cssi/SciSciGPT-SciSciNet huggingface dataset:
Reversal of profound rocuronium-induced blockade with sugammadex: a randomized comparison with neostigmine.

BACKGROUND Traditionally, reversal of nondepolarizing neuromuscular blocking agents was achieved using acetylcholinesterase inhibitors, but these are unable to adequately reverse profound blockade. Sugammadex is a novel reversal agent, reversing the effects of rocuronium by encapsulation. This study assessed the efficacy and safety of sugammadex versus neostigmine for reversal of profound rocuronium-induced neuromuscular blockade. METHODS This phase III, randomized study enrolled surgical patients, aged 18 yr or older with American Society of Anesthesiologists physical status I-IV. Patients were randomized to receive sugammadex (4.0 mg/kg) or neostigmine (70 microg/kg) plus glycopyrrolate (14 microg/kg). Anesthetized patients received an intubating dose of rocuronium (0.6 mg/kg), with maintenance doses (0.15 mg/kg) as required. Neuromuscular monitoring was performed by acceleromyography. Sugammadex or neostigmine was administered at reappearance of 1-2 posttetanic counts (profound neuromuscular blockade). The primary efficacy parameter was the time from sugammadex or neostigmine-glycopyrrolate administration to return of the train-of-four ratio to 0.9. RESULTS In the intent-to-treat population (n = 37 in each group), geometric mean time to recovery to a train-of-four ratio of 0.9 with sugammadex was 2.9 min versus 50.4 min with neostigmine-glycopyrrolate (P < 0.0001) (median, 2.7 min vs. 49.0 min). Most sugammadex patients (97%) recovered to a train-of-four ratio of 0.9 within 5 min after administration. In contrast, most neostigmine patients (73%) recovered between 30 and 60 min after administration, with 23% requiring more than 60 min to recover to a train-of-four ratio of 0.9. CONCLUSIONS Recovery from profound rocuronium-induced neuromuscular blockade was significantly faster with sugammadex versus with neostigmine, suggesting that sugammadex has a unique ability to rapidly reverse profound rocuronium neuromuscular blockade.
Outcomes of multiple gestations with advanced maternal age

Objective. To investigate outcomes of twin gestations with advanced maternal age (AMA).Study design. Historical cohort of twin gestations cared for by a maternal–fetal medicine faculty practice. Outcomes of patients with AMA (70) and non-AMA (75) were compared. AMA was defined as age ≥35. Analysis including mode of delivery, gestational age at delivery and overall complications was performed. Significance was determined using the chi-square test or the Student's t-test.Results. The Cesarean rate for AMA was significantly greater compared to non-AMA (80.0% vs. 54.7%; p = 0.001). The main reason for the increased rate was uterine dysfunction. The mean gestational age at delivery for AMA was significantly greater than for non-AMA (36.7 weeks vs. 35.4 weeks; p = 0.02). There were no differences in rates of other adverse outcomes including gestational hypertension, pre-eclampsia, gestational diabetes, suspected fetal growth restriction, preterm birth, low birth weight or low birth weight percentiles. This rema...
Metabolic inhibitors and mitosis: III. Effects of dinitrophenol on spindle disassembly in Pinnularia

At telophase in the diatomPinnularia, the two half spindles that comprise the central spindle, separate and then disassemble unidirectionally from the end formerly in the central overlap, back to the pole (Soranno andPickett-Heaps 1982). The metabolic inhibitors dinitrophenol plus deoxyglucose were applied to cells at telophase, depleting their ATP levels at the early stages of half-spindle disassembly; the cells were maintained in this state for 5 minutes, before the inhibitors were washed out. Disassembly of the half spindles, as judged from their birefringence, ceased in ATP-depleted conditions, and recommenced soon after the inhibitors were removed, going to completion quite rapidly. We conclude that disassembly of these MTsin vivo requires energy, probably in the form of ATP.
Effect of Rapamycin Alone and in Combination with Antiangiogenesis Therapy in an Orthotopic Model of Human Pancreatic Cancer

Purpose: The overall 5-year survival of patients with pancreatic cancer remains <5%. Novel therapeutic strategies are needed. We examined the effect of rapamycin, alone and in combination with antiangiogenesis therapy, on pancreatic cancer in vivo. Experimental Design: Human pancreatic cancer AsPC-1 cells were orthotopically injected into severe combined immunodeficient/beige mice to evaluate primary tumor growth and liver metastasis after treatment with rapamycin alone or in combination with anti-vascular endothelial growth factor antibody 2C3. Tumor cell proliferation was determined by bromodeoxyuridine incorporation. To detect tumor cell apoptosis, the terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling assay was used. Tumor angiogenesis was investigated by using a monoclonal anti-CD31 antibody. All statistical tests were two-sided. Results: Rapamycin, alone and in combination with 2C3, strongly inhibited primary and metastatic tumor growth in an orthotopic pancreatic cancer animal model. Furthermore, the combination therapy significantly improved the effect on liver metastasis compared with single treatment with either rapamycin (P 0.0128) or 2C3 (P 0.0099). Rapamycin alone inhibited pancreatic tumor cell proliferation, induced apoptosis, and decreased tumor angiogenesis. Nevertheless, the combination therapy showed a significant, stronger inhibition of tumor cell proliferation (P 0.0002 versus rapamycin alone and P < 0.0001 versus 2C3 alone). The induction of apoptosis was significantly higher than in the rapamycin-treated group (P 0.0039). Additionally, the combination therapy further improved suppression of tumor cell angiogenesis compared with rapamycin treatment (P 0.029) Conclusions: Our studies propose new therapeutic strategies to inhibit both primary and metastatic tumor growth in pancreatic cancer. Considering the fact that liver metastasis is a crucial problem in advanced stages of pancreatic cancer, the combination therapy of rapamycin plus anti-vascular endothelial growth factor antibody 2C3 is a significant advantage compared with single treatment with rapamycin.
Time of onset of uveitis in children with juvenile rheumatoid arthritis.

