. The identified genes encode an MxaD homolog, an ABC-type transporter, an aminopeptidase, a putative homospermidine synthase, and two genes of unknown function annotated asorf6andorf7. Lanthanide transport and trafficking genes were also identified. Growth and lanthanide uptake were measured using strains lacking individual lanthanide transport cluster genes and transmission electron microscopy was used to visualize lanthanide localization. We corroborated previous reports that a TonB-ABC transport system is required for lanthanide incorporation to the cytoplasm. However, cells are able to acclimate overtime and bypass the requirement for the TonB outer membrane transporter to allow expression ofxoxF1and growth. Transcriptional reporter fusions show that excess lanthanides repress the gene encoding the TonB-receptor. Using growth studies along with energy dispersive X-ray spectroscopy and transmission electron microscopy, we demonstrate that lanthanides are stored as cytoplasmic inclusions that resemble polyphosphate granules.IMPORTANCEThe increasing genetic and biochemical evidence that lanthanide-dependent enzymes are widespread among numerous environmental microbes leads to the parallel questions of how these insoluble metals are scavenged, transported, and used by bacteria. Results herein describe the contribution of the different gene products that constitute the lanthanide utilization and transport machinery in the methylotrophM. extorquensAM1 and highlight possible redundancies by periplasmic components. The discovery and characterization of intracellular lanthanide storage in mineral form by these microbes opens the possibility of using methylotrophic platforms for concentration and recovery of these critical energy metals from diverse sources. In addition, methylotrophs are effective biotechnological platforms for the production of biofuels and bioplastics from pollutants such as methane, and inexpensive carbon feedstocks like methanol. Defining the lanthanide acquisition, transport, and storage machinery is a step forward in designing a sustainable platform to recover lanthanides efficiently.

Background: Group B enteroviruses are common causes of acute myocarditis, which can be a precursor of chronic myocarditis and dilated cardiomyopathy, leading causes of heart transplantation. To date, the specific viral functions involved in the development of dilated cardiomyopathy remain unclear. Methods: Total RNA from cardiac tissue of patients with dilated cardiomyopathy was extracted, and sequences corresponding to the 5’ termini of enterovirus RNAs were identified. After next-generation RNA sequencing, viral cDNA clones mimicking the enterovirus RNA sequences found in patient tissues were generated in vitro, and their replication and impact on host cell functions were assessed on primary human cardiac cells in culture. Results: Major enterovirus B populations characterized by 5’ terminal genomic RNA deletions ranging from 17 to 50 nucleotides were identified either alone or associated with low proportions of intact 5’ genomic termini. In situ hybridization and immunohistological assays detected these persistent genomes in clusters of cardiomyocytes. Transfection of viral RNA into primary human cardiomyocytes demonstrated that deleted forms of genomic RNAs displayed early replication activities in the absence of detectable viral plaque formation, whereas mixed deleted and complete forms generated particles capable of inducing cytopathic effects at levels distinct from those observed with full-length forms alone. Moreover, deleted or full-length and mixed forms of viral RNA were capable of directing translation and production of proteolytically active viral proteinase 2A in human cardiomyocytes. Conclusions: We demonstrate that persistent viral forms are composed of B-type enteroviruses harboring a 5’ terminal deletion in their genomic RNAs and that these viruses alone or associated with full-length populations of helper RNAs could impair cardiomyocyte functions by the proteolytic activity of viral proteinase 2A in cases of unexplained dilated cardiomyopathy. These results provide a better understanding of the molecular mechanisms that underlie the persistence of EV forms in human cardiac tissues and should stimulate the development of new therapeutic strategies based on specific inhibitors of the coxsackievirus B proteinase 2A activity for acute and chronic cardiac infections.

This work addresses the sum-capacity-achieving signaling schemes and the sum-capacity of a multiple access channel (MAC) with two mobile users communicating to a base station equipped with 1-bit quantizers. We consider Rayleigh fading channels between the users and the base station where channel state information (CSI) is known only at the base station. Towards this end, we first establish a necessary and sufficient condition refereed to as Kuhn-Tucker condition (KTC) on the input distribution of one user for a given input signal used at another user so that the input/output mutual information (MI) is maximized. By relaxing the power constraint and establishing upper bounds on the MI, we demonstrate that the power constraint of the first user is active. Then using Fubini-Tonelli theorem to exchange the order of integrations between fading and input distributions, and exploiting novel bounds on the output distribution and a related relative entropy, it is shown that the optimal input distribution has a bounded amplitude. Due to the symmetry of the problem, it is then concluded that the sum-capacity-achieving amplitude distributions are bounded, and both users must use full power to achieve the sum-capacity. Next, we exploit the independence of the amplitude and phase of fading gains to show that the optimal inputs are π/2 circular symmetric. Building upon the results on the amplitude and phase, it is then demonstrated that any π/2 circular symmetric input distribution having a constant amplitude is sum-capacity achieving. The sum-capacity is finally obtained in a precise form.

