Development of a multidecadal land reanalysis over High Mountain Asia.

Anthropogenic and climatic changes affect the water and energy cycles in High Mountain Asia (HMA), home to over two billion people and the largest reservoirs of freshwater outside the polar zone. Despite their significant importance for water management, consistent and reliable estimates of water storage and fluxes over the region are lacking because of the high uncertainties associated with the estimates of atmospheric conditions and human management. Here, we relied on multivariate data assimilation (MVDA) to provide estimates of energy and water storage and fluxes that reflect the processes occurring in the region such as greening and irrigation-driven groundwater depletion.

Prediction of Active Microwave Backscatter Over Snow-Covered Terrain Across Western Colorado Using a Land Surface Model and Support Vector Machine Regression.

The main objective of this article is to develop a physically constrained support vector machine (SVM) to predict C-band backscatter over snow-covered terrain as a function of geophysical inputs that reasonably represent the relevant characteristics of the snowpack. Sentinel-1 observations, in conjunction with geophysical variables from the Noah-MP land surface model, were used as training targets and input datasets, respectively. Robustness of the SVM prediction was analyzed in terms of training targets, training windows, and physical constraints related to snow liquid water content.

A Pilot Study to Determine the Impact of Adipose Tissue Attachment to Polypropylene Fibers In Hernia Mesh.

Introduction: Prior publications have demonstrated chemical and physical alteration of hernia mesh analyzed after explantation from the body. The specific alteration documented is oxidative degradation of polypropylene mesh fibers. An animal study recently published has demonstrated that adipose tissue attachment is present instead of reparative fibrous tissue infiltration in an average of 10.

Discovery of novel modulators for the PPARα (peroxisome proliferator activated receptor α): Potential therapies for nonalcoholic fatty liver disease.

Nonalcoholic fatty liver disease (NAFLD) is a severe liver disease causing serious liver complications, including nonalcoholic steatohepatitis (NASH). Nuclear receptor PPARα (peroxisome proliferator-activated receptor α) has drawn special attention recently as a potential developmental drug target to treat type-2 diabetes and related diseases due to its unique functions in regulating lipid metabolism, promoting triglyceride oxidation, and suppressing hepatic inflammation, raising interest in PPARα agonists as potential therapies for NAFLD. However, how PPARα coordinates potential treatment of NAFLD and NASH between various metabolic pathways is still obscure.

The use of a novel synthetic resorbable scaffold (TIGR Matrix) in a clinical quality improvement (CQI) effort for abdominal wall reconstruction (AWR).

Purpose: The use of hernia mesh is a common practice in abdominal wall reconstruction (AWR) operations. The high cost of biologic mesh has raised questions about the value of its use in AWR. Resorbable synthetic mesh may have the potential benefits of biologic mesh, minimizing the need for removal when infected, at a lower cost.

Water Storage Trends in High Mountain Asia.

Changes in terrestrial water storage (TWS) in High Mountain Asia (HMA) could have major societal impacts, as the region's large reservoirs of glaciers, snow, and groundwater provide a freshwater source to more than one billion people. We seek to quantify and close the budget of secular changes in TWS over the span of the GRACE satellite mission (2003-2016). To assess the TWS trend budget we consider a new high-resolution mass trend product determined directly from GRACE L1B data, glacier mass balance derived from Digital Elevation Models (DEMs), groundwater variability determined from confined and unconfined well observations, and terrestrial water budget estimates from a suite of land surface model simulations with the NASA Land Information System (LIS).

Evaluating effectiveness of cognitive behavioral therapy within multimodal treatment for chronic groin pain after inguinal hernia repair.

Introduction: The development of chronic groin pain after inguinal hernia repair is a complex problem with many potential factors contributing to its development. Surgical options for alleviation of symptoms are limited and only performed by a few centers dedicated to its treatment. Opportunities to apply the principles of a prehabilitation program, including Cognitive Behavioral Therapy (CBT), aim to improve the surgical outcomes for this condition.