Abstract Background: Recently, it has been advocated to decrease the frequency of eye examinations to screen for uveitis in children with juvenile rheumatoid arthritis (JRA) because of the low yield of positive findings after an initial normal eye examination.This study was undertaken to determine the time interval for the development of uveitis after the diagnosis of JRA and to further describe patients who develop uveitis related to JRA. Methods: This was a retrospective chart review of all patients with JRA examined by either of 2 pediatric ophthalmologists from August 1984 to June 2001. All patients were also under the care of the Pediatric Rheumatology Division at Schneider Children's Hospital. Age of diagnosis of JRA, disease onset subtype of JRA, antinuclear antibody titers, age of diagnosis of uveitis, and complications from uveitis were recorded. Results: One hundred fifty eight patients with JRA had eye examinations; 39 (25%) developed uveitis. Sixteen patients had uveitis on the initial eye examination, and 23 subsequently developed uveitis. When uveitis was absent at the initial eye examination, the mean time to develop it was 20 months (range, 4-81 months). Conclusions: A normal initial eye examination does not preclude the development of uveitis in patients with JRA. We recommend continuing the current standards of ophthalmologic examinations to screen for uveitis in children with JRA as prescribed by the Section on Rheumatology and Ophthalmology of the American Academy of Pediatrics. (J AAPOS 2002;6:373-6)
Morphology of the turtle accessory optic system

Neural signals of the moving visual world are detected by a subclass of retinal ganglion cells that project to the accessory optic system in the vertebrate brainstem. We studied the dendritic morphologies and direction tuning of these brainstem neurons in turtle (Pseudemys scripta elegans) to understand their role in visual processing. Full-field checkerboard patterns were drifted on the contralateral retina while whole-cell recordings were made in the basal optic nucleus in an intact brainstem preparation in vitro. Neurobiotin diffused into the neurons during the recording and was subsequently localized in brain sections. Neuronal morphologies were traced using appropriate computer software to analyze their position in the brainstem. Most labeled neurons were fusiform in shape and had numerous varicosities along their processes. The majority of dendritic trees spread out in a transverse plane perpendicular to the rostrocaudal axis of the nucleus. Neurons near the brainstem surface were often oriented tangential to that surface, whereas more cells at the dorsal side of the nucleus were oriented radial to the brainstem surface. Further analysis of Nissl-stained neurons revealed the largest neurons are located in the rostral and medial portions of the nucleus although neurons are most densely packed in the middle of the nucleus. The preferred directions of the visual responses of the neurons in this sample did not correlate with their morphology and position in the nucleus. Therefore, the morphology of the cells in the turtle accessory optic system appears dependent on its position within the nucleus while its visual responses may depend on the synaptic inputs that contact each cell.
A new set of chemotaxis homologues is essential for Myxococcus xanthus social motility

Myxococcus xanthus cells aggregate and develop into multicellular fruiting bodies in response to starvation. A new M. xanthus locus, designated dif for defective in fruiting, was identified by the characterization of a mutant defective in fruiting body formation. Molecular cloning, DNA sequencing and sequence analysis indicate that the dif locus encodes a new set of chemotaxis homologues of the bacterial chemotaxis proteins MCPs (methyl-accepting chemotaxis proteins), CheW, CheY and CheA. The dif genes are distinct genetically and functionally from the previously identified M. xanthus frz chemotaxis genes, suggesting that multiple chemotaxis-like systems are required for the developmental process of M. xanthus fruiting body formation. Genetic analysis and phenotypical characterization indicate that the M. xanthus dif locus is required for social (S) motility. This is the first report of a M. xanthus chemotaxis-like signal transduction pathway that could regulate or co-ordinate the movement of M. xanthus cells to bring about S motility.
Polarization Swiching in (111) Oriented PZT Thin Films

Local domain structures in Pb(Zr,Ti)O3 (PZT) ferroelectric thin films have been investigated using linear finite element analysis to qualitatively assess the effect of crystal structure, domain wall orientation and mechanical constraints from electrodes on local polarization switching behavior. The finite element model was used to illustrate that the evolution of residual stress during polarization reorientation may play an important role in the backswitching behavior which has been observed experimentally in (111)-orientated PZT films. The domain size and orientation used in the finite element model utilizes domain sizes determined from piezoresponse force microscopy (PFM) measurements given in the literature together with domain wall orientation from strain and charge compatibility in the (111) orientation. During polarization switching, domains with polarization components aligned anti-parallel to the applied field are expected to switch 90° to partially align with the applied field. 180° switching is not expected to occur in the (111) oriented film. The 90° switching induces residual stress that is computed using the finite element model. It is illustrated that thicker top electrodes increase the residual stress in the ferroelectric layer which may play an important role in polarization retention behavior in ferroelectric capacitors.Copyright © 2006 by ASME
Miniature radio frequency ion trap mass spectrometry

