cssi/SciSciGPT-SciSciNet huggingface dataset:
Impacts of maternal nutrition on uterine and placental vascularity and mRNA expression of angiogenic factors during the establishment of pregnancy in beef heifers

We hypothesized that maternal nutrient restriction starting at the time of breeding would influence placental vascular development and gene expression of angiogenic factors during the first 50 d of gestation in beef heifers. Commercial Angus crossbred heifers (n = 49) were maintained on a total mixed ration and supplemented with dried distillers grains with solubles. All heifers were subject to 5-d CO-Synch + CIDR estrous synchronization protocol, AI to a single Angus sire, and randomly assigned to dietary treatments. One half were assigned to control diet (CON) targeted to gain 0.45 kg/d and the remaining half were assigned to restricted diet (RES), which received 60% of CON. Heifers were subjected to ovariohysterectomy on d 16, 34, or 50 of gestation. Utero-placental tissues were obtained from the uterine horns ipsilateral and contralateral to the corpus luteum and separated into maternal caruncle (CAR); maternal endometrium, inter-caruncle (ICAR), and fetal membranes (FM). After collection, all tissues were snap frozen and stored at -80°C. There were no treatment × stage of gestation interactions (P >0.13) on the mRNA expression of vascular endothelial growth factor (VEGF) or endothelial nitric oxide synthase (eNOS). Heifers on CON treatment had greater (P = 0.03) expression of VEGF compared with RES heifers in NP-ICAR. On d 50 expression of eNOS was increased (P = 0.05) compared with d 16 in P-CAR. Expression of eNOS mRNA was decreased (P = 0.04) on d 16 compared with d 34 and 50 in CON heifer. Gene expression of eNOS was increased (P < 0.001) in the pregnant uterine horn compared with the NP uterine horn on d 34 and 50. Expression of eNOS was also increased (P < 0.003) on d 34 and 50 in the pregnant uterine horn compared with FM. There was a maternal nutritional plane × stage of gestation interaction (P = 0.01) on the vascular ratio (vascular volume/tissue volume) in maternal tissues. The RES heifers had a greater vascular ratio on d 16 compared with d 34 and 50; whereas, CON heifers had a greater vascular ratio on d 34 compared with d 16 and 50. In the NP uterine horn, there was also an increase (P = 0.02) in vascular volume of FM from CON heifers compared with FM from RES heifers. We conclude that maternal nutrient restriction did alter both vascularity and mRNA expression of angiogenic factor in utero-placental tissues during the establishment of pregnancy in first parity beef heifers.
Influence of Thoracic Fluid Compartments on Pulmonary Congestion in Chronic Heart Failure.

Abstract Introduction Pulmonary congestion is a common finding of heart failure (HF), but it remains unclear how pulmonary and heart blood volumes (Vp and Vh, respectively) and extravascular lung water (EVLW) change in stable HF and affect lung function. Methods Fourteen patients with HF (age 68 ± 11 y, LVEF 33 ± 8%) and 12 control subjects (age 65 ± 9 y) were recruited. A pulmonary function test, thoracic computerized tomographic (CT) scan, and contrast perfusion scan were performed. From the thoracic scan, a histogram of CT attenuation of lung tissue was generated and skew, kurtosis, and full-width half-max (FWHM) calculated as surrogates of EVLW. Blood volumes were calculated from the transit time of the contrast through the great vessels of the heart. Results Patients with HF had greater Vp and Vh (Vp 0.55 ± 0.21 L vs 0.41 ± 0.13 L; Vh 0.53 ± 0.33 L vs 0.40 ± 0.15 L) and EVLW (skew 3.2 ± 0.5 vs 3.7 ± 0.7; kurtosis 19.4 ± 6.6 vs 25.9 ± 9.4; FWHM 73 ± 13 HU vs 59 ± 9 HU). Spirometric measures were decreased in HF (percentage of predicted: forced vital capacity 86 ± 17% vs 104 ± 9%; forced expiratory volume in 1 second 83 ± 20% vs 105 ± 11%; maximal mid-expiratory flow 82 ± 42% vs 115 ± 43%). Vp was associated with decreased expiratory flows, and EVLW was associated with decreased lung volumes. Conclusions Congestion in stable patients with HF includes expanded Vp and Vh and increased EVLW associated with reductions in lung volumes and expiratory flows.
Prenatal parental designing of children and the problem of acceptance.