Laparoscopic Ventral Hernia Repair with a Non-Woven Hernia Mesh.

Introduction: Laparoscopic ventral hernia repair is a commonly performed procedure with a variety of mesh options. A relatively new mesh option is a non-woven polypropylene mesh with a silicone barrier designed for intraabdominal placement. This non-woven randomly oriented polypropylene microfiber hernia mesh may have benefits with potentially better biocompatibility compared with other ventral hernia repair mesh options.

Characteristics of the National Applicant Pool for Clinical Informatics Fellowships (2016-2017).

We conducted a national study to assess the numbers and diversity of applicants for 2016 and 2017 clinical informatics fellowship positions. In each year, we collected data on the number of applications that programs received from candidates who were ultimately successful vs. unsuccessful.

Evaluating the uncertainty of terrestrial water budget components over High Mountain Asia.

This study explores the uncertainties in terrestrial water budget estimation over High Mountain Asia (HMA) using a suite of uncoupled land surface model (LSM) simulations. The uncertainty in the water balance components of precipitation (), evapotranspiration (), runoff(), and terrestrial water storage (TWS) is significantly impacted by the uncertainty in the driving meteorology, with precipitation being the most important boundary condition. Ten gridded precipitation datasets along with a mix of model-, satellite-, and gauge-based products, are evaluated first to assess their suitability for LSM simulations over HMA.

Estimating snow mass in North America through assimilation of AMSR-E brightness temperature observations using the Catchment land surface model and support vector machines.

To estimate snow mass across North America, brightness temperature observations collected by the Advanced Microwave Scanning Radiometer from 2002 to 2011 were assimilated into the Catchment model using a support vector machine (SVM) as the observation operator and a one-dimensional ensemble Kalman filter. The performance of the assimilation system is evaluated through comparisons against ground-based measurements and reference snow products. In general, there are no statistically significant skill differences between the domain-averaged, model-only ("open loop", or OL) snow estimates and assimilation estimates.

Assimilation of MODIS Snow Cover Fraction Observations into the NASA Catchment Land Surface Model.

The NASA Catchment land surface model (CLSM) is the land model component used for the Modern-Era Retrospective Analysis for Research and Applications (MERRA). Here, the CLSM versions of MERRA and MERRA-Land are evaluated using snow cover fraction (SCF) observations from the Moderate Resolution Imaging Spectroradiometer (MODIS). Moreover, a computationally-efficient empirical scheme is designed to improve CLSM estimates of SCF, snow depth, and snow water equivalent (SWE) through the assimilation of MODIS SCF observations.

The Value Proposition for Complex Abdominal Wall Reconstruction: How to Make It Work.

Background: The challenge for health care in the 21st century is to understand how to measure and improve value in the context of each patient care process for the entire cycle of care. For patients who undergo an abdominal wall reconstruction, there is a great opportunity to improve value because of the high cost and variability in outcomes for this complex operation.

Methods: For almost a decade, our hernia team has been applying the principles of systems and data science to actual patient care.

Evaluation and enhancement of permafrost modeling with the NASA Catchment Land Surface Model.

Besides soil hydrology and snow processes, the NASA Catchment Land Surface Model (CLSM) simulates soil temperature in six layers from the surface down to 13m depth. In this study, to examine CLSM's treatment of subsurface thermodynamics, a baseline simulation produced subsurface temperatures for 1980-2014 across Alaska at 9-km resolution. The results were evaluated using in situ observations from permafrost sites across Alaska.

Identification of novel inverse agonists of estrogen-related receptors ERRγ and ERRβ.

Estrogen-related receptors (ERRs, α, β, and γ) are orphan nuclear receptors most closely related in sequence to estrogen receptors (ERα and ERβ). Much attention has been paid recently to the functions of ERRs for their potential roles as new therapeutic targets implicated in the etiology of metabolic disorders. While no endogenous ligand has been identified for any of the ERR isoforms to date, the potential for using synthetic small molecules to modulate their activity has been demonstrated.