RF ion traps are useful in chemical analysis and have added benefits when scaled to smaller dimensions. For a miniature ion trap it is ideal to be able to predict the performance of the ion trap prior to fabrication in order to save time and optimize parameters. We have developed both the simulation and fabrication of scaled ion traps. The simulation tool allows us to model miniature ion traps in order to predict how the frequency and amplitude of the RF voltage could be scaled in order to optimize the performance of the ion trap. We demonstrate the performance of a scaled ion trap array fabricated through the integration of stereolithography on circuit board and compare its performance with our ion trajectory simulator.
FERMIONS AND LINK INVARIANTS

This paper deals with various aspects of knot theory when fermionic degrees of freedom are taken into account in the braid group representations and in the state models. We discuss how the Ř matrix for the Alexander polynomial arises from the Fox differential calculus, and how it is related to the quantum group Uqgl(1,1). We investigate new families of solutions of the Yang Baxter equation obtained from "linear" representations of the braid group and exterior algebra. We study state models associated with Uqsl(n,m), and in the case n=m=1 a state model for the multivariable Alexander polynomial. We consider invariants of links in solid handlebodies and show how the non trivial topology lifts the boson fermion degeneracy that is present in S3. We use "gauge like" changes of basis to obtain invariants in thickened surfaces Σ×[0,1].
Beyond the enemy image and spiral model: cognitive–strategic research after the cold war

Systemic theories of international politics are inadequate for explaining particular states' policies, and some neorealists reach for supplementary foreign-policy-level concepts. Yet these studies almost never provide the empirical evidence required by their motivational constructs. Available psychological studies rely too heavily on notions peculiar to the cold war—such as the image of the enemy. A new theory proposes four additional ideal-type images. Each image is likely to lead to a specified set of strategic behaviors. An application to dyadic relations across the Persian Gulf from 1977 through 1990 suggests that this theory can help account for otherwise puzzling behavior, and it illustrates a promising route toward a more sensitive interactionist international relations theory suited both to the former superpower relationship and to diverse others.
Refining the clinical presentation of the C9ORF72 hexanucleotide repeat expansion.

In 2011, two papers simultaneously described a large hexanucleotide repeat expansion in the first intron of C9ORF72 that is a frequent cause of amyotrophic lateral sclerosis (ALS), frontotemporal dementia (FTD), and ALS-FTD (1,2). It is a common autosomal dominant gene mutation that encodes a protein of unknown function. Patients with the mutation have a mean disease onset at 56 to 58 years and typically present with behavioral symptoms suggestive of behavioral variant FTD (bvFTD), although there are some individuals in whom ALS is the presenting feature (3). Often, there is a long psychiatric prodrome with myriad symptoms that can suggest bipolar illness, borderline personality disorder, antisocial personality or obsessive-compulsive disorder. Rarely, these patients are misdiagnosed with parkinsonian disorders or Alzheimer’s disease. In this issue of Biological Psychiatry, Galimberti et al. provide a detailed genotype-phenotype description of the clinical characteristics of carriers and noncarriers of the C9ORF72 hexanucleotide repeat expansion (4). With any new discovery in genetics, an accurate clinical description of the presentation helps to determine if diagnostic genetic testing of the patient or predictive genetic testing in the family is warranted. With the potentially long prodromal period with psychiatric symptoms, a detailed phenotype will help to recognize individuals in the early clinical stages of this illness. Of the 39 carriers in their study, 74% had bvFTD, 21% had bvFTD with motor neuron disease, and 5% had semantic variant primary progressive aphasia. Interestingly, none of the patients with diagnoses of corticobasal syndrome, progressive supranuclear palsy, or nonfluent/agrammatic variant primary progressive aphasia were carriers, nor were any of the control participants. Late-onset psychosis (predominant symptoms included hallucinations and delusions) and cognitive impairment (learning and delayed recall) occurred more often in carriers than noncarriers. Most carriers also had a family history of dementia, ALS, or both. These results of this study verify the psychiatric and cognitive clinical presentation of the C9ORF72 repeat. Refining the clinical presentation of each type of pathological or genetic FTD is an essential task as we approach disease-modifying treatments. Accurate diagnoses are essential to build appropriate cohorts for clinical trials, and reliable biomarkers or clinical endpoints are needed to measure the results of treatment to know if the treatment is working.
Menopause: Salient Issues for Counselors

Counselors are in ideal positions to help change attitudes toward viewing menopause as a time of positive change, rather than a time of psychological distress. Following definitions and a review of historical, sociological, psychological, and attitudinal factors that account for negative responses associated with menopause, recommendations for counselor interventions are proposed.
Photoreceptor for Curling Behavior in Peranema trichophorum and Evolution of Eukaryotic Rhodopsins