Seemingly ever improving medical technology and techniques portend the possibility of prenatally enhancing otherwise healthy, normal children—seamlessly enhancing or adding to a child’s natural abilities and characteristics. Though parents normally engage in enhancing children, i.e., child rearing, these technologies present radically new possibilities. This sort of enhancement, I argue, is morally problematic for the parent: the expectations of the enhancing parent necessarily conflict with attitudes of acceptance that moral parenting requires. Attitudes of acceptance necessitate that parents are open to the essentially-individual choices of the child that will determine the kind of person he or she becomes. However, the intentional act of enhancing contradicts this openness by setting expectations on who the child becomes. Because of this, there is strong moral weight against parents’ prenatally enhancing their children.
A National Study of the Use of Asymptomatic Systemic Imaging for Surveillance Following Breast Cancer Treatment (AFT-01).

Although not guideline recommended, studies suggest 50% of locoregional breast cancer patients undergo systemic imaging during follow-up, prompting its inclusion as a Choosing Wisely measure of potential overuse. Most studies rely on administrative data that cannot delineate scan intent (prompted by signs/symptoms vs. asymptomatic surveillance). This is a critical gap as intent is the only way to distinguish overuse from appropriate care. Our aim was to assess surveillance systemic imaging post-breast cancer treatment in a national sample accounting for scan intent. A stage-stratified random sample of 10 women with stage II–III breast cancer in 2006–2007 was selected from each of 1217 Commission on Cancer-accredited facilities, for a total of 10,838 patients. Registrars abstracted scan type (computed tomography [CT], non-breast magnetic resonance imaging, bone scan, positron emission tomography/CT) and intent (cancer-related vs. not, asymptomatic surveillance vs. not) from medical records for 5 years post-diagnosis. Data were merged with each patient’s corresponding National Cancer Database record, containing sociodemographic and tumor/treatment information. Of 10,838 women, 30% had one or more, and 12% had two or more, systemic surveillance scans during a 4-year follow-up period. Patients were more likely to receive surveillance imaging in the first follow-up year (lower proportions during subsequent years) and if they had estrogen receptor/progesterone receptor-negative tumors. Locoregional breast cancer patients undergo asymptomatic systemic imaging during follow-up despite guidelines recommending against it, but at lower rates than previously reported. Providers appear to use factors that confer increased recurrence risk to tailor decisions about systemic surveillance imaging, perhaps reflecting limitations of data on which current guidelines are based. ClinicalTrials.gov Identifier: NCT02171078.
Sunday Afternoon on the Porch: Reflections of a Small Town in Iowa, 1939–1942

Review of: "Sunday Afternoon on the Porch: Reflections of a Small Town in Iowa, 1939–1942," by Jim Heynen (text), and Everett W. Kuntz (photog.)
Monitoring and Forecasting Insect Outbreaks

Most forestry organizations periodically monitor their lands in order to detect incipient pest outbreaks and to determine damage levels or changes in the boundaries of ongoing infestations. These surveys may be designed to monitor large areas of forest (extensive surveys) or to examine particular infestations in considerable detail (intensive surveys). In addition to providing information on current damage levels, survey data may be used to forecast damage trends.
X-Irradiation for Promoting Recovery in Lesioned Adult Mammalian CNS