An all-encompassing finite-strain representation of rods, shells and continuum can share a common kinematic/constitutive framework where specific conditions for strain, stress and constitutive updating are applied. In this work, finite strain beams are under examination, with several classical requirements met by cooperative techniques judiciously applied. Specifically: the use of a continuum constitutive law is possible due to the relative strain formulation previously introduced, the rotation singularity problem is absent due to the use of a consistent (quadratic) updated Lagrangian technique. Objectiveness and path-independence of director interpolation are satisfied due to the use of a Lowdin frame. These properties are proved in this work. Moreover, high coarse-mesh accuracy is introduced by the least-squares assumed-strain technique, here specialized for a beam. Examples show the accuracy and robustness of the formulation.

Network protocols are difficult to test due to the extremely large number of packet dynamics possibilities. Random testing is simple and effective in achieving reasonable coverage but unable to cover corner cases. Symbolic execution based testing is more efficient in exploring low-possibility paths but suffers from the scalability problem. In this demonstration, we apply the combination of symbolic execution based testing and random testing to symbolically and efficiently explore the state space of packet dynamics. We use the code coverage metric to evaluate the effectiveness of different testing methods on network protocols. Our experiments on Multipath-TCP (MPTCP) show that the combination method can achieve higher coverage than symbolic execution based testing and random testing.

Some spectroscopic applications require excitation light sources with dual-wavelength laser emission. For example, in absorption spectroscopy one on-resonance and one off-resonance wavelength are needed for concentration measurements. For shifted excitation Raman difference spectroscopy (SERDS), two excitation wavelengths are used to distinguish between disturbing light and Raman signals. In both cases an adjustable wavelength spacing allows optimizing the measurements according to the spectral width of the target. In addition, a tuning of the spectral distance also allows generating a tunable sum or difference frequency signal, enabling further applications. In this paper, diode lasers with customized designs according to the spectral requirements of the applications will be presented. As basis for all devices, Y-branch diode lasers with an integrated grating for wavelength stabilization are realized. The emission of the two branches is combined in an implemented Y-shaped coupler. The bent waveguides are sine shaped S-bends. The spectral tuning is performed via implemented heater elements next to the Distributed Bragg Reflector (DBR) gratings or via the injection current when using a Distributed Feedback (DFB) grating. Powervoltage current characteristics, spectral and tuning properties will be shown. The devices emitting at 671 nm and 785 nm are used for SERDS, whereas devices at 965 nm were tested as seed sources for pulsed master oscillator power amplifiers (MOPA) suitable for the detection of water vapor. Devices at 785 nm are also suitable for the generation of THz radiation using difference frequency generation. A widely tunable Y-branch diode laser near 972 nm is used for the sum frequency generation in an up-conversion system.

To compare the effectiveness of cervical pessary to vaginal progesterone for the prevention of preterm birth in women with twin pregnancies and short cervix.This randomized controlled trial was conducted at My Duc Hospital, Vietnam. Asymptomatic women with twin pregnancies and cervical length less than 38 mm were randomized to Arabin pessary or vaginal progesterone (400 mg once a day) group. The primary outcome was preterm birth at less than 34 weeks of gestation. Secondary outcomes were adverse maternal and perinatal complications. We planned a subgroup analysis according to quartile of cervical length. Analysis was conducted on an intention-to-treat basis. We estimated that the primary outcome would occur in 28.4% of women treated with progesterone. Thus a total sample size of 290 women divided equally into two groups was required to detect a 14% absolute risk difference in the primary outcome between the two groups (power 80%, alpha-error 5%, 10% loss to follow-up).Between March 2016 and June 2017, we randomized 300 women, 150 women in each group. Preterm birth at less than 34 weeks of gestation occurred in 24 (16%) women in the pessary group and 33 (22%) women in the progesterone group (relative risk [RR] 0.73, 95% CI 0.46-1.18). The use of pessary significantly reduced the composite of poor perinatal outcomes (19% vs 27%; RR 0.70, 95% CI 0.43-0.93). In women with cervical length of 28 mm or less (25th percentile), pessary significantly reduced the preterm birth rate at less than 34 weeks of gestation from 46% (16/35) to 21% (10/47) (RR 0.47, 95% CI 0.24-0.90) and significantly improved the composite of poor perinatal outcomes.Cervical pessary and 400 mg vaginal progesterone resulted in similar rates of preterm birth at less than 34 weeks of gestation in women with twin pregnancies and cervical length less than 38 mm.ClinicalTrials.gov, NCT02623881.