When it is gliding, the unicellular euglenoid Peranema trichophorum uses activation of the photoreceptor rhodopsin to control the probability of its curling behavior. From the curled state, the cell takes off in a new direction. In a similar manner, archaea such as Halobacterium use light activation of bacterio- and sensory rhodopsins to control the probability of reversal of the rotation direction of flagella. Each reversal causes the cell to change its direction. In neither case does the cell track light, as known for the rhodopsin-dependent eukaryotic phototaxis of fungi, green algae, cryptomonads, dinoflagellates, and animal larvae. Rhodopsin was identified in Peranema by its native action spectrum (peak at 2.43 eV or 510 nm) and by the shifted spectrum (peak at 3.73 eV or 332 nm) upon replacement of the native chromophore with the retinal analog n-hexenal. The in vivo physiological activity of n-hexenal incorporated to become a chromophore also demonstrates that charge redistribution of a short asymmetric chromophore is sufficient for receptor activation and that the following isomerization step is probably not required when the rest of the native chromophore is missing. This property seems universal among the Euglenozoa, Plant, and Fungus kingdom rhodopsins. The rhodopsins of animals have yet to be studied in this respect. The photoresponse appears to be mediated by Ca2+ influx.
Inability of men mutants of Escherichia coli to use trimethylamine-N-oxide as an electron acceptor

Mutants of Escherichia coli blocked in the biosynthesis of menaquinone were unable to use trimethylamine-N-oxide as an electron acceptor in complex medium containing glucose. Trimethylamine-N-oxide reduction and the consequent in-crease in growth could be restored in a menC mutant by either o-succinylbenzoic acid (OSB) or 1,4-dihydroxy-2-naphthoic acid (DHNA). In the case of a menB mutant, growth could not be restored by OSB; but addition of DHNA resulted in the restoration of growth to the full extent. These results are consistent with the metabolic blocks in the respective men mutants.
Phenomenology and Ecofeminism

Ecological feminism is an important aspect of environmentalism and is making important contributions to environmental ethics. It is also of particular interest to phenomenologist for several reasons. Ecofeminists use methods very similar to those of phenomenological analysis. Also the emphasis on contextual and pluralistic ethics calls for attention to the voices of many different types of people who had been ignored. This gives phenomenologists opportunity to look at many types of lived worlds; this can add intersubjective richness to our “returning to the matters themselves.”
Cocaine- or stress-induced metaplasticity of LTP in the dorsal and ventral hippocampus.

Despite the well documented role of the hippocampus in various modes of drug reinstatement behavior, the persisting effects of in vivo cocaine exposure on hippocampal synaptic plasticity are not sufficiently understood. In this report we investigated the effects of cocaine conditioning on long-term potentiation (LTP) in the CA1 region of hippocampus along its septotemporal axis. Male Sprague-Dawley rats experienced a behavioral protocol, in which locomotor activity was monitored in response to various conditioning treatments. LTP was measured in ex vivo slice preparations taken 1-2 weeks after the last behavioral session from the ventral (vH) and dorsal (dH) sectors of hippocampus. Unexpectedly, experiencing the minor intermittent stimuli of the behavioral protocol caused stress-induced metaplastic changes in both vH (increased LTP) and dH (decreased LTP) in the saline conditioned rats relative to behaviorally naive controls. These stress effects in the vH and dH were blocked by conditioning with either mineralocorticoid (spironolactone) or glucocorticoid (mifepristone) antagonists, respectively. Stress-induced metaplasticity in the vH was also prevented by prior administration of the kappa opioid antagonist nor-binaltorphimine. Cocaine conditioning induced locomotor sensitization and significantly increased LTP in the vH without causing significant change in LTP in the dH. Cocaine-induced metaplasticity in the vH was prevented by co-administration of the dopamine D2-like antagonist eticlopride during cocaine conditioning, but not by co-administration of the D1/5 antagonist SCH 23390. Our results suggest that the functional connectivity of hippocampus is altered by metaplastic triggers such as exposure to drugs of abuse and/or stressors, thereby shifting the efferent output of hippocampus from dH (cortical) toward vH (limbic) influenced circuits.
They Really Do Eat Insects

Carnivorous plants. The idea of plants eating animals conjures up visions of giant Venus’s flytraps making meals of humans in a Little Shop of Horrors or Triffids marauding across the English countryside. And indeed, these strange plants have inspired countless children’s books and science-fiction movies.
Clustered mutations have no effect on the overdispersed molecular clock: a response to Huai and Woodruff.

