cssi/SciSciGPT-SciSciNet huggingface dataset:
Endophyte Infection May Affect the Competitive Ability of Tall Fescue Grown with Red Clover

Cool-season grasses infected with Neotyphodium endophytes may be more persistent and competitive than non-infected plants. In a greenhouse experiment, two tall fescue (Festuca arundinacea Schreb.) cloned genotypes (DN2 and DN11) with different growth characteristics and endophyte status (E−, non-infected; E+, infected) were grown in monocultures and in full competition with red clover (Trifolium pratense L.) cv. Reddy Red for 20 weeks. When grown in monoculture, endophyte infection reduced the root dry matter (DM) of DN2 (16 %) and DN11 (5 %) when compared to E− plants, while shoot DM was not affected. In full competition with red clover, root and shoot DM of tall fescue were not influenced by endophytes, but cumulative herbage DM yield was less in E+ than in E− plants. Root growth of red clover was significantly depressed (22 %) in competition with E+ plants of DN2 compared to E− plants, but was not affected when plants were grown in competition with DN11. The relative yield total (RYT) did not differ from 1.0 in red clover mixtures with E− plants of DN2 and DN11, and with E+ plants of DN11, indicating competition between the competitors for the same resources. In contrast, RYT was less than 1.0 in the red clover/DN2 E+ mixture, suggesting a negative interaction between the competitors. Endophyte infection increased the competitive ability of DN2 but reduced that of DN11 when compared to E− plants. Because the concentration of pyrrolizidine alkaloids in roots of E+ plants of DN2 was twice that found in roots of DN11 (1083 and 536 μg g−1, respectively), we suggest that pyrrolizidine alkaloids might influence the competitive ability of some endophyte–tall fescue associations through a possible allelopathic effect on companion species.
A high-level block-diagram signal processing language

The model of discrete-time computation underlying most block diagram languages makes them inappropriate for many important signal processing algorithms. A conceptual framework for a general high-level block diagram programming system is proposed. This framework, the closure model, is motivated by the representation of functions used in applicative languages such as LISP. An experimental block diagram language, BDL, based on this model is described.
Deliberate perioperative systems design improves operating room throughput

Background: New operating room (OR) design focuses more on the surgical environment than on the process of care. The authors sought to improve OR throughput and reduce time per case by goal-directed design of a demonstration OR and the perioperative processes occurring within and around it. Methods: The authors constructed a three-room suite including an OR, an induction room, and an early recovery area. Traditionally sequential activities were run in parallel, and nonsurgical activities were moved from the OR to the supporting spaces. The new workflow was supported by additional anesthesia and nursing personnel. The authors used a retrospective, case- and surgeon-matched design to compare the throughput, cost, and revenue performance of the new OR to traditional ORs. Results: For surgeons performing the same case mix in both environments, the new OR processed more cases per day than traditional ORs and used less time per case. Throughput improvement came from superior nonoperative performance. Nonoperative Time was reduced from 67 min (95% confidence interval, 64‐70 min) to 38 min (95% confidence interval, 35‐40 min) in the new OR. All components of Nonoperative Time were meaningfully reduced. Operative Time decreased by approximately 5%. Hospital and anesthesia costs per case increased, but the increased throughput offset costs and the global net margin was unchanged. Conclusions: Deliberate OR and perioperative process redesign improved throughput. Performance improvement derived from relocating and reorganizing nonoperative activities. Better OR throughput entailed additional costs but allowed additional patients to be accommodated in the OR while generating revenue that balanced these additional costs. OPERATING room (OR) time is expensive, with an estimated cost of $10 –30/min. 1,2 Concomitantly, minimally invasive surgery is increasingly prevalent, with longer setup times for the technology required to support minimally invasive procedures in multipurpose ORs. At the same time, changes in reimbursements and increasing costs create tremendous pressure to maximize surgical productivity from valuable OR space. Considerable recent effort has been applied to optimizing the use of OR time to improve access for patients, reduce costs, and improve patient and personnel satisfaction. However, emphasis on reduction of turnover time has not been rewarding. The achievable reduction in time between operations is likely to be too small to accomplish additional cases during regular OR hours. 3 Alternatively, the reductions in total case time that must be achieved to reliably accommodate an additional case within scheduled hours vary as a function of the total case time but are probably too large to be obtained by incremental improvements in standard perioperative processes. 4 Against this backdrop, we decided to change the basic paradigms by which one of our ORs functions, seeking to achieve increased throughput.
Development and evaluation of thermal infrared imaging system for high spatial and temporal resolution crop water stress monitoring of corn within a greenhouse

