A Variational Perspective on Accelerated Methods in Optimization

Accelerated gradient methods play a central role in optimization, achieving optimal rates in many settings. While many generalizations and extensions of Nesterov's original acceleration method have been proposed, it is not yet clear what is the natural scope of the acceleration concept. In this paper, we study accelerated methods from a continuous-time perspective. We show that there is a Lagrangian functional that we call the \emph{Bregman Lagrangian} which generates a large class of accelerated methods in continuous time, including (but not limited to) accelerated gradient descent, its non-Euclidean extension, and accelerated higher-order gradient methods. We show that the continuous-time limit of all of these methods correspond to traveling the same curve in spacetime at different speeds. From this perspective, Nesterov's technique and many of its generalizations can be viewed as a systematic way to go from the continuous-time curves generated by the Bregman Lagrangian to a family of discrete-time accelerated algorithms.Comment: 38 pages. Subsumes an earlier working draft arXiv:1509.0361

The Veterans Affairs Neuropathy Scale: A Reliable, Remote Polyneuropathy Exam.

Introduction: Polyneuropathy (PN) complaints are common, prompting many referrals for neurologic evaluation. To improve access of PN care in distant community clinics, we developed a telemedicine service (patient-clinician interactions using real-time videoconference technology) for PN. The primary goal of this study was to construct a remote exam for PN that is feasible, reliable, and concordant with in-person assessments for use in our tele-PN clinics. Methods: To construct the VA Neuropathy Scale (VANS), we searched the literature for existing, validated PN assessments. From these assessments, we selected a parsimonious set of exam elements based on literature-reported sensitivity and specificity of PN detection, with modifications as necessary for our teleneurology setting (i.e., a technician examination under the direction of a neurologist). We recruited 28 participants with varying degrees of PN to undergo VANS testing under 5 scenarios. The 5 scenarios differed by mode of VANS grading (in-person vs. telemedicine) and by the in-person examiner type (neurologist vs. technician) in telemedicine scenarios. We analyzed concordance between the VANS and a person's medical chart-derived PN status by modeling the receiver operating characteristic (ROC) curve. We analyzed reliability of the VANS by mixed effects regression and computing the intraclass correlation coefficient (ICC) of scores across the 5 scenarios. Results: The VA Neuropathy Scale (VANS) tests balance, gait, reflexes, foot inspection, vibration, and pinprick. Possible scores range from 0 to 50 (worst). From the ROC curve, a cutoff of >2 points on the VANS sets the sensitivity and specificity of detecting PN at 98 and 91%, respectively. There is a small (1.3 points) but statistically significant difference in VANS scoring between in-person and telemedicine grading scenarios. For telemedicine grading scenarios, there is no difference in VANS scores between neurologist and technician examinations. The ICC is 0.89 across all scenarios. Discussion: The VANS, informed by existing PN instruments, is a promising clinical assessment tool for diagnosing and monitoring the severity of PN in telemedicine settings. This pilot study indicates acceptable concordance and reliability of the VANS with in-person examinations

In vitro effect of canine hyperimmune sera on TNFa activity

[Introduction]: Septic shock in dogs is caused by cardiovascular and vasomotor failure associated with an uncontrolled intrinsic release of inflammatory mediators [1–5]. The syndrome is characterized by cardiovascular dysfunction, vascular permeability alterations, pulmonary oedema and tissue hypoxia resulting from microthrombi which may culminate in disseminated intravascular coagulation and catastrophic multiple organ failure [6,7]. Systemic bacterial infection, particularly by Gram-negative enterobacteria, haemorrhagic trauma, gastric dilation/volvulus and pancreatitis are the major underlying causes leading tosepsis [8,9]. Because of haemodynamic instability and associated hypovolemia, fluid replacement therapy is generally applied to restore effective circulating volume. The use of fresh frozen plasma has been recommended in cases of coagulopathies as it has been recognized to assist restoration of haemodynamic stability [1,5,10,11]. There is increasing evidence that the drivers of the haemodynamic instability are inflammatory mediators (particularly TNFa) activated primarily by bacterial endotoxin [3,4,12,13]

To Be or Not To Be a Molecular Ion: The Role of the Solvent in Photoionization of Arginine.