IN a recent paper, Huai and Woodruff ([1997][1]) make the mistake of equating substitution with mutation, and arrive, quite erroneously, at the conclusion that clustered mutations can have a significant effect on the pattern of molecular evolution. I will show that clustered mutations have no effect
Hydrogen wishes

Hydrogen Wishes, presented at MIT's Center for Advanced Visual Studies, explores the themes of wishes and peace. It dramatizes the intimacy and power of transforming one's breath and vocalized wishes into a floating sphere, a bubble charged with hydrogen. The floating bubble represents transitory anticipation as a wish is sent on its trajectory toward fulfillment. Light, heat sensors, microphones, projected imagery, hydrogen and ordinary soap bubbles come together in this exploration of human aspiration. As in our lives, many wishes escape, but many others are catalyzed by the heat of the candle and become ethereal. The fulfilled wishes then become living artifacts within projected photographs of Earth cities as seen from outer space.
Development of Angoumois Grain Moths in Kernels of Wheat, Sorghum, and Corn as Affected by Site of Feeding1

Larvae of the Angoumois grain moth, Sitotroga cerealella (Olivier), which entered 0.34-mm holes predrilled near germ or into endosperm of wheat, sorghum, and corn kernels, developed at different rates. Larval-pupal periods in germ-drilled kernels averaged 32.5, 30.1, and 37.2 days in wheat, sorghum, and corn, respectively and 49.4, 50.2, and 72.5 days in endosperm-drilled kernels. X-ray techniques were used to study larval development. Number of instars as determined by larval mandible counts were 4 and 5 in germ-drilled kernels and 5-9 in endosperm-drilled kernels.
Pool systems in iron metabolism; with special reference to polycythemia vera.

Previous reports(1,2) concerning the disappearance of a tracer dose of radioactive iron from the plasma implied a single plasma iron pool with no significant return of radioiron to the plasma during the experimental period of one to 2 hours. Assuming instantaneous mixing following the injection of ferric 59-beta-1 globulinate, as well as a constant relative disappearance rate, the theoretical data could be represented by a single exponential function, i.e., a straight line on semi-log paper. Such a first approximation fitted the experimental data well because of the large errors involved in electroplating(123) and the relatively insensitive counting technics employed(123).Two considerations prompted reevaluation of the above concepts. Firstly, utilizing improved counting technics it was noted that the experimental data were no longer approximated by a straight line when plotted on semilog paper. Re-examination of some of the published data in earlier reports reveals similar findings(1,4). Secondly, the ap...
New anticoagulants for stroke prophylaxis in atrial fibrillation: assessing the impact on medication adherence

Atrial fibrillation (AF), the most common sustained cardiac arrhythmia, is a potent risk factor for stroke and transient ischemic attack. Most patients with AF receive antithrombotic stroke prophylaxis, often in the form of a vitamin K antagonist, typically warfarin. Drug treatment with warfarin is associated with significant management issues, such as an unpredictable dose response necessitating dose adjustments, frequent laboratory monitoring, and multiple interactions with other medications, as well as foods. A new generation of novel anticoagulants has emerged that includes dabigatran etexilate, a direct thrombin inhibitor, and rivaroxaban and apixaban, both highly selective factor Xa inhibitors. These newer agents possess a highly predictable pharmacokinetic-pharmacodynamic relationship, allowing for fixed dosing and no necessity for routine laboratory monitoring; additionally these agents have minimal drug interactions. Dabigatran etexilate and apixaban are both twice-daily medications, whereas rivaroxaban is administered once daily for stroke prophylaxis. The impact of dosing frequency on medication adherence with these agents has not been prospectively evaluated; however, the frequency of dosing intervals has been shown to affect medication adherence, which in turn may influence patient outcomes.
The clinical characteristics and treatment of hand,foot and mouth disease complicated with brain injury

The present paper aims to investigate the prevalence trends,early clinical characteristics,and treatment experience of hand,foot and mouth disease complicated with brain injury.Cases were analyzed from both the outpatient clinic with diagnosis of hand,foot and mouth disease,and inpatient service with severe hand,foot and mouth disease,during the period of August 1,2008to July 31,2009in our hospital.Clinical manifestations,laboratory results,and treatment and outcome data from 43patients with hand,foot and mouth disease complicated with brain injury were retrospectively analyzed.The results showed that hand,foot and mouth disease occurred throughout the year.The incidence of hand,foot and mouth disease complicated with brain injury was 1.57%,which mainly occurred from May to October.The average age of patients was 2.89years old(range 5months to 13years).Clinical classification revealed that brain stem encephalitis accounted for 48.8%of the cases,encephalitis accounted for 32.6%,and meningoencephalitis accounted for 18.6%.Administration of mannitol,methyl-prednisolone,intravenous gamma globulin,and mechanical ventilation for precursors of pulmonary edema were the main treatment measures.Among the patients,98%had a good prognosis.The average hospital stay was 11.1days.Early diagnosis,effective reduction of intracranial pressure,rational use of high-dose intravenous gamma globulin,and short-term high-dose hormone are effective measures in preventing disease progression.
Effects of composite catalysts on combustion property of PET-type gas generator propellant

A better composite catalyst GP/ZC was obtained by mean of selection of catalysts and combustion property test.Theexperiments results indicate that the composite catalyst GP/ZC can not only increase the burning rate of PET-type gas generator pro-pellant to a certain extent(the maximum burning rate is up to 7.4 mm/s at 9 MPa),but also decrease the pressure exponent ofPET-type gas generator propellant significantly(the minimum pressure exponent is 0.19).
Outcomes of lead extraction without subsequent device reimplantation.