The role of the non-neuronal cells, the glial cells and, in particular, the reactive astrocytes in the failure of the severed adult CNS axons to regrow beyond the lesion site has been a topic of many studies and of much debate for almost a century (e.g., Reier et al., 1989). The current consensus is that the glia have a pivotal role in control of the fate of axonal regeneration. However, there are several points of ongoing debate; for one, the identity of the subset of the glial cell populations which plays the key role is yet to be resolved. In addition, it is not clear whether adult CNS glia inhibit or enhance axonal regeneration and whether their effects are directly exerted on the axons or mediated via a cascade of cellular interactions. In spite of the extensive research, to date, it is not known which cell types and which environment the severed axons encounter after injury and whether the physical encounter with a certain cell type plays any role in determining the fate of axonal regeneration in situ.
Rare Cause of Explosive Headache: Iatrogenic Pneumocephalus Following Epidural Blood Patch (P3.107)

Objective: To describe a case of severe headache secondary to pneumocephalus complicating an epidural blood patch (EBP). Background: Pneumocephalus is an uncommon but recognized complication of epidural block and most commonly presents with sudden onset headache that is aggravated by motion and not relieved with lying down. Pneumocephalus complicating EBP is extremely rare, with only a handful of cases reported in the literature. Design/Methods: A 31 year-old P0101 was admitted for premature rupture of membranes. She underwent epidural anesthesia without complication and had a normal spontaneous delivery 12 hours later. The following morning, she reported a bifrontal headache worse when standing and improved when lying flat. She was given oral ibuprofen and oxycodone, and continued on caffeine and intravenous fluids, with only mild relief. She underwent an EBP the following afternoon, with 20cc of autologous blood injected into the L3–4 interspace with loss of resistance using air technique. Immediately post-procedure, she reported a new headache, described as an explosive, pressure-like pain located bifrontally, temporally and retrorbitally. The pain was constant, worse with any movement, but without change in severity when standing versus lying flat. She reported no nausea, vomiting, photophobia or phonophobia, and had no back pain or radicular symptoms. Results: Neurologic exam was normal. Non-contrast head CT showed pneumocephalus in the subarachnoid space, most prominently in the bilateral frontal and left temporal spaces. She received ibuprofen and oxycodone, and was given three treatments of high flow oxygen via non-rebreather mask, with gradual improvement in symptoms. Conclusions: Pneumocephalus complicating EBP is rare, but should be considered when assessing a patient with sudden, severe headache following the procedure. The timing of onset, and postural characteristics of the headache, are useful in distinguishing pneumocephalus from post-dural puncture headache. In patients with new, explosive headache immediately post-procedure, a non-contrast head CT may be indicated to evaluate for pneumocephalus. Study Supported by: NA Disclosure: Dr. Thaler has nothing to disclose. Dr. Pace has nothing to disclose.
Black visuality and the practice of refusal

What constitutes a practice of refusal? This article engages the practice of refusal collaboratively articulated by the Practicing Refusal Collective, a group founded three years ago by myself and ...
Finding the 'QR' to Patient Safety: Applying Gamification to Incorporate Patient Safety Priorities Through a Simulated 'Escape Room' Experience.

