Calculating the work of breathing during mechanical ventilation.

Left figure: Passive patient esophageal pressure (Pes) in cmH2O on x-axis versus tidal volume in ml on y-axis. Green dashed line represents the chest wall compliance Right figure: same patient actively breathing on pressure support ventilation. (Pes) in cmH2O on x-axis versus tidal volume in ml on y-axis. Green dashed line represents the chest wall compliance. Red shaded area is the Campbell diagram representing the inspiratory work of breathing

Stochastic resetting of active Brownian particles with Lorentz force

Stochastic resetting of active Brownian particles to the line x = 0 subjected to a magnetic field (left figure) can direct transport by spatially controlling Lorentz force with no need for structured geometries (right figure).

Stabilization of proteins embedded in sugars and water as studied by dielectric spectroscopy

Illustration of how a relatively large amount of disaccharides stabilizes proteins (left figure) more than a very low concentration (right figure).

Contraculture: Bird Names and the Degendering of Contra Dance

At Oakland’s Circle Left contra dance, I notice my hands fumbling as I take “hands four” with my partner and our neighbour couple to form one of many foursomes in a long line of contra dancers. My partner and I place our hands facing palm up expecting to find a hand to hold facing palm down. In “traditional” contra, it is the person in the “lady” role who places their hand palm down on the hand of the person in the “gent” role. But this time it is I, a cisgendered male,1 who am in the wrong, since we decided before the dance that I am dancing the “raven” part, traditionally the “lady,” and my partner is dancing the “lark,” traditionally the “gent.” I correct myself and place my hand upon theirs. When I adopt the “raven” role, thirty-three years of contra dancing, that is, thirty-three years of gendered behaviour that have contributed to how I have learned to be male, are slightly difficult, but, as it turns out, not too difficult to unlearn. As we advance down and back up the hall, I make other, less minute mistakes, some that have to do with the new role expectations and some that are just part of a customary failure at executing dance moves perfectly. Like “traditional” contra dance, Circle Left (Figure 1) is a communitarian, participatory activity, and forgiveness is quickly given with a smile.

4302Machine-learning integration of complex echocardiographic patterns and clinical parameters from cohorts and trials

Introduction Contemporary machine learning (ML) allows comparing individuals based on a wide range of heterogenous data. We aimed to use similarity-based unsupervised ML to integrate clinical variables and complex imaging patterns from a population-based cohort (Atherosclerosis Risk in Communities study - ARIC) with a HFPEF (Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist - TOPCAT) as well as a HFREF (Multicenter Automatic Defibrillator Implantation Trial with Cardiac Resynchronization Therapy - MADIT-CRT) clinical trial and to predict the outcome of the patients based on their location in the derived ML universe, rather than on their original cohort. Methods An unsupervised ML for dimensionality reduction algorithm (multiple kernel learning) was trained using 2123 subjects enrolled in ARIC. The algorithm positioned them based on similarities in longitudinal strain patterns of 12 LV regions and an LV volume curve, together with 17 clinical parameters (age, sex, myocardial infarct, QRS width, prior HF, LVEDVi, LAVi, race, heart rate, SBP, BP meds, diabetes, smoking status, BMI, GLS, LVMi, LVEF). Using the same descriptors, 105 untreated TOPCAT and 429 untreated MADIT-CRT patients were projected onto the learned space (upper-left figure). A k-means algorithm was subsequently used to partition the resulting space into 3 clusters (broadly speaking, the number of expected clinical categories: controls (ARIC), HFPEFs (TOPCAT) and HFREFs (MADIT-CRT) (upper-right figure). Finally, cluster-wise event rates (composite of death or HF hospitalization) were computed for the combination of the two trials (bottom-left figure) and only considering subjects from ARIC (bottom-right figure). Results The visualisation of the low-dimensional space (upper-left figure) showed a clear aggregation of individuals according to the study, highlighting their different clinical and deformation properties. The individuals located around the MADIT-CRT patients (predominantly in cluster 3) showed the highest event rate (26.6%, similar to the MADIT-CRT event rate 25.4%) while those around the majority of the ARIC cohort showed the lowest rates (5.3%, similar to the ARIC event rate 5.7%). The MADIT-CRT-like ARIC individuals showed a much higher event-rate compared to the one expected from the cohort (21.1% vs 5.7%). Figure 1 Conclusion Our results serve as a proof-of-concept that unsupervised ML based analysis of complex clinical and imaging data can be used to integrate patient-based data, including complex echocardiographic data, to project individuals onto a multi-dimensional space with event rates that track with multidimensional location. Acknowledgement/Funding ARIC and TOPCAT were funded by the National Heart, Lung and Blood Institute, MADIT-CRT by Boston Scientific

Playing Games of Dress-Up During the Italian Renaissance

Throughout the Renaissance, people would dress sculptures of the Virgin during sacred ceremonies, adorn sculptures of the Madonna and Child with jewels, and swaddle sculptures of the infant Christ. Agostino di Giovanni’s Annunciate Virgin (1321) [Fig. 1] reflects the popular tradition of dressing sculptures in Tuscany during the Trecento and Quattrocento. Agostino di Giovanni carved the Annunciate Virgin wearing only a red underdress, as this sculpture was originally dressed in an actual fabric mantle and veil. The moveable joints in her elbows and shoulders facilitated dressing. The Virgin reflects the idealized beauty standards of the period, with full cheeks, almond-shaped eyes, a small pointed nose, and delicate rosebud lips. During the Trecento and Quattrocento, dressing sculptures were popular, and worshipers likely engaged in the act of dressing as a form of devotion. Her youthful beauty, and the fact that worshipers dressed her, raise issues of decorum, especially considering that the act of dressing implies undressing. These tensions are reflected in later accounts of priests dressing sculptures of the Virgin Mary using poles and under the supervision of pious women. Given that worshipers dressed this sculpture in actual fabric, how did the Annunciate Virgin balance humanity and divinity, thus mitigating these concerns of modesty? This research paper explores this question using the visual reconstruction of the Annunciate Virgin, which recreates the original physical and social context of the sculpture [Figs. 2 –3]. (clockwise from upper left) Figure 1.Annunciate Virgin by Agostino di Giovanni1321 Figure 2.Annunciate Virgin Reconstruction Figure 3.Reconstruction

Case 15.7

65-year-old woman with bilateral breast implants placed 25 years ago presents with increasing capsular contracture Axial (Figure 15.7.1) and bilateral sagittal (right, Figure 15.7.2A; left, Figure 15.7.2B) IR images with fat suppression and selective water suppression demonstrate silicone outside of the fibrous capsule bilaterally. Intracapsular rupture of both implants is indicated by the teardrop signs and subcapsular line signs in both breasts....

Unstable spiral modes in the Milky Way system

Discrete spiral modes of density waves have been calculated for models of the Milky Way system. The calculation is based on a fluid dynamical formulation. (See Lau and Bertin, 1978.) The equilibrium assumes a rotation curve given by Schmidt in 1965. The surface density σ of the active disk is less than the projected value implied by the Schmidt model, because of the presence of the spheroidal component and of the finite thickness of the disk. One such model (left figure) supports a spiral mode with a pattern speed of 13.6 km/sec/kpc. The spiral pattern (right figure) is very similar to that calculated earlier by Lin and Shu (1967) who used only the short wave. The perturbation density on the contours shown equals 1/5 of the maxima. There are other unstable modes. The modes are sensitive to the assumed Q profile. The superposition of these modes opens the way to the explanation of the complicated features observed but not well explained by the single spiral pattern computed earlier.