Aims Outcomes among patients who do not receive device reimplantation after cardiovascular implantable electronic device (CIED) extraction have not been well studied. The present study aims to investigate the outcomes of patients without device reimplantation after lead extraction and device removal. Methods and results We retrospectively searched for consecutive patients who underwent CIED extraction at Mayo Clinic, Rochester, MN and University of California San Diego Medical Center from 2001 through 2012. Among the patients identified, we compared characteristics of those who did and did not have device reimplantation. The Kaplan–Meier survival was analysed. Among 678 patients, 97 patients had their device extracted without reimplantation during 1-year follow-up (‘no-reimplant group’). Median age was younger in the no-reimplant group (60.7 vs. 70.6 years; P < 0.001). The reasons for no reimplantation were as follows: no longer meeting criteria for CIED (48%), inappropriate device indication at initial implantation (23%), patient preference (17%), and unresolved device complications (12%). Three major arrhythmias were reported in the no-reimplant group. Overall survival in the no-reimplant group was significantly lower than in the reimplant group (60 vs. 93%; P < 0.001). Ongoing device-related complications [hazard ratio (HR), 3.91; 95% CI, 1.74–8.81; P = 0.001], infection (HR, 3.06; 95% CI, 1.24–7.52; P = 0.02), and concurrent dialysis (HR, 2.74; 95% CI, 1.12–6.71; P = 0.03) were associated with increased mortality. Of 31 deaths in the no-reimplant group, 1 was secondary to cardiac arrhythmia. Conclusion Fourteen per cent of patients who had device extraction did not undergo reimplantation mainly because they no longer met CIED indications. The high mortality in these patients is related to device complications and comorbid conditions, whereas mortality associated with arrhythmia is rare.
Primary CNS Lymphoma

Primary central nervous system lymphoma (PCNSL) is an uncommon extranodal form of non-Hodgkin lymphoma affecting the brain, leptomeninges, eyes, or the spinal cord, in the absence of systemic involvement. The predominant risk factor for disease development is immunodeficiency. PCNSL is an acquired immune deficiency syndrome (AIDS) defining malignancy; however, the incidence in this patient population is decreasing due to advancements in antiretroviral treatment. On the other hand, among immunocompetent individuals, the incidence of PCNSL has increased over the past few decades, representing 3–4 % of all primary brain tumors (Eby et al. Cancer 62(11):2461–2465, 1988). The explanation for the growing incidence is not clear. PCNSL has a predilection for the elderly population with a median age of diagnosis of 55 years and peak incidence in the sixth and seventh decades of life (Hochberg and Miller, J Neurosurg 68(6):835–853, 1988; Fine and Mayer, Ann Intern Med 119(11):1093–1104, 1993).
Survey of thermal plasma ions in Saturn's magnetosphere utilizing a forward model

The Cassini Plasma Spectrometer instrument gathered thermal ion data at Saturn from 2004 to 2012, predominantly observing water group ions and protons. Plasma parameters, with uncertainties, for those two ion species are derived using a forward model of anisotropic convected Maxwellians moving at a shared velocity. The resulting dataset is filtered by various selection criteria to produce a survey of plasma parameters derived within 10° of the equator at radial distances of 5.5 to 30RS(1RS = SaturnOs radius). The previous 2008 work used a simpler method and had just 150 records over 5 orbits, this comprehensive survey has 9736 records over all 9 years. We present the results of this survey and compare them with a previous survey derived from numerical moments, highlighting the differences between the reported densities and temperatures from the two methods. Radial profiles of the plasma parameters in the inner and middle magnetospheres out to ≈22RS are stable year by year, but variable at distances larger than 23RS near the magnetopause. New results include: proton densities increasing in the near magnetopause region, suggestive of plasma mixing, evidence for the global electric field in Saturns' inner magnetosphere extends out to ≈15RS, no evidence for super-corotating plasma nor the middle magnetosphere ‘plasma cam’ feature is present, the thermal plasma β is found to exceed unity at equatorial distances greater than 15RS.
Using Learning Communities to Support Cantonese/Mandarin Family Child Care Providers in a Professional Development Intervention Program

High-impact educational practices can promote student involvement and learning outcomes, but are rarely tested in the community college setting—where involvement is a typical challenge to student success. For Family Child Care (FCC) providers, who tend to be older and overworked, higher-education training can be especially difficult. The present study examined the use of learning communities as a high-impact practice in Project Vista Higher Education Academy (PVHEA), a two-year professional development intervention program for Cantonese/Mandarin FCC providers at the East Los Angeles College in California. Quantitative and qualitative data during the inaugural term (January 2012-December 2013) indicated that PVHEA successfully helped FCC providers access and complete college coursework towards Child Development degrees and credentials. Course completion rate reached 100%, and the providers gradually increased course load while maintaining above-average grades. Positive changes were also observed in self-efficacy, aspirations, and professional image. The associated program challenges were discussed.
Escherichia coli O157:H7 Converts Plant-Derived Choline to Glycine Betaine for Osmoprotection during Pre- and Post-harvest Colonization of Injured Lettuce Leaves.