The greenhouse thermal imaging system had a ?0.62?C (α=0.05) measurement accuracy.Unstressed canopy temperatures followed closely to characteristic crop water use.Canopy temperature is a viable water stress indicator throughout growth stages.Spatial and temporal canopy temperature provide accurate crop health assessment.82% of soil moisture variation was explained by CWSI values above 0.6. Inadequate water application often decreases yield and grain quality. Existing methods using single, localized soil moisture or canopy temperature measurements do not account for crop water stress on both a high spatial and temporal resolution for precision irrigation water management decisions and scheduling. Therefore, this study was conducted to understand the feasibility of thermal cameras in order to quantify high resolution spatial canopy temperatures in relation to soil moisture. The objectives of this study were to deploy a thermal infrared imaging system (TIRIS) for high spatial and temporal monitoring of corn canopy temperature in greenhouse, test camera durability and measurement accuracy during full-season crop development, remove background temperatures with image segmentation, and sample individual plants to investigate full-season crop water stress versus soil moisture content. A TIRIS was developed using a lightweight uncooled thermal camera. Corn plants were divided into well-watered and water-stressed irrigation zones to observe stress from water deficits. Canopy temperatures were used to develop empirical canopy and air temperature deficit versus vapor pressure deficit linear regressions. Results showed that the TIRIS system maintained measurement accuracy of ?0.62?C (α=0.05) while compensating for changing ambient greenhouse conditions. Canopy and air temperature deficit versus vapor pressure deficit regression equations revealed that the predicted canopy temperature was closely related to characteristic water use. Results of the 80-day study demonstrated that 82% of soil moisture variation was explained by the crop water stress index (CWSI) values between 0.6 and 1.0. Results indicated that the CWSI derived by remotely measuring canopy temperature using TIRIS can be used as an alternate irrigation scheduling method in order to quantify spatial and temporal soil moisture variability.
Cerebral Whipple’s Disease. Diagnosis by Brain Biopsy

Whipple's disease, a multisystem chronic granulomatous disease treatable by antibiotics, usually presents clinically with gastrointestinal or joint symptoms. Usually, the diagnosis is substantiated by small intestinal biopsy. This shows diastase-resistant periodic-acid-Schiff-(PAS)-positive inclusions in the cytoplasm of macrophages within the lamina propria. By electron microscopy, this PAS-positive material consists of 1.5 X 0.2-mum bacilli and fine fibrillar material within macrophage phagolysosomes. Rarely, Whipple's disease presents clinically as a primary neurologic disease without gastrointestinal symptoms. Because untreated cerebral Whipple's disease usually progresses rapidly to death, it is imperative to establish the diagnosis promptly. This report describes a case of cerebral Whipple's disease without gastrointestinal symptoms that was diagnosed early by light-and electron-microscopic study of brain biopsy material.
Fast First-Phase Candidate Generation for Cascading Rankers

Current search engines use very complex ranking functions based on hundreds of features. While such functions return high-quality results, they create efficiency challenges as it is too costly to fully evaluate them on all documents in the union, or even intersection, of the query terms. To address this issue, search engines use a series of cascading rankers, starting with a very simple ranking function and then applying increasingly complex and expensive ranking functions on smaller and smaller sets of candidate results. Researchers have recently started studying several problems within this framework of query processing by cascading rankers; see, e.g., [5, 13, 17, 51]. We focus on one such problem, the design of the initial cascade. Thus, the goal is to very quickly identify a set of good candidate documents that should be passed to the second and further cascades. Previous work by Asadi and Lin [3, 5] showed that while a top-k computation on either the union or intersection gives good results, a further optimization using a global document ordering based on spam scores leads to a significant reduction in quality. Our contribution is to propose an alternative framework that builds specialized single-term and pairwise index structures, and then during query time selectively accesses these structures based on a cost budget and a set of early termination techniques. Using an end-to-end evaluation with a complex machine-learned ranker, we show that our approach finds candidates about an order of magnitude faster than a conjunctive top-k computation, while essentially matching the quality.
Abstract 191: Ras GTPase-activating Protein SH3 Domain Binding Protein 1 (G3BP1) Regulates The Induction Of Stress Granules During Cardiac Hypertrophy