The aim of this study was to describe outcomes of laparoscopic living donor right nephrectomy (LLDRN) and study factors affecting the length of right renal vein from the donors.This study was conducted in 60 donors (48 males and 12 females) from January 2016 to December 2017. We performed a retrospective review of consecutive patients who underwent transperitoneal right laparoscopic living donor nephrectomy at our unit.LLDRN was successfully performed in all subjects by the same surgeons. Among 60 cases, 47 donors had single renal artery and vein, 2 cases had one artery and 2 veins, and 5 donors had 2 arteries and one vein, and the rest had 2-3 arteries with 1-3 veins. Operative time was 142.60±33.73min. Warm ischemic time was 2.64±0.76min. The mean hospital stay was 6.69±0.63 days. The median length of right renal vein was 1.92±0.41cm. All transplanted kidneys showed immediate function. No graft losses were recorded. Almost no gender differences were found in study variables except BMI and warm ischemic time, that was higher BMI but shorter warm ischemic time in female versus male donors. Further analysis showed a negative correlation between BMI and right renal vein (r=-0.282, P0.05), but a positive correlation between operative time and estimate blood loss (r=0.37, P0.01).LLDRN is a feasible safe procedure, less traumatic approach, and provides good outcomes kidney for recipients. Notably, in the study group the higher BMI was associated with resulting more difficult LLDRN and kidney transplantation.

Anemia affects 1.62 billion people worldwide. Although iron deficiency is the main cause of anemia, several other factors may explain its high prevalence. In this study, we sought to analyze the association between outdoor particulate matter PM2.5 levels with anemia prevalence in children aged 6–59 months residing in Lima, Peru (n = 139,368), one of the cities with the worst air pollution in Latin America. The study period was from 2012 to 2016. Anemia was defined according to the World Health Organization (Hb 2.5 values were estimated by a mathematical model that combined data observed from monitors, with satellite and meteorological data. PM2.5 was analyzed by quintiles. Multiple linear and logistic regressions were used to estimate the associations between hemoglobin concentration (beta) and anemia (odds ratio) with PM2.5, after adjusting by covariates. Prevalence of anemia was 39.6% (95% confidence interval (CI): 39.3–39.9). Mild anemia was observed in 30.8% of children and moderate/severe in 8.84% of children. Anemic children compared with nonanemic children are mainly males, have low body weight, higher rate of stunting, and live in an environment with high PM2.5 concentration. A slight decrease in hemoglobin (4Q B: −0.03, 95% CI: −0.05 to −0.02; 5Q B: −0.04, 95% CI: −0.06 to −0.01) and an increase in the probability of moderate/severe anemia (4Q OR: 1.18, 95% CI: 1.10–1.27; 5Q OR: 1.18, 95% CI: 1.08–1.29) were observed with increased exposure to PM2.5. We conclude that outdoor PM2.5 levels were significantly associated with decreased hemoglobin values and an increase in prevalence of moderate/severe anemia in children under 5 years old.

This paper examines for the first time the impact of problem loans on Japanese productivity growth. We exploit a new data set of Japanese problem loans classified into two categories: bankrupt and restructured loans. We opt for a novel and flexible productivity growth decomposition that allows to measure the direct impact of these problem loans on productivity growth. The results reveal that Japanese bank productivity growth was severely constrained by bankrupt and restructured loans early in 2000s, whilst some persistence of the negative impact of problem loans on productivity growth is observed in the late 2000s. Thereafter, there is only some partial recovery in the productivity growth from 2012 to 2015. Further, we also perform cluster analysis to examine convergence or divergence across regions and over time. We observe limited convergence, though Regional Banks seem to form clusters in some regions.

In this paper, we propose a novel Heterogeneous Gaussian Mechanism (HGM) to preserve differential privacy in deep neural networks, with provable robustness against adversarial examples. We first relax the constraint of the privacy budget in the traditional Gaussian Mechanism from (0, 1] to (0, \infty), with a new bound of the noise scale to preserve differential privacy. The noise in our mechanism can be arbitrarily redistributed, offering a distinctive ability to address the trade-off between model utility and privacy loss. To derive provable robustness, our HGM is applied to inject Gaussian noise into the first hidden layer. Then, a tighter robustness bound is proposed. Theoretical analysis and thorough evaluations show that our mechanism notably improves the robustness of differentially private deep neural networks, compared with baseline approaches, under a variety of model attacks., Comment: arXiv admin note: text overlap with arXiv:1903.09822

Synaptic vesicles fuse with the plasma membrane to release neurotransmitter following an action potential, after which new vesicles must refill vacated release sites. How many vesicles can fuse at a single active zone, where they fuse within the active zone, and how quickly they are replaced with new vesicles is not well-established. To capture synaptic vesicle exocytosis at cultured mouse hippocampal synapses, we induced single action potentials by electrical field stimulation then subjected neurons to high-pressure freezing to examine their morphology by electron microscopy. During synchronous release, multiple vesicles can fuse at a single active zone; this multivesicular release is augmented by increasing the extracellular calcium concentration. Synchronous fusions are distributed throughout the active zone, whereas asynchronous fusions are biased toward the center of the active zone. Immediately after stimulation a large fraction of vesicles become undocked. Between 8 and 14 ms, new vesicles are recruited to the plasma membrane and fully replenish the docked pool, but docking of these vesicles is transient and they either undock or fuse within 100 ms. These results demonstrate that recruitment of synaptic vesicles to release sites is rapid and reversible.