Plant injury is inherent to the production and processing of fruit and vegetables. The opportunistic colonization of damaged plant tissue by human enteric pathogens may contribute to the occurrence of outbreaks of foodborne illness linked to produce. E. coli O157:H7 (EcO157) responds to physicochemical stresses in cut lettuce and lettuce lysates by upregulation of several stress response pathways. We investigated the tolerance of EcO157 to osmotic stress imposed by the leakage of osmolytes from injured lettuce leaf tissue. LC-MS analysis of bacterial osmoprotectants in lettuce leaf lysates and wound washes indicated an abundant natural pool of choline, but sparse quantities of glycine betaine and proline. Glycine betaine was a more effective osmoprotectant than choline in EcO157 under osmotic stress conditions in vitro. An EcO157 mutant with a deletion of the betTIBA genes, which are required for biosynthesis of glycine betaine from imported choline, achieved population sizes two-fold lower than those of the parental strain (P<0.05) over the first hour of colonization of cut lettuce in modified atmosphere packaging (MAP). The cell concentrations of the betTIBA mutant also were 12-fold lower than those of the parental strain (P<0.01) when grown in hypertonic lettuce lysate, indicating that lettuce leaf cellular contents provide choline for osmoprotection of EcO157. To demonstrate the utilization of available choline by EcO157 for osmoadaptation in injured leaf tissue, deuterated (D-9) choline was introduced to wound sites in MAP lettuce; LC-MS analysis revealed the conversion of D9-choline to D-9 glycine betaine in the parental strain, but no significant amounts were observed in the betTIBA mutant. The EcO157 ΔbetTIBA-ΔotsBA double mutant, which is additionally deficient in de novo synthesis of the compatible solute trehalose, was significantly less fit than the parental strain after their co-inoculation onto injured lettuce leaves and MAP cut lettuce. However, its competitive fitness followed a different time-dependent trend in MAP lettuce, likely due to differences in O2 content, which modulates betTIBA expression. Our study demonstrates that damaged lettuce leaf tissue does not merely supply EcO157 with substrates for proliferation, but also provides the pathogen with choline for its survival to osmotic stress experienced at the site
Maturing out of delinquency: unpacking the effects of identity achievement and future orientation on crime desistance

The current investigation sought to determine whether identity achievement and future orientation had a bearing on desistance from crime. Participants were the 1,354 members of the Pathways to Desi...
Synthesis of Cross-Linked 2-Aminoethyl Methacrylate in P22 Viral Capsid via Atom-Transfer Radical Polymerization

Virus-like particles (VLPs) resemble viruses, but are devoid their genetic material, rendering them as noninfectious, hollow protein shells. VLPs are ideal templates to synthesize nanoparticles because they have homogeneous size and their empty cavity can provide a confined environment for selectively directed synthesis. Atom-transfer radical polymerization (ATRP) is well suited for directed synthesis of polymers inside VLPs. In addition to being rapid, monomer-promiscuous, and resulting in products with relatively low polydispersity, the simplicity of the ATRP initiator allows it to be readily modified for amending to biomolecules. This chapter describes the polymerization of 2-aminoethyl methacrylate (AEMA) via ATRP in a viral capsid derived from the bacteriophage P22.
Attention as Directed Consciousness

In Chapter 6, consciousness was defined as an epiphenomenon of the functioning consciousness system. Activation of the locus coeruleus-driven reticular activating system (RAS), of the thalamic-basal gangliar brain stem awareness system, and of the nucleus accumbens, substantia innominata, and posterior inferior parietal lobe self-awareness system produces a generalized state of alertness and awareness. However, this condition if not further directed would be without sufficient specificity or concentration to cope with critical events in the environment. To enhance the effectiveness of consciousness activity, higher organisms are endowed with a complex consciousness-directing mechanism known as the attentional apparatus. This apparatus evaluates environmental events that are deemed biologically significant, directs consciousness more specifically onto those events, ties those events directly into the activated self-concept system, and mobilizes all resources to deal most effectively with them.
Brain parenchymal metabolism of 5-iodo-2'-deoxyuridine and 5'-ester prodrugs

In an attempt to generate derivatives of 5-iodo-2′-deoxyuridine (IDU) with enhanced blood-brain barrier (BBB) permeability, a series of 5′ ester prodrugs of IDU was synthesized and their metabolism studied in rat brain homogenate and its different subcellular fractions. The rate of hydrolysis was dependent on the steric and polar nature of the ester substituent. Ester hydrolyzing activities were associated primarily with the cytosolic fraction and were due mainly to the presence of cholinesterases as confirmed by inhibition experiments performed with different esterase inhibitors. The metabolism of IDU to 5-iodouracil (5-IU) by the cytosolic fraction, in the presence and absence of specific pyrimidine nucleoside phosphorylase inhibitors, also suggests that there are two specific enzyme systems catalyzing two different metabolic processes. IDU 5′-esters competitively inhibit the metabolism of IDU and the inhibitory effect depends on the affinity of a particular ester toward the enzyme and also on the rate by which the ester itself undergoes hydrolysis. In the absence of any 5′-ester, 95% IDU was metabolized within 6 hr. However, in the presence of an eightfold molar excess of butyryl-IDU, the hydrolysis of IDU was completely inhibited over a 6-hr time period.
The Acute Phase Response in the Pathogenesis of Inflammatory Disease