Stress granules (SGs) are dynamic, microscopically visible, cytoplasmic bodies that play a major role in mRNA metabolism (e.g. sorting, storage, decay) and induced in cells during stress conditions like starvation, oxidative strain or growth. With substantial role in cancer and neurodegenerative diseases, these granules have never been studied during cardiac hypertrophy, or in the heart in general. Several studies have identified independent proteins, mostly mRNA binding proteins that are part of these granules, some of which are sufficient to nucleate the assembly in quiescent cells even without stress. One such mRNA binding protein is Ras GTPase-activating protein SH3 domain binding protein 1 (G3BP1), which increases during cardiac hypertrophy via posttranscriptional regulation. Thus, we hypothesized that G3BP1 might be involved in the induction of SGs during hypertrophy and hence in regulating mRNA processing and gene expression. Our aim was to investigate, 1) if these SGs appear in hypertrophied hearts and 2) if G3BP1 is necessary and sufficient to induce them during hypertrophic stimuli. In vivo staining of TIA-1/TIAR (SG marker) in mouse hearts subjected to sham or transaortic coarctation (TAC) surgeries showed accumulation of these granules with cardiac hypertrophy. Similar induction was seen in isolated, cultured, rat neonatal cardiac myocytes with hypertrophic stimulation (Endothelin1) or overexpression of G3BP1 alone (>60% of myocytes stained for SG). Conversely, switch to growth-inhibited conditions or knockdown of G3BP1 in hypertrophying myocytes was sufficient to prevent the assembly of these structures. Co-staining with other components of these granules like TIA-1/TIAR or proteins specific to P bodies, like decapping enzyme 1 validated these structures as SGs in cardiac myocytes. Interestingly, a long non-coding RNA, Gas5 (Growth Arrest Specific 5) that is validated binding partner of G3BP1 sequestered to perinuclear focal locations in myocytes stimulated with ET1, suggesting growth-induced recruitment to SGs. While we are still in process of examining G3BP1 targets that are recruited to SGs and their role in hypertrophy development, we have concluded that G3BP1 is required for the induction of SGs during cardiac hypertrophy
Contraception Initiation in the Emergency Department: A Pilot Study on Providers' Knowledge, Attitudes, and Practices.

OBJECTIVES: Almost half of all pregnancies in the United States are unintended; these pregnancies are associated with adverse outcomes. Many reproductive-age females seek care in the emergency department (ED) are at risk of pregnancy and are amenable to contraceptive services in this setting. Through a pilot study we sought to assess ED providers current practices; attitudes; and knowledge of emergency contraception (EC) and nonemergency contraception (non-EC) as well as barriers with respect to contraception initiation. METHODS: ED physicians and associate providers in Georgia were e-mailed a link to an anonymous Internet questionnaire using state professional databases and contacts. The questionnaire included Likert scales with multiple-choice questions to assess study objectives. Descriptive statistics were generated as well as univariate analyses using chi(2) and Fisher exact tests. RESULTS: A total of 1232 providers were e-mailed with 119 questionnaires completed. Participants were predominantly physicians (80%) men (59%) and individuals younger than 45 years (59%). Common practices were referrals (96%) EC prescriptions (77%) and non-EC prescriptions (40%). Common barriers were perceived as low likelihood for follow-up (63%) risk of complications (58%) and adverse effects (51%). More than 70% of participants correctly identified the highly effective contraceptive methods 3% identified the correct maximum EC initiation time and 42% correctly recognized pregnancy as a higher risk than hormonal contraception use for pulmonary embolism. CONCLUSIONS: Most ED providers in this pilot study referred patients for contraception; however there was no universal contraceptive counseling and management. Many ED providers in this study had an incorrect understanding of the efficacy risks and eligibility associated with contraceptive methods. This lack of understanding may affect patient access and be a barrier to patient care.
Hypotheses ranking and state tracking for a multi-domain dialog system using multiple ASR alternates.

In this paper, we present an approach to improve the accuracy of multi-domain multi-turn spoken dialog system (SDS) by including alternate results from automatic speech recognition (ASR). Often, even if the top ranked result from the ASR is not correct, the correct result may still be available in the NBest list or in the word confusion network (WCN). Thus, the SDS performance can be improved by considering beyond the top ranked choice from the ASR. We employ late binding, such that multiple ASR choices are propagated through the SDS and knowledge fetch so that additional context can be utilized at later stages to determine the top choice that is good for the overall SDS. We rank alternate domain dependent semantic frames, multiple semantic frames per ASR choice, to determine the true SDS output. Using real-world data, extracted from the logs of Cortana personal digital assistant deployed to millions of users, we show that significant gains can be achieved in domain detection, intent determination, and slot tagging, by considering additional results from ASR.
Hemodynamic effect of myocardial revascularization in the impaired ventricle.

The hemodynamic effect of myocardial revascularization with saphenous vein grafts (mean 3.3 per patient) was analyzed I year after operation in 111 patients. Operations were performed using one continuous period of aortic cross-clamping with hyperkalemic cardioplegia for distal anastomoses in 84% of patients; 16% had arrest with topical and systemic hypothermia for myocardial protection. Group I (N = 18) had normal ventricles (ejection fraction [EF] ≥ 50%; left ventricular end-diastolic pressure [LVEDP] ≤ 12 torr); Group II (N = 64) had ischemic ventricles (EF ≥ 50%, LVEDP > 13 torr); and Group III (N = 30) had abnormal ventricles (EF 13 torr). Hemodynamic measurements were obtained before and 1 year after operation. Fifteen of 18 patients (83%) in Group I did not show significant hemodynamic changes, but in three EF decreased by ≥ 10% and LVEDP increased by ≥ 10% over preoperative levels. In Group II, EF was unchanged or slightly better in 89% (57/64) and worse in seven patients. Improvement in cardiac index (p 35% to
Wischnitzer's Residency Manual: Selecting Your Specialty