Application of photoionization mass spectroscopy, a technique capable of assessing protonation states in complex molecules in the gas phase, is challenging for arginine due to its fragility. We report photoionization efficiencies in the valence region of aqueous aerosol particles produced from arginine solutions under various pH and vaporization conditions. By using ab initio calculations, we investigate the stability of different conformers. Our results show that neutral arginine fragments upon ionization in the gas phase but solvation stabilizes the molecular ion, resulting in different photoionization dynamics. We also report the valence-band photoelectron spectra of the aerosol solutions obtained at different pH values

Using Nanoparticle X-ray Spectroscopy to Probe the Formation of Reactive Chemical Gradients in Diffusion-Limited Aerosols.

For aerosol particles that exist in highly viscous, diffusion-limited states, steep chemical gradients are expected to form during photochemical aging in the atmosphere. Under these conditions, species at the aerosol surface are more rapidly transformed than molecules residing in the particle interior. To examine the formation and evolution of chemical gradients at aerosol interfaces, the heterogeneous reaction of hydroxyl radicals (OH) on ∼200 nm particles of pure squalane (a branched, liquid hydrocarbon) and octacosane (a linear, solid hydrocarbon) and binary mixtures of the two are used to understand how diffusion limitations and phase separation impact the particle reactivity. Aerosol mass spectrometry is used to measure the effective heterogeneous OH uptake coefficient (γeff) and oxidation kinetics in the bulk, which are compared with the elemental composition of the surface obtained using X-ray photoemission. When diffusion rates are fast relative to the reaction frequency, as is the case for squalane and low-viscosity squalane-octacosane mixtures, the reaction is efficient (γeff ∼ 0.3) and only limited by the arrival of OH to the interface. However, for cases, where the diffusion rates are slower than reaction rates, as in pure octacosane and higher-viscosity squalane-octacosane mixtures, the heterogeneous reaction occurs in a mixing-limited regime and is ∼10× slower (γeff ∼ 0.03). This is in contrast to carbon and oxygen K edge X-ray absorption measurements that show that the octacosane interface is oxidized much more rapidly than that of pure squalane particles. The O/C ratio of the surface (estimated to be the top 6-8 nm of the interface) is measured to change with rate constants of (3.0 ± 0.9) × 10-13 and (8.6 ± 1.2) × 10-13 cm3 molecule-1 s-1 for squalane and octacosane particles, respectively. The differences in surface oxidation rates are analyzed using a previously published reaction-diffusion model, which suggests that a 1-2 nm highly oxidized crust forms on octacosane particles, whereas in pure squalane, the reaction products are homogeneously mixed within the aerosol. This work illustrates how diffusion limitations can form particles with highly oxidized surfaces even at relatively low oxidant exposures, which is in turn expected to influence their microphysics in the atmosphere

Teleneurology clinics for polyneuropathy: a pilot study.

INTRODUCTION:Polyneuropathy (PN) is a common condition with significant morbidity. We developed tele-polyneuropathy (tele-PN) clinics to improve access to neurology and increase guideline-concordant PN care. This article describes the mixed-methods evaluation of pilot tele-PN clinics at three community sites within the Greater Los Angeles VA Healthcare System. METHODS:For the first 25 patients (48 scheduled visits), we recorded the duration of the tele-PN visit and exam; the performance on three guideline-concordant care indicators (PN screening labs, opiate reduction, physical therapy for falls); and patient-satisfaction scores. We elicited comments about the tele-PN clinic from patients and the clinical team. We combined descriptive statistics with qualitative themes to determine the feasibility and acceptability of the tele-PN clinics. RESULTS:The average tele-PN encounter and exam times were 28.5 and 9.1 min, respectively. PN screening lab completion increased from 80 to 100%. Opiate freedom improved from 68 to 88%. Physical therapy for patients with recent falls increased from 58 to 100%. The tele-PN clinic was preferred for follow-up over in-person clinics in 86% of cases. Convenience was paramount to the clinic's success, saving an average of 231 min per patient in round-trip travel. The medical team's caring and collaborative spirit received high praise. While the clinic's efficiency was equal or superior to in-person care, the limited treatment options for PN and the small clinical exam space are areas for improvement. CONCLUSION:In this pilot, we were able to efficiently see and examine patients remotely, promote guideline-concordant PN care, and provide a high-satisfaction encounter