Medical errors are the eighth leading cause of mortality in the United States and contribute to over one million preventable injuries. In an effort to prevent medical errors, reporting systems serve as invaluable tools to detect patient safety events and quality problems longitudinally. Historically, trainees (i.e., students and residents) rarely submit incident reports for encountered patient safety threats. The authors propose an immersive learning experience utilizing gamification theory and leveraging the increasingly popular ‘escape room’ to help resident trainees identify reportable patient safety priorities. All 130 incoming intern physicians at the Thomas Jefferson University (Jefferson) were enrolled in the Patient Safety Escape Room study as part of their residency orientation (June 2018). The residents were randomly divided into 16 teams. Each team was immersed in a simulated escape room, tasked with identifying a predetermined set of serious patient safety hazards, and successfully manually entering them into the Jefferson Event Reporting System within the time allotted to successfully ‘win the game’ by ‘escaping the room’. Quick response (QR) codes were planted throughout the activity to provide in-game instructions; clues to solve the puzzle; and key information about patient safety priorities at Jefferson. All participants underwent a formal debriefing using the feedback capture grid method and completed a voluntary post-study survey, adapted from Brookfield’s Critical Incident Questionnaire (CIQ). The study was IRB exempt. Thematic analysis of the post-activity CIQ survey (n = 102) revealed that interns were engaged during the immersive learning experience (n = 42) and were specifically engaged by having to independently identify patient safety threats (n = 30). Participants identified team role assignment (n = 52) and effective communication (n = 26) as the two most helpful actions needed to successfully complete the activity. Participants were overall surprised by the success of the education innovation (n = 45) and reported that it changed how they viewed patient safety threats. Areas for improvement include clearer game instructions and using a more streamlined event reporting process. The escape room patient-safety activity allowed interns to actively engage in an innovative orientation activity that highlighted the importance of patient safety hazards, as well as providing them with the opportunity to document event reports in real-time. Next steps will include longitudinally tracking the quantity of error reports entered by this cohort to determine the effectiveness of this educational intervention.
Symptom Care at Home: A Comprehensive and Pragmatic PRO System Approach to Improve Cancer Symptom Care

Introduction:There is growing recognition that systematically obtaining the patient’s perspective on their health experience, using patient-reported outcomes (PRO), can be used to improve patient care in real time. Few PRO systems are designed to monitor and provide symptom management support betwee
36 – COMPARATIVE ECONOMIC SYSTEMS

Publisher Summary This chapter discusses comparative economic systems and, in particular, Russia's economic planning shift. With the slowdown of investment volume and capital stock, the rate of increase of output in Russia had fallen down. The growth target in the new plan continues the previous downward trend. In terms of gross national product (GNP), the target would probably be somewhat lower than the Soviet data indicate. As between investment volume and the capital stock, it is the increase of the latter that is more immediately relevant to output growth. By allowing investment volume and the capital stock to decelerate, however, the leadership has avoided devoting even more of the GNP to that purpose. For the coming five years, the plan projects an estimated yearly increase of factor, that is, labor and capital, productivity of little more than 1%. The planned increase in national income, while representing a decline from earlier tempos, must arouse some envy in western countries still emerging from their sharpest post-World War II recession. Under the new plan, then, the Russians could hope to make little further progress in attaining their historic goal of overtaking and surpassing the United States economically. According to the plan, the volume of Soviet foreign trade was to increase by 30%–35%. The new program also helps one understand the persistent Soviet interest, despite rebuffs, in economic detente with the United States.
Modeling and Simulation of a Robotic Bridge Inspection System

Abstract Inspection and preservation of the aging bridges to extend their service life has been recognized as one of the important tasks of the State Departments of Transportation. Yet manual inspection procedure is not efficient to determine the safety status of the bridges in order to facilitate the implementation of appropriate maintenance. In this paper, a complex model involving a remotely controlled robotic platform is proposed to inspect the safety status of the bridges which will eliminate labor-intensive inspection. Mobile cameras from unmanned airborne vehicles (UAV) are used to collect bridge inspection data in order to record the periodic changes of bridge components. All the UAVs are controlled via a control station and continuously feed image data to a deep learning-based detection algorithm to analyze the data to detect critical structural components. A cellular automata-based pattern recognition algorithm is used to find the pattern of structural damage. A simulation model is developed to validate the proposed method by knowing the frequency and time required for each task involved in bridge inspection and maintenance. The effectiveness of the model is demonstrated by simulating the bridge inspection and maintenance with the proposed model for five years in AnyLogic. The simulated result shows around 80% of man-hour can be saved with the proposed approach.
Shut up and dribble? How popularity, activism, and real-world events shape attitudes towards LeBron James and race

With great regularity, celebrities add their voices to the political debates that shape our future. One celebrity who has added his voice to the conversation about the status of African Americans i...
MRI activity in MS and completed pregnancy: Data from a tertiary academic center