Overview Medicine as a profession is going through turbulent times. Medical education and patient reimbursement are among issues in a state of flux. Nevertheless, as a medical student, you can exercise considerable control over your personal career. This is because your choice of a specialty will determine (1) how long a training period you will have, (2) how many programs will be accessible to you, and (3) the geographic area of your training site. To achieve a favorable outcome of the specialty selection process, careful planning is essential. Medical students, being intensively involved in demanding educational activities, may find themselves pressured into choosing a specialty with undue haste, not giving it the thought that this very important decision deserves. Some elect to choose the specialty of a physician they admire, or of their medical school mentor, trying merely to imitate a person looked upon as a role model. These motivating factors present serious risks, due to the inherent differences that usually exist between individuals, and the sought-after results may not materialize. The specifics of choosing a specialty will be discussed later in this chapter, but some generalizations are in order at this point. In seeking to establish a tentative choice of specialty, try to determine what approach to medicine appeals to you most. Do you prefer to focus on wellness or on sickness? Are you interested in treating adults of varying ages? Do you prefer short- or long-term patient relationships? Do you favor contact with peers in your profession or with patients? Do you prefer a contemplative or decisive approach to solving problems? […]
Short-Duration ACTH Therapy for West Syndrome

Short-term developmental and seizure outcomes were assessed in 7 children, aged <12 months, with cryptogenic West syndrome treated with a short-duration (7-12 days) and low-dose synthetic ACTH at Nagoya City Hospital, Japan.
Identification of genetic alterations associated with the process of human experimental colon cancer liver metastasis in the nude mouse

Understanding the genetic elements controlling the process of tumor metastasis to distant organ sites such as the liver may be the key to improving survivorship from colon cancer. By using standard cytogenetic techniques in combination with comparative genomic hybridization, multiple genetic imbalances within three human colon cancer cell lines previously selected for differences in liver-metastatic behavior were identified. The entire genome of one poorly metastatic cell line (KM12C) was compared directly with that of two highly metastatic cell lines (KM12SM, KM12L4A) derived from it. A number of chromosomal gains (8q, 12q15, 20q11.2) and losses (5p13, 6p21.3, 18) were common to all three cell lines and are likely related to early tumor development rather than to the selection process used to generate cell lines of increased metastatic potential. Chromosomal imbalances detected only in the highly metastatic cell lines were also observed. KM12SM showed losses of portions of 2p22, 2q24.3--> 2q32.2, 4p15.3--> cen, 4q24 without the 13q and 15q22.3 gains noted for KM12C. Both gains (1p31.3--> 1p21, 2q22--> 2q33, 3cen--> 3q26.2, 5q14--> 5q23, 6cen--> 6q23) and losses (16p, 17p, 17q 19p, 19q 22q) were observed for KM12L4A but not for the other two cell lines. Identification of these alterations provides valuable insight into the process of experimental liver metastasis and is a first step towards mapping genes linked to the terminal phases of human colon cancer progression.
Response by Ehrlich et al to Letter Regarding Article, “Safety of Computed Tomographic Angiography in the Evaluation of Patients With Acute Stroke: A Single-Center Experience”

We appreciate Drs Wu, Tu, and Malhotra’s well-informed comments on our article, “Safety of Computed Tomographic Angiography in the Evaluation of Patients With Acute Stroke: A Single-Center Experience,” and the opportunity to respond. Although the conclusions drawn from our study regarding safety of contrast medium in this setting have been suggested by others in the past,1–3 it was felt our own experience compared with a contemporary control group would provide guidance for neurologists in practice who manage acute ischemic stroke. We also directly examined whether additional imaging with computed tomographic angiography (CTA) delayed key time-interval goals or whether inclusion of CTA in the evaluation of these patients would delay tissue-type plasminogen activator administration. As Wu et al point out, of the 289 …
Palladium-coated photonic crystal vertical cavity lasers for hydrogen sensing applications

We report the integration of palladium on the surface of a photonic crystal VCSEL for use as a hydrogen sensor. We demonstrate a shift in output power and peak wavelength in response to hydrogen concentration.
Explaining the distribution of Rhabdopterus jansoni in coffee plantations: insights from diet breadth and preference

Understanding the factors that influence the dynamics of herbivory becomes a particularly important challenge when considering agricultural systems. Here we use the regionally specific herbivore of Coffea spp., Rhabdopterus jansoni (Jacoby) (Coleoptera: Chrysomelidae) and explore the potential factors which contribute to its dynamics and relative densities in coffee agroecosystems. Our experiments have shown that R. jansoni did not feed differentially on varieties of Coffea arabica, but preferred all varieties of Coffea arabica to Coffea canephora. No difference was found in R. jansoni’s preference for young or old coffee leaves, R. jansoni was more abundant in plantations of C. arabica relative to C. canephora, and finally, R. jansoni was found on 15 of 18 shade trees surveyed in the agroecosystem. Interestingly the lab preference experiments correspond to the relative densities of R. jansoni in the field, suggesting to us that field surveys may represent a metric of preference for some herbivores in agroecosystems. Additionally we discuss various factors to be considered when attempting to understand the role that shade trees may play in agroforestry systems.
Chromatid Interactions during Intrachromosomal Recombination in Mammalian Cells

