Predictors of Acute Liver Failure in Patients With Acute Hepatitis A: An Analysis of the 2016-2018 San Diego County Hepatitis A Outbreak.

Background:Between 2016 and 2018, San Diego County experienced a hepatitis A outbreak with a historically high mortality rate (3.4%) that highlighted the need for early recognition of those at risk of developing acute liver failure (ALF). Methods:A retrospective case series of adult hospitalized patients with acute hepatitis A. Results:One hundred six patients with hepatitis A were studied, of whom 11 (10.4%) developed ALF, of whom 7 (6.6%) died. A history of alcohol abuse, hyperbilirubinemia, hypoalbuminemia, hyponatremia, and anemia were associated with increased odds of developing ALF. Initial Maddrey's and Model of End-Stage Liver Disease Sodium (MELD-Na) scores were also associated with the development of ALF. Multivariable analysis showed that a higher initial MELD-Na score (odds ratio [OR], 1.205; 95% confidence interval [CI], 1.018-1.427) and a lower initial serum albumin concentration (OR, 9.35; 95% CI, 1.15-76.9) were associated with increased odds of developing ALF. Combining serum albumin and MELD-Na (SAM; C-statistic, 0.8878; 95% CI, 0.756-0.988) yielded a model that was not better than either serum albumin (C-statistic, 0.852; 95% CI, 0.675-0.976) or MELD-Na (C-statistic, 0.891; 95% CI, 0.784-0.968; P = .841). Finally, positive blood cultures were more common among patients with ALF compared with those without ALF (63.6% vs 4.3%; P < .00001). Conclusions:Hypoalbuminemia was associated with an increased risk of ALF in patients with acute hepatitis A. Positive blood cultures and septic shock as a cause of death were common among patients with ALF. Providers caring for patients with acute hepatitis A should monitor for early signs of sepsis and consider empiric antibiotics, especially in patients presenting with hypoalbuminemia

Excimer laser annealing for fabrication of low-cost solar cells

Pulsed excimer laser annealing was successfully performed using a 50 w laser. Both polished and texturized cells were tried, however, there are serious problems with nonuniformity on texturized cells. A number of cells were produced and compared to diffusion furnace annealed cells. There was no clear economic advantage in using an excimer laser and there was a small penalty on average efficiency. The conclusion was that the excimer laser anneal process must be able to produce superior cells to be considered as a viable process option

Macroeconomic Fluctuations, Inequality, and Human Development

This paper examines the two-way relationship between inequality and economic fluctuations, and the implications for human development. For years, the dominant paradigm in macroeconomics, which assumed that income distribution did not matter, at least for macroeconomic behavior, ignored inequality--both its role in causing crises and the effect of fluctuations in general, and crises in particular, on inequality. But the most recent financial crisis has shown the errors in this thinking, and these views are finally beginning to be questioned. Economists who had looked at the average equity of a homeowner--ignoring the distribution--felt comfortable that the economy could easily withstand a large fall in housing prices. When such a fall occurred, however, it had disastrous effects, because a large fraction of homeowners owed more on their homes than the value of the home, leading to waves of foreclosure and economic stress. Policy-makers and economists alike have begun to take note: inequality can contribute to volatility and the creation of crises, and volatility can contribute to inequality. Here, we explore the variety of channels through which inequality affects fluctuations and fluctuations affect inequality, and explore how some of the changes in our economy may have contributed to increased inequality and volatility both directly and indirectly. After describing the two-way relationship, the paper discusses hysteresis--the fact that the consequences of an economic downturn can be long-lived. Then, it examines how policy can either mitigate or exacerbate the inequality consequences of economic downturns, and shows how well-intentioned policies can sometimes be counterproductive. Finally, it links these issues to human development, especially in developing countries

Sawtooth period changes with mode conversion current drive on Alcator C-Mod

DEFC0299ER54512. Reproduction,  translation,  publication,  use and disposal,  in whole or in part,  by or for the United States government is permitted. Submitted for publication to Plasma Physics and Controlled Fusion. Sawtooth period changes with mode conversion current drive on Alcator C-Mo

ELVIS: Entertainment-led video summaries

© ACM, 2010. This is the author's version of the work. It is posted here by permission of ACM for your personal use. Not for redistribution. The definitive version was published in ACM Transactions on Multimedia Computing, Communications, and Applications, 6(3): Article no. 17 (2010) http://doi.acm.org/10.1145/1823746.1823751Video summaries present the user with a condensed and succinct representation of the content of a video stream. Usually this is achieved by attaching degrees of importance to low-level image, audio and text features. However, video content elicits strong and measurable physiological responses in the user, which are potentially rich indicators of what video content is memorable to or emotionally engaging for an individual user. This article proposes a technique that exploits such physiological responses to a given video stream by a given user to produce Entertainment-Led VIdeo Summaries (ELVIS). ELVIS is made up of five analysis phases which correspond to the analyses of five physiological response measures: electro-dermal response (EDR), heart rate (HR), blood volume pulse (BVP), respiration rate (RR), and respiration amplitude (RA). Through these analyses, the temporal locations of the most entertaining video subsegments, as they occur within the video stream as a whole, are automatically identified. The effectiveness of the ELVIS technique is verified through a statistical analysis of data collected during a set of user trials. Our results show that ELVIS is more consistent than RANDOM, EDR, HR, BVP, RR and RA selections in identifying the most entertaining video subsegments for content in the comedy, horror/comedy, and horror genres. Subjective user reports also reveal that ELVIS video summaries are comparatively easy to understand, enjoyable, and informative

Quantification of Ophthalmic Changes After Long-Duration Spaceflight, and Subsequent Recovery

A subset of crewmembers are subjected to ophthalmic structure changes due to long-duration spaceflight (>6 months). Crewmembers who experience these changes are described as having Spaceflight Associated Neuro-Ocular Syndrome (SANS). Characteristics of SANS include optic disk edema, cotton wool spots, choroidal folds, refractive error, and posterior globe flattening. SANS remains a major obstacle to deep-space and planetary missions, requiring a better understanding of its etiology. Quantification of ocular, structural changes will improve our understanding of SANS pathophysiology. Methods were developed to quantify 3D optic nerve (ON) and ON sheath (ONS) geometries, ON tortuosity, and posterior globe deformation using MR imaging