Objective To evaluate postpartum MRI activity in patients with MS and a completed pregnancy and to compare these results to an age-matched untreated nonpregnant MS cohort. Methods Patient with MS from a tertiary care MS center between 2006 and 2015, with prepartum and postpartum neurologic follow-ups and MRI scans were analyzed. Clinical activity and inflammatory brain MRI activity (new T2-hyperintense or gadolinium-enhancing [Gd+] lesions) were assessed peripartum. The results were compared with untreated reproductive-age patients with MS from the placebo arm of the clinical trials. Results A total of 123 pregnancies in 123 women (median Expanded Disability Status Scale 1.0) were analyzed. Approximately 7.2% relapsed during pregnancy and 48.7% relapsed postpartum. Of pregnancies with prepartum and postpartum gadolinium (Gd)-enhanced MRI (n = 112), 8% had Gd+ lesions prepartum and 33% had new Gd+ lesions postpartum. Overall, 54.4% had either new T2 or Gd+ lesions postpartum. Seventy-nine percent of subjects with postpartum relapse had new MRI activity compared with 37.1% without relapse (p 0.5). MRI and clinical outcomes were also assessed for 126 nonpregnant untreated female patients with MS. Comparing pregnancy and no pregnancy groups, there was no difference in MRI activity at follow-up. Conclusions There was a high level of inflammatory radiographic disease activity which was related to relapses in postpartum patients with MS. Further studies are needed to determine whether hormonal fluctuations vs extended time off DMTs may be the underlying cause of our observations.
Assessing the Validity of Echocardiographic Criteria for Left Ventricular Diastolic Dysfunction in Patients with Pulmonary Hypertension.

BACKGROUND In patients with pulmonary hypertension (PHT), the assessment of left ventricular (LV) diastolic function by echocardiography may not be reliable. PHT can affect Doppler parameters of LV diastolic function such as mitral inflow velocities and mitral annular velocities. The current guidelines for the assessment of LV diastolic function do not recommend specific adjustments for patients with PHT. METHODS We analyzed 36 patients from the PHT clinic that had an echocardiogram and right heart catheterization performed within 6 months of each other. Early mitral inflow velocity (E), lateral mitral annular velocity (lateral e'), septal mitral annular velocity (septal e'), tricuspid free wall annular velocity (RV e') were measured and compared to the invasively measured intracardiac pressures including pulmonary capillary wedge pressure (PCWP), mean pulmonary artery pressure, and right ventricular end-diastolic pressure. RESULTS Among patients with PHT, the specificity of the septal e' for LV diastolic dysfunction was 0.19, and the positive predictive value was 0.13 (lower than the lateral e' or E/average e'). By receiver-operating characteristic curve analysis, the area under the curve (AUC) of lateral and septal e' was just 0.64 (p = 0.9) and 0.53 (p = 0.6), respectively, while the AUC of average E/e' was 0.94 (p < 0.001). The septal e' was paradoxically lower at 6.5 ± 1.9 cm/s for normal PCWP compared to 6.9 ± 1.7 cm/s for elevated PCWP (p = 0.04). 81 versus 40% (p = 0.017) of patients with normal versus elevated PCWP had an abnormal septal e' <7 cm/s. By linear regression, there was no correlation between the Doppler parameters of LV diastolic function and the PCWP. CONCLUSION Our study suggests E/average e' may be the only reliable tissue Doppler parameter of LV diastolic dysfunction in patients with PHT, and that septal e' is paradoxically decreased in patients with PHT and normal left-sided filling pressures.
Confrontation in the Age of Plea Bargaining