Publisher Summary This chapter discusses chromatid interactions during intrachromosomal recombination in mammalian cells. Intrachromosomal recombination can involve two discrete types of chromatid interactions: (1) intrachromatid, which occurs between linked sequences on a DNA molecule and (2) sister chromatid, which occurs between equally or unequally paired homologous sequences following DNA replication. In most cell systems, equal sister chromatid exchange has no genetic consequence. Orientation I refers to a configuration in which mutations are proximal to the intervening sequences, whereas the orientation II constructs harbors genes with mutations distal to the intervening sequences. In the study presented in the chapter, the directions of both tk genes were reversed on the recombination substrate to produce direct repeats in orientation II, and the construct was introduced into mouse L cells by direct nuclear microinjection. The focus of the study was a comparison of products of reciprocal recombination from orientation I and orientation II direct repeats. The primary goal is to infer the types of chromatid interactions among repeated genes. Because gene conversions are noninformative, the strategy involves a comparison of reciprocal exchanges between orientation I and orientation II direct repeats.
Microfabricated Biosensing Devices: MEMS, Microfluidics, and Mass Sensors

The ability to microfabricate sensors, actuators, and the components of microsystems has become commonplace in the past decade. The term microelectromechanical systems, or MEMS, commonly describes devices and integrated microsystems in the micrometer to millimeter size range, fabricated using technologies akin to the lithographic patterning and physical/chemical feature definition processes developed for electronic semiconductor chips. As the acronym implies, MEMS devices differ from traditional electronic components in the inclusion of mechanical features: moving parts, or simply structures for which physical parameters such as pressure, stress, or acceleration perturb the device mechanically to produce a signal, or where mechanical effects are used to implement device function, e.g., in an actuator. In the past ten years, MEMS devices have found increasing commercial success in applications ranging from intravenous blood pressure transducers to automobile airbag accelerometers and digital light projectors. MEMS is expanding from its roots in electromechanical devices in multiple directions. Explosive growth in optical telecommunications applications—followed in the commercial world, unfortunately, by a smaller but nearly as impressive implosion—has stretched the capabilities of, and demands upon, this technology. The emergence and integration of sub-
Marijuana Law, Policy, and Authority

This is the introductory Chapter from my textbook, Marijuana Law, Policy, and Authority. This-first-of its kind textbook is designed to guide instructors, students, and practitioners alike through the competing approaches to regulating marijuana, the policies behind those approaches, and the power of various federal, state, and local government actors to pursue them. The introductory Chapter explains why marijuana law and policy has become such a fascinating and worthwhile area of study, even for people who never intend to work/practice in this field. It also provides more details about the content and features of the book and how it can be used in the classroom or as a desk reference.
Ralph Ellison: Capturing the Idiom

Ralph Ellison spent four years in Harlem collecting Negro lore and assembling personal narratives and children’s rhymes that would influence his literary vision. This chapter focuses on Ellison’s archived fieldwork reports and their connections to his novel Invisible Man and several of his short stories. The FWP provided Ellison with an important venue for working through some of the central thematic and aesthetic elements of his writing: his original use of the vernacular and his reimagining of folk art forms, his fusion of oral culture with the reverberations of jazz and blues, and his abiding belief in the first-person voice and its power to fuel democratic principles and help define American identity. In his own words, Ellison maintained that working for the FWP taught him how to “capture the idiom” in his own writing.
Work-Related Predictors of Psychological Distress among Medical Examiner and Coroner Personnel:

Personnel employed in medical examiner and coroner offices are involved in the identification of the deceased, the determination of causes of death, and the communication of this information to rel...
Pre-existing psychological depression confers increased risk of adverse cardiovascular outcomes following cardiac surgery: A systematic review and meta-analysis

– Psychologically depressed patients undergoing coronary artery by-pass grafting for coronary artery disease experience worse clinical outcomes. However, data are limited in this patient population.
Associations of Food Addiction in a Sample Recruited to Be Nationally Representative of the United States

The current study investigated the prevalence of food addiction and its associations with obesity and demographic factors in a sample recruited to be more nationally representative of the United States than previous research. Individuals (n = 1050) were recruited through Qualtrics' qBus, which sets demographic quotas developed using the United States census reference population. Participants (n = 986) self-reported food addiction, measured by the modified Yale Food Addiction Scale 2.0, height, weight, age, gender, race and income. Food addiction was observed in 15% of participants, with greater prevalence in individuals who were younger, Hispanic and/or reported higher annual income. Food addiction prevalence was higher in persons who were underweight or obese, relative to normal weight or overweight. Food addiction was associated with higher body mass index in women and persons who were older, White and/or reported lower income. Identifying the scope of food addiction and individual risk groups may inform public policy initiatives and early intervention efforts. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
Clinical implications of somatic mutations in aplastic anemia and myelodysplastic syndrome in genomic age