Real-World Clinical Quality Improvement for Complex Abdominal Wall Reconstruction.

Introduction: Traditional methods of clinical research may not be adequate to improve the value of care for patients undergoing abdominal wall reconstruction (AWR). These patients are prone to high complication rates and high costs. Here, we describe a clinical quality improvement (CQI) effort to enhance outcomes for patients undergoing AWR.

A Clinical Quality Improvement (CQI) Project to Improve Pain After Laparoscopic Ventral Hernia Repair.

Patients who undergo laparoscopic ventral hernia repair can have significant post-operative pain and discomfort from both somatic pain due to mesh fixation and visceral pain due to CO2 insufflation pressure. In an attempt to improve outcomes, a Clinical Quality Improvement (CQI) project was implemented by a multi-disciplinary hernia team. CQI tools were applied for consecutive patients who underwent laparoscopic ventral hernia repair from June 2012 through September 2015 (39 months).

Can Abdominal Wall Reconstruction Be Safely Performed Without Drains?

The use of closed suction drains in the abdominal wall is a common practice in abdominal wall reconstruction (AWR) operations. Drains can be a conduit for bacteria and can cause pain and discomfort for patients after surgery. A single hernia program has implemented the principles of clinical quality improvement in an attempt to improve outcomes for hernia patients.

Novel FXR (farnesoid X receptor) modulators: Potential therapies for cholesterol gallstone disease.

Metabolic disorders such as diabetes are known risk factors for developing cholesterol gallstone disease (CGD). Cholesterol gallstone disease is one of the most prevalent digestive diseases, leading to considerable financial and social burden worldwide. Ursodeoxycholic acid (UDCA) is the only bile acid drug approved by FDA for the non-surgical treatment of gallstones.

Value-based Clinical Quality Improvement (CQI) for Patients Undergoing Abdominal Wall Reconstruction.

Patients with complex ventral/incisional hernias often undergo an abdominal wall reconstruction (AWR). These operations have a high cost of care and often result in a long hospital stay and high complication rates. Using the principles of clinical quality improvement (CQI), several attempts at process improvement were implemented in one hernia program over a 3-year period.

Stereoselective synthesis, biological evaluation, and modeling of novel bile acid-derived G-protein coupled bile acid receptor 1 (GP-BAR1, TGR5) agonists.

GP-BAR1 (also known as TGR5), a novel G-protein coupled receptor regulating various non-genomic functions via bile acid signaling, has emerged as a promising target for metabolic disorders, including obesity and type II diabetes. However, given that many bile acids (BAs) are poorly tolerated for systemic therapeutic use, there is significant need to develop GP-BAR1 agonists with improved potency and specificity and there also is significant impetus to develop a stereoselective synthetic methodology for GP-BAR1 agonists. Here, we report the development of highly stereo-controlled strategies to investigate a series of naturally occurring bile acid derivatives with markedly enhanced GP-BAR1 activity.

Identification of trisubstituted-pyrazol carboxamide analogs as novel and potent antagonists of farnesoid X receptor.

Farnesoid X receptor (FXR, NRIH4) plays a major role in the control of cholesterol metabolism. This suggests that antagonizing the transcriptional activity of FXR is a potential means to treat cholestasis and related metabolic disorders. Here we describe the synthesis, biological evaluation, and structure-activity relationship (SAR) studies of trisubstituted-pyrazol carboxamides as novel and potent FXR antagonists.

Development of time resolved fluorescence resonance energy transfer-based assay for FXR antagonist discovery.

FXR (farnesoid X receptor, NRIH4), a nuclear receptor, plays a major role in the control of cholesterol metabolism. FXR ligands have been investigated in preclinical studies for targeted therapy against metabolic diseases, but have shown limitations. Therefore, there is a need for new agonist or antagonist ligands of FXR, both for potential clinical applications, as well as to further elucidate its biological functions.