A defendant’s right to confront the witnesses against him is a cornerstone of our adversarial system of criminal justice. Or is it? Under current law, defendants can invoke their confrontation right only by going to trial. But trials account for about five percent of criminal convictions. That means that the overwhelming majority of defendants convicted in the United States never get to exercise their constitutional right to confront the government’s witnesses. This Essay argues that the Supreme Court should align its Confrontation Clause jurisprudence with the reality of contemporary criminal justice. The Sixth Amendment grants a criminal defendant the right “to be confronted with the witnesses against him.” The problem is that the Court reads this text as if it said “the witnesses against him at trial.” Nothing compels the Court’s trial-centric gloss on what it means to be a witness. To the contrary, the Confrontation Clause’s text and purposes point towards recognizing that those whose “testimony” the government relies on in plea bargaining are “witnesses” too. This Essay therefore proposes a procedural device through which defendants could exercise their right to confront (i.e., cross-examine) that class of witnesses—the “Sixth Amendment deposition.” By conducting Sixth Amendment depositions, defendants would learn the strengths and weaknesses of the government’s evidence, enabling them to negotiate fairer and more reliable plea bargains. Sixth Amendment depositions would deliver to our “system of pleas” what confrontation at trial brought to an earlier version of American criminal justice—adjudication enhanced by adversarial testing of the government’s case.
Dynamics and peer effects of brand revenue in college sports

Abstract Team branding plays a key role in attracting corporate sponsorship for the multi-billion dollar business of college sports. In this paper, we study peer effects in the dynamic brand revenue evolution of major college sports teams that play in the same National Collegiate Athletic Association conferences. To examine the peer effects in each conference, we propose a new dynamic model that can identify conference-specific peer effects while capturing the dynamic evolution of brand revenue. Our model estimation results reveal significant positive peer effects in the six conferences — ACC, Big 12, Big East, Big Ten, SEC, and Pac-12 — where the brand revenue of teams benefit from other teams in the same conference. Our modeling approach also sheds light on the effect of a conference switch on a team's brand revenue by showing the difference between predicted brand revenue with a switch and the predicted brand revenue without a switch.
Exertional hypoxia in patients without resting hypoxia is an early predictor of moderate to severe COVID-19.

The importance of exertional hypoxia without resting hypoxia in COVID-19 is unknown and may help objectively identify high-risk patients. Interventions may be initiated earlier with sufficient lead-time between development of exertional hypoxia and other outcome measures. We performed a retrospective study of adult patients hospitalized with COVID-19 from March 1, 2020 to October 30, 2020 in an integrated academic medical system in the Chicagoland area. We analyzed patients who had daily exertional oximetry measurements taken. We defined exertional hypoxia as SpO2 < 90% with ambulation. We excluded patients who had first exertional oximetry measurements or first exertional hypoxia after the use of oxygen therapies. We determined the association of exertional hypoxia without resting hypoxia with the eventual need for nasal cannula or advanced oxygen therapies (defined as high flow nasal cannula, Bi-PAP, ventilator, or extracorporeal membrane oxygenation). We also calculated the time between development of exertional hypoxia and the need for oxygen therapies. Of 531 patients included, 132 (24.9%) had exertional hypoxia. Presence of exertional hypoxia was strongly associated with eventual use of nasal cannula (OR 4.8, 95% CI 2.8–8.4) and advanced oxygen therapy (IRR 7.7, 95% CI 3.4–17.5). Exertional hypoxia preceded nasal cannula use by a median 12.5 h [IQR 3.25, 29.25] and advanced oxygenation by 54 h [IQR 25, 82]. Exertional hypoxia without resting hypoxia may serve as an early, non-invasive physiologic marker for the likelihood of developing moderate to severe COVID-19. It may help clinicians triage patients and initiate earlier interventions.
Robotic mitral valve repair following failed transcatheter edge-to-edge repair

Abstract Mitral valve repair is infrequently performed in patients undergoing corrective surgery for failed mitral transcatheter edge-to-edge repair (TEER) in current US practice. This article describes surgical techniques for reconstructive surgery following failed TEER. A total of nine patients underwent robotic-assisted mitral surgery following failed TEER between 2010 and 2020 at a single center. Repair was completed in 88.9% (n=8) patients and freedom from >2+ mitral regurgitation was 87.5% (n=7) at a median follow up of 1.9 years.
Salt-Sensitive Hypertension, Renal Injury, and Renal Vasodysfunction Associated With Dahl Salt-Sensitive Rats Are Abolished in Consomic SS.BN1 Rats.