Recent technological advances in genomics have led to the discovery of new somatic mutations and have brought deeper insights into clonal diversity. This discovery has changed not only the understanding of disease mechanisms but also the diagnostics and clinical management of bone marrow failure. The clinical applications of genomics include enhancement of current prognostic schemas, prediction of sensitivity or refractoriness to treatments, and conceptualization and selective application of targeted therapies. However, beyond these traditional clinical aspects, complex hierarchical clonal architecture has been uncovered and linked to the current concepts of leukemogenesis and stem cell biology. Detection of clonal mutations, otherwise typical of myelodysplastic syndrome, in the course of aplastic anemia (AA) and paroxysmal nocturnal hemoglobinuria has led to new pathogenic concepts in these conditions and created a new link between AA and its clonal complications, such as post-AA and paroxysmal nocturnal hemoglobinuria. Distinctions among founder vs subclonal mutations, types of clonal evolution (linear or branching), and biological features of individual mutations (sweeping, persistent, or vanishing) will allow for better predictions of the biologic impact they impart in individual cases. As clonal markers, mutations can be used for monitoring clonal dynamics of the stem cell compartment during physiologic aging, disease processes, and leukemic evolution.
Progression of convulsive and nonconvulsive seizures during epileptogenesis after pilocarpine-induced status epilepticus

Nonconvulsive seizures usually represent the first bona fide seizure following a latent period, dominate the early stages of epileptogenesis, and change in severity in a manner consistent with the ...
CONCORDANCES OF HILBERT CUBE MANIFOLDS AND TUBULAR NEIGHBORHOODS OF FINITE-DIMENSIONAL MANIFOLDS

In this paper it is shown how some new approximation theorems for maps of manifolds into fiber bundles can be used to prove some well-known results obtained by different methods. These results are (1) the stable equivalence of finite- and infinite-dimensional concordances, and (2) the existence of tublar neighborhoods for codimension 2 locally flat embeddings of finite-dimensional manifolds.
Why Is It So Difficult to Identify the Onset of Ice Premelting

Premelting of ice at temperatures below 0 °C is of fundamental importance for environmental processes. Various experimental techniques have been used to investigate the temperature at which liquid-like water first appears at the ice–vapor interface, reporting onset temperatures from −160 to −2 °C. The signals that identify liquid-like order at the ice–vapor interface in these studies, however, do not show a sharp initiation with temperature. That is at odds with the expected first-order nature of surface phase transitions, and consistent with recent large-scale molecular simulations that show the first premelted layer to be sparse and to develop continuously over a wide range of temperatures. Here we perform a thermodynamic analysis to elucidate the origin of the continuous formation of the first layer of liquid at the ice–vapor interface. We conclude that a negative value of the line tension of the ice–liquid–vapor three-phase contact line is responsible for the continuous character of the transition and...
Supplementation with N-Acetyl Cysteine Affects Motor and Cognitive Function in Young but Not Old Mice.

BACKGROUND N-acetyl cysteine (NAC) is a thiolic antioxidant that is thought to increase cellular glutathione (GSH) by augmenting the concentration of available cysteine, an essential precursor to GSH production. Manipulating redox status can affect brain function, and NAC intake has been associated with improving brain function in models of neurodegenerative diseases. OBJECTIVES The objective of the study was to determine if short-term dietary supplementation with NAC could ameliorate functional impairment associated with aging. METHODS C57BL/6J male mice aged 6, 12, or 24 mo were fed a control diet or the control diet supplemented with 0.3% NAC for a total of 12 wk. After 4 wk of dietary supplementation, mice began a series of behavioral tests to measure spontaneous activity (locomotor activity test), psychomotor performance (bridge-walking and coordinated running), and cognitive capacity (Morris water maze and discriminated active avoidance). The performance of the mice on these tests was analyzed through the use of analyses of variance with Age and Diet as factors. RESULTS Supplementation of NAC improved peak motor performance in a coordinated running task by 14% (P < 0.05), and increased the time spent around the platform by 24% in a Morris water maze at age 6 mo. However, the supplementation had no to minimal effect on the motor and cognitive functions of 12- and 24-mo-old mice. CONCLUSIONS The findings of this preclinical study support the claim that NAC has nootropic properties in 6-mo-old mice, but suggest that it may not be useful for improving motor and cognitive impairments in older mice.
Controversies in free tissue transfer for head and neck cancer: A review of the literature.