Trauma and many diseases are followed or accompanied by a sequence of cellular and molecular reparative reactions known as the acute phase response. The early, or local, part of the acute phase response is initiated by release of proinflammatory cytokines at site(s) of tissue injury and cell necrosis, and is amplified by the formation of chemotactic peptides (chemokines) that cause leucocyte infiltration. The late, systemic, part of the acute phase response is characterised by a second wave of cytokine production that initiates cellular and cytokine cascades that temporarily alter metabolism in nearly all organ systems of the body. If tissue injury and cell necrosis are massive or recurrent, chronic inflammation ensues, with self-propagating tissue remodelling and fibrosis. Knowledge of the acute phase response can be applied to pharmacotherapy in various ways: (a) anticytokine strategies can be applied to diseases with either acute or chronic inflammatory components to ameliorate the disease process; (b) interpretation of standard clinical measurements, such as plasma lipid concentrations as indicators of coronary artery disease, is subject to the confounding influences of early and late acute phase reactants; and (c) acute phase reactants can be used as surrogate markers of proinflammatory cytokines in clinical monitoring of disease therapy. Treatment of diseases with a chronic inflammatory component, such as arthritis, can be expected to require different intervention strategies from those with an acute inflammatory component, such as sepsis and septic shock. However, characterisation of cells and cytokines at each stage of either acute or chronic inflammation will be necessary for adequate definition of intervention strategies.
Probable Evolutionary History of Cryptomonad Algae

It has been proposed that cryptomonad algae arose by two distinct endosymbiotic events, the first involving a photosynthetic prokaryote and a phagotrophic eukaryotic host and the second involving the resulting primitive eukaryotic alga and a different phagotrophic eukaryotic host. Cryptomonad algae are unique in retaining the nucleus of the first endosymbiont (the nucleomorph) in the space between the inner and outer plastid membrane pairs. Comparisons of small subunit rRNA sequences from the nucleomorph and nucleus show that two distinct endosymbiotic events involving phylogenetically distinct eukaryotes contributed to the formation of the cryptomonad cell. Phylogenetic reconstructions using the sequences of plastid ribosomal RNA and ribulose-1,5-bisphosphate carboxylase/ oxygenase genes are presented and the evolutionary history of the cryptomonad plastid discussed. The evolution of other photosynthetic groups, deduced from the above sequence information, is also discussed.
'This Naughty, Naughty City': Prostitution in Eau Claire from the Frontier to the Progressive Era

The history of sexuality has gained new respectability in recent years, perhaps because sexuality is now widely acknowledged as being shaped not only by nature but also by culture. With this emphasis on cultural influence, the study of prostitution and sexuality falls within the legitimate purview of social history. Windows are being opened, and light shed on a shadowy corner of American history. One such glimmer of light may be discerned by investigating the city of Eau Claire, Wisconsin in the late 19th and early 20th centuries and the prostitution that flourished there.
Neuromonitoring for Spinal Cord Stimulation Lead Placement Under General Anesthesia

Spinal cord stimulation (SCS) is a common therapeutic technique for treating medically refractory neuropathic back and other limb pain syndromes. SCS has historically been performed using a sedative anesthetic technique where the patient is awakened at various times during a surgical procedure to evaluate the location of the stimulator lead. This technique has potential complications, and thus other methods that allow the use of a general anesthetic have been developed. There are two primary methods for placing leads under general anesthesia, based on 1) compound muscle action potentials and 2) collisions between somatosensory evoked potentials. Both techniques are discussed, and the literature on SCS lead placement under general anesthesia using intraoperative neurophysiological mapping is comprehensively reviewed.
Characterization of Imatinib Resistant CML Leukemic Stem/Initiating Cells and Their Sensitivity to CBP/Catenin Antagonists.

Background and objective The development of the tyrosine kinase inhibitor Imatinib (IM) represents a milestone in CML (Chronic Myeloid Leukemia) treatment. However, it is not curative and patients develop IM resistance. IM resistance has been previously correlated with the emergence of drug-resistant LIC/LSC (Leukemia Initiating Cell/Leukemia Stem Cell) and increased nuclear catenin levels and enhanced Wnt signaling. It has been demonstrated previously that drug resistant CML LIC/LSC can be safely eliminated both in vitro and in vivo via disruption of the CBP/catenin interaction, utilizing the highly biochemically selective small molecule CBP/catenin antagonist ICG- 001. Methods Here, we utilized an in vitro IM selection of primary CML patients' samples to identify drug-resistant LIC/LSC populations. In this report, we characterized the drug-resistant CML LIC/LSC population using FACS, Smartchip qPCR and colony assays to analyze cell surface markers, transcriptomics and function. Results As opposed to previous characterization of the CML leukemic stem cell population as being either CD34+CD38- or CD34+CD38+, the in vitro selected Imatinib resistant (IM-R) CML LSC population was consistently CD34-CD38-. In Long-Term Culture Initiating Cell assay (LTC-IC, a surrogate assay for long term repopulating stem cells), our results suggest that the CBP/catenin antagonist ICG- 001 sensitizes LIC/LSC to IM treatment by forced differentiative elimination of the CML LIC/LSC population. Conclusion In vitro selected IM resistant cells are negative for both CD34 and CD38 by FACS analysis. These cells acquire CD34/CD38 expression after co-culture with stromal cells. CBP/catenin antagonist ICG-001 facilitates IM function in eliminating these cells.