Background Abnormal renal hemodynamic responses to salt‐loading are thought to contribute to salt‐sensitive (SS) hypertension. However, this is based largely on studies in anesthetized animals, and...
Sources of Correlation of Expert Opinion — A Pilot Study

Expert estimates are relied upon as sources of data whenever experimental data is lacking such as in risk analyses and reliability assessments. Correlation between experts is a problem in the elicitation and use of subjective estimates. This pilot study seeks to identify the sources and structure of interexpert correlation and to discuss some of its ramifications. Until now, there has been no data that identify sources of correlation. Data were gathered using questioning techniques from ethnography and educational psychology. The results of this pilot study indicate that the key to correlation is in the way that people solve problems.
Ataxia Without Headache: Atypical Presentation of Spontaneous Intracranial Hypotension. (P2.107)

OBJECTIVE: Intracranial hypotension generally presents as a postural headache which is usually caused by an index event of trauma. In our case, our patient presented with cerebellar ataxia without headache secondary to spontaneous cerebrospinal fluid (CSF) leak. Rapid improvement with blood patch was key to diagnosis. BACKGROUND: 53 year old man with history of partial epilepsy presented with 2 week history of nausea, vomiting and falls. Initial examination revealed, mild bilateral horizontal nystagmus, mild upper and lower extremity ataxia and unsteady gait. Initial head CT and MRI were unremarkable. Lumbar puncture was attempted and required multiple attempts and was significant for 6408 RBC’s and xanthochromia. No opening pressure was able to be obtained presumably from a low-flow state. A few days after admission, the patient began to have multiple falls. Neurological examination was remarkable for bilateral fast beating nystagmus and wildly ataxia in all limbs. Repeat MRI with gadolinium revealed crowding of the posterior fossa, engorgement of venous vessels, and diffuse dural thickening and enhancement along the convexities and the tentorium. Repeat lumbar puncture was initially unsuccessful and required aspiration under fluoroscopy. CSF was notable for >10,000 RBC’s and xanthochromia. RESULTS: After epidural blood patch, patient’s symptoms of ataxia improved rapidly over a few days. MRI two months later showed radiographic resolution of intracranial hypotension. CONCLUSIONS: We believe that our case is notable since patient likely had a spontaneously CSF leak from the initial fall which presented atypically with ataxia without headache. Given the worsening of ataxia with repeated lumbar punctures and radiographic evidence of intracranial hypotension, the decision to perform an empiric epidural blood patch which resulted in rapid resolution of his symptoms. Study Supported by: Penn State Hershey Medical Center Disclosure: Dr. Nguyen has nothing to disclose. Dr. Raheja has nothing to disclose. Dr. Lowden has nothing to disclose.
Some One-Dimensional Dynamical Problems

We now consider some dynamical problems involving especially simple geometries: torsional oscillations of a rod, and propagation of plane waves in a semi-infinite medium. We have several purposes in mind. First, these problems illustrate some important similarities between the behavior of viscoelastic materials and the behaviors of materials that are purely viscous or purely elastic, and they also illustrate some important distinctions. Second, we wish to illustrate that viscoelasticity problems can be analyzed to significant depth even if the basic response functions are given only graphically or numerically, in the form of data. Third, the mathematical techniques used in these problems are of interest in themselves because they find applications in many areas.
An Optimal Algorithm for Proper Learning of Unions of Two Rectangles with Queries

We study the problem of proper learning of unions of two discretized axis-parallel rectangles over the domain {0,n−1}d in the on-line model with equivalence and membership queries. An obvious approach to this problem would use two equivalence queries to find one example in each of the two rectangles contained in the target concept and then use membership queries to find end points of the rectangles. However, there is one substantial difficulty: For any two end points, how to decide whether they belong to the same rectangle? In this paper, we develop some strategies to overcome the above difficulties and construct an algorithm that properly learns unions of two rectangles over the domain {0,n−1}d with at most two equivalence queries and at most (11d+2) log n+d+3 membership queries. We also show that this algorithm is optimal in terms of query complexity
Family social support in crises: the special case of divorce.