Background Microvascular free tissue transfer provides superior functional outcomes when reconstructing head and neck cancer defects. Careful patient selection and surgical planning is necessary to ensure success, as many preoperative, intraoperative, and postoperative patient and technical factors may affect outcome. Aims To provide a concise, yet thorough, review of the current literature regarding free flap patient selection and management for the patient with head and neck. Materials and methods PubMed and Cochrane databases were queried for publications pertaining to free tissue transfer management and outcomes. Results Malnutrition and tobacco use are modifiable patient factors that negatively impact surgical outcomes. The use of postoperative antiplatelet medications and perioperative antibiotics for greater than 24 hours have not been shown to improve outcomes, although the use of clindamycin alone has been shown to have a higher risk of flap failure. Liberal blood transfusion should be avoided due to higher risk of wound infection and medical complications. Discussion There is a wide range of beliefs regarding proper management of patients undergoing free tissue transfer. While there is some data to support these practices, much of the data is conflicting and common practices are often continued out of habit or dogma. Conclusion Free flap reconstruction remains a highly successful surgery overall despite as many different approaches to patient care as there are free flap surgeons. Close patient monitoring remains a cornerstone of surgical success.
“To Meet Her, that Changed Everything”: Adult Adoptees’ Discursive Construction of the Meaning of “Parent” Following Birth Parent Contact

This study utilized Relational Dialectics Theory 2.0 to examine how adult adoptees constructed the meaning of the term parent following contact with a birth parent. Semi-structured interviews were ...
Merchants & Explorers: Roger Barlow, Sebastian Cabot, & Networks of Atlantic Exchange 1500-1560: By Heather Dalton. Oxford and London: Oxford University Press, 2016. Xi - 239 pp., images, introduction, glossary, index of persons, general index. $75.02 (HC). ISBN: 978-0199672059.

Heather Dalton’s Merchants & Explorers: Roger Barlow, Sebastian Cabot, & Networks of Atlantic Exchange 1500-1560 offers needed insight into a chapter of Atlantic exploration that has long been marg...
Charlotte Brontë: From a Yorkshire Girl to a Regency Writer and Dandy

While Charlotte Bronte is a renowned Victorian novelist, many of her early prose pieces were written well before Victoria ascended the throne in 1837. In her youth, Bronte produced a rich collection of literary works written during the reign of William IV that invites us to rethink the Bronte canon from a new literary and historical perspective. We should consider her not only as a Victorian writer but also as an author of the late Regency. Her silver-fork fiction from the 1830s reveals this un-Victorian side of Bronte’s legacy. However, the treatment of her early manuscripts as material objects—Bronte relics—rather than as narratives has limited our understanding of the breadth of Bronte’s literary legacy.
Quality improvement for reducing utilization drift in hypoxic-ischemic encephalopathy management

Objectives Therapeutic hypothermia is an effective neuroprotective intervention for infants with moderate or severe hypoxic-ischemic encephalopathy (HIE). With the introduction of new medical therapy comes a learning curve with regards to its proper implementation and understanding of eligibility guidelines. We hypothesized that variation in patient selection and lack of adherence to established protocols contributed to the utilization drift away from the original eligibility guidelines. Methods A retrospective cohort study was conducted including infants who received therapeutic hypothermia in the neonatal intensive care unit (NICU) for HIE to determine utilization drift. We then used QI methodology to address gaps in medical documentation that may lead to the conclusion that therapeutic hypothermia was inappropriately applied. Results We identified 54% of infants who received therapeutic hypothermia who did not meet the clinical, physiologic, and neurologic examination criteria for this intervention based on provider admission and discharge documentation within the electronic medical record (EMR). Review of the charts identified incomplete documentation in 71% of cases and led to the following interventions: 1) implementation of EMR smartphrases; 2) engagement of key stakeholders and education of faculty, residents, and neonatal nurse practitioners; and 3) performance measurement and sharing of data. We were able to improve both adherence to the therapeutic hypothermia guidelines and achieve 100% documentation of the modified Sarnat score. Conclusions Incomplete documentation can lead to the assumption that therapeutic hypothermia was inappropriately applied when reviewing a patient's EMR. However, in actual clinical practice physicians follow the clinical guidelines but are not documenting their medical decision making completely. QI methodology addresses this gap in documentation, which will help determine the true utilization drift of therapeutic hypothermia in future studies.
In vitro co-culture system for Prunus spp. and Armillaria mellea in phenolic foam rooting matric

Armillaria and Desarmillaria spp. are causal agents of a devastating root-borne disease of peach. Breeding resistant rootstock requires a reliable screening tool. An in vitro co-culture screen designed for almond was modified by replacing agar-gelled medium with a more aerated phenolic foam and combining resistant and susceptible rootstocks (i.e., common garden experiment) and minimizes variation in inoculum pressure or rooting substrate among replicate vessels. Eight Prunus rootstocks tested (peach, plum, peach × plum, and choke cherry) were rooted and had no decline in health. Susceptible peach rootstock, ‘GF 305’, was cultured for 15 wk in phenolic foam in the same vessel with a resistant peach × plum hybrid, ‘MP-29’, inoculated with Armillaria mellea at week 5, that led to more severe shoot symptoms in the former after an additional 8 wk. This method accommodated peach genotypes that were difficult to root in agar medium. The difference during a uniform challenge with the A. mellea fungus recapitulates resistant/susceptible reactions. The phenolic foam-based co-culture method will work on many Prunus spp. of potential use in rootstock breeding.
Delayed Intracranial Hemorrhage in Patients Taking Warfarin with Head Trauma.