Characterization of Anopheles gambiae s.l. and insecticide resistance profile relative to physicochemical properties of breeding habitats within Accra Metropolis, Ghana

Malaria is endemic in Ghana as in most countries of sub-Saharan Africa. This study was conducted to characterize Anopheles gambiae s.l. and determine pyrethroid resistance profiles relative to physicochemical properties of breeding habitats in Accra, Ghana. Eight aquatic habitats containing Anopheles larvae were identified and from each habitat, larvae and water were sampled. Adult An. gambiae reared from larvae were morphologically identified and tested for permethrin (0.75%) and deltamethrin (0.05%) resistance using WHO bioassay method. An. gambiae s.s. found were identified to their molecular levels and kdr mutation detected using PCR-based methods. Twenty-nine physicochemical parameters of each water sample were measured and their levels connected with pyrethroid resistance and proportions of An. gambiae s.s. molecular forms in habitats. A total of 2,257 mosquitoes were morphologically identified as An. gambiae s.l. and all 224 processed for PCR were identified as An. gambiae s.s., of which 56.46% and 43.54% were M and S-forms, respectively. Both forms occurred in sympatry in all larval habitats and no S/M hybrids were detected. However, M-form larvae were in high proportion in polluted habitats than the S-form. An. gambiae s.s. was highly resistant to both deltamethrin and permethrin with mortality rates of 42.98-70.0% and 6.5-20.0% respectively. The frequency of kdr mutation was 60.5 % (n=195). This mutation occurred in both S and M-forms, but was mainly associated with the S-form (X2=10.92, df =1, P=0.001). Carbonate and pH were both selected in discriminant function analysis as best predictors of high proportion of M-form in the habitats. The adaptation of An. gambiae s.s. in polluted aquatic habitats coupled with occurrence of insecticide resistance is quite alarming particularly for urban malaria control and needs further exploration in a wider context

High Mass Star Formation. II. The Mass Function of Submillimeter Clumps in M17

We have mapped an approximately 5.5 by 5.5 pc portion of the M17 massive star-forming region in both 850 and 450 micron dust continuum emission using the Submillimeter Common-User Bolometer Array (SCUBA) on the James Clerk Maxwell Telescope (JCMT). The maps reveal more than 100 dusty clumps with deconvolved linear sizes of 0.05--0.2 pc and masses of 0.8--120 solar masses, most of which are not associated with known mid-infrared point sources. Fitting the clump mass function with a double power law gives a mean power law exponent of alpha_high = -2.4 +/- 0.3 for the high-mass power law, consistent with the exponent of the Salpeter stellar mass function. We show that a lognormal clump mass distribution with a peak at about 4 solar masses produces as good a fit to the clump mass function as does a double power law. This 4 solar mass peak mass is well above the peak masses of both the stellar initial mass function and the mass function of clumps in low-mass star-forming regions. Despite the difference in intrinsic mass scale, the shape of the M17 clump mass function appears to be consistent with the shape of the core mass function in low-mass star-forming regions. Thus, we suggest that the clump mass function in high-mass star-forming regions may be a scaled-up version of that in low-mass regions, instead of its extension to higher masses.Comment: 33 pages, 6 figures, 3 tables. Accepted for publication in the Astrophysical Journa