# CONTEXT Patients presenting to the Emergency Department after a minor head injury have been shown to have a higher incidence of delayed spontaneous intracranial bleed, even with an initial negative CT. Some institutions have initiated a protocol of 24-hour observation followed by repeat head CT scan the next day. At the authors’ institution, a 24-hour observation protocol was adopted in January 2012. The authors sought to evaluate the utility of this protocol given the apparently limited amount of data to support such a practice. # METHODS A 12-month prospective observational study conducted at a community hospital evaluating a 24-month observation protocol for patients presenting after a minor head injury. During this study period, a sample of minor head injury patients were identified and followed through their hospital course. CT scan results were also compiled, and patient charts were reviewed at 30 days for any return visits or post-injury complications. # RESULTS A total of 51 patients were enrolled during the study period. Of those patients receiving a repeat head CT, none showed any evidence of a new or worsening intracranial bleed, with all patients discharged safely from the hospital. At 30 days, patients’ charts were reviewed to examine whether any patients had returned to the hospital for any reason. No sample patients returned to the hospital within the 30-day review period. # CONCLUSION Similar to the results of the retrospective chart review, no sample patients with minor head injuries showed any evidence of a subsequent delayed intracranial bleed during the 12-month study period. Our study results suggest that 24-hour observation protocols with costly repeat CT head scans may not be useful in the management of most head trauma patients. Patients may be better served to be discharged home with education including signs of symptoms of a worsening bleed (i.e., confusion, worsening headaches and not feeling right) that actually warrant a return to the hospital.
Association between Longer Travel Distance for Transplant Care and Access to Kidney Transplantation and Graft Survival in the United States.

Background Transplant candidates may gain an advantage by traveling to receive care at a transplant center that may have more favorable characteristics than their local center. Factors associated with longer travel distance for transplant care and whether the excess travel distance (ETD) is associated with access to transplantation or with graft failure are unknown. Methods This study of adults in the United States wait-listed for kidney transplantation in 1995-2015 used ETD, defined as distance a patient traveled beyond the nearest transplant center for initial waiting list registration. We used linear regression to examine patient and center characteristics associated with ETD and Fine-Gray models to examine the association between ETD (modeled as a spline) and time to deceased or living donor transplantation or graft failure. Results Of 373,365 patients, 11% had an ETD≥50 miles. Traveling excess distance was more likely among patients who were of non-Black race or those whose nearest transplant center had lower annual living donor transplant volume. At an ETD of 50 miles, we observed a lower likelihood of deceased donor transplantation (subhazard ratio [SHR], 0.85; 95% confidence interval [95% CI], 0.84 to 0.87) but higher likelihood of living donor transplantation (SHR, 1.14; 95% CI, 1.12 to 1.16) compared with those who received care at their nearest center. ETD was weakly associated with higher risk of graft failure. Conclusions Patients who travel excess distances for transplant care have better access to living donor but not deceased donor transplantation and slightly higher risk of graft failure. Traveling excess distances is not clearly associated with better outcomes, especially if living donors are unavailable.
Utilization and Impact of Complementary and Alternative Medicines in Symptomatic Autoimmune Hepatitis Patients.

Complementary and alternative medicine (CAM) use has become increasingly common. It is also prevalent in patients with chronic liver disease, but the scope, depth, and safety of use is not well known. This study aimed to evaluate the prevalence and patterns of CAM use in autoimmune hepatitis (AIH) patients. Electronic invitation to complete a 22 item CAM-specific questionnaire was posted weekly to well-established AIH Facebook communities (combined membership of 4700 individuals) during a 6-week study period. Age ≥ 18 years and AIH diagnosis made by a treating physician were the eligibility criteria. The prevalence of ever CAM use among participants was 56.4%, and nearly 42% used CAM after AIH diagnosis. Among those reporting CAM use after diagnosis, 53.7% (51/95) indicated CAM was used to mitigate AIH-related phenomenon, most often targeting liver inflammation/fibrosis (67.7%), fatigue (51%), joint pain (47.1%), and sleep issues (45.1%). Most frequent physical CAM strategies were exercise (49.5%) and yoga (34%), whereas most frequent consumable CAM included healthier eating (45.3%), cannabidiol preparations (45.3%), and probiotics (44.3%). Seventy-five percent reported that CAM improved AIH symptoms and no severe adverse events were reported. CAM use in AIH patients is prevalent, yet providers have historically failed to document their patient’s CAM strategies. Beyond inherent drug-induced liver injury risk, drug-drug interactions remain a concern and could alter baseline immunosuppression levels in AIH. Despite a majority found CAM approaches that improved targeted symptoms, all were unable to alter the course of chronically prescribed medications by physicians.