Using data from a survey of divorced and separated men and women, this study suggests that family help is less likely to be provided when the families are themselves experiencing life change events or disapprove of the divorce decision. Family help does tend to be forthcoming, however, when respondents are simultaneously undergoing other life stressors in addition to the divorce experience.
Vitamin K-dependent carboxylation.

Abstract Vitamin K‐dependent (VKD) protein carboxylation uses vitamin K epoxidation to convert Glus to carboxylated Glus (Glas), rendering VKD proteins active in physiologies that include hemostasis, apoptosis, bone mineralization, calcium homeostasis, growth control, and signal transduction. Clusters of Glus are modified by a processive carboxylase, generating a calcium‐binding module that allows binding to either hydroxyapatite in the extracellular matrices or cell surfaces where anionic phospholipids become exposed, for example, during apoptosis or cell activation. Naturally occurring carboxylase mutations have been informative for function and are associated with bleeding complications and, surprisingly, a pseudoxanthoma elasticum (PXE)‐like phenotype. A major advance in defining carboxylase function is the identification of the base that initiates carboxylation, which raises interesting possibilities for how vitamin K epoxidation is regulated by Glu substrate and carboxylase membrane topology. Vitamin K oxidoreductase (VKOR), the target of warfarin, generates the reduced vitamin K cofactor used by the carboxylase. Oxidation of active site thiols during vitamin K reduction inactivates VKOR, and activity is regenerated by an unknown reductase. The amounts of reduced vitamin K limit the capacity for carboxylation in cells, and overexpression of VKOR, but not carboxylase, improves carboxylation. However, the effect of VKOR overexpression is small, possibly because the reductase that regenerates VKOR activity is saturated. The review discusses these advances, as well as the potential impact of secretory components on carboxylation, which occurs during VKD protein secretion. Also discussed is the role of the carboxylase in mammals and lower organisms, including the bacterial pathogen Leptospira interrogans that has acquired a VKD carboxylase by horizontal transfer.
Deoxyribonucleic acid replication in meiosis of Chlamydomonas reinhardi. I. Isotopic transfer experiments with a strain producing eight zoospores.

Abstract DNA replication in meiosis of Chlamydomonas reinhardi has been studied by 15N density-labeling experiments coupled with cytological observations. It has been shown that (1) during zygotic maturation, there is neither chromosomal DNA replication nor meiotic division; (2) during zygospore germination, meiosis occurs, and the first meiotic division is preceded by a single chromosomal DNA replication; (3) the replication of chromosomal DNA associated with meiosis is semiconservative; (4) only hybrid chromosomal DNA molecules are detected at the end of zygote germination, when eight zoospores emerge from each zygote, indicating that only one DNA replication occurs in the entire period between the mating of gametes and the germination of zygotes; (5) a DNA component (M-band DNA) replicates extensively and appears in large quantity during zygote maturation.
Untangling the Web: The Diverse Functions of the PIWI/piRNA Pathway

Small RNAs impact several cellular processes through gene regulation. Argonaute proteins bind small RNAs to form effector complexes that control transcriptional and post-transcriptional gene expression. PIWI proteins belong to the Argonaute protein family, and bind PIWI-interacting RNAs (piRNAs). They are highly abundant in the germline, but are also expressed in some somatic tissues. The PIWI/piRNA pathway has a role in transposon repression in Drosophila, which occurs both by epigenetic regulation and post-transcriptional degradation of transposon mRNAs. These functions are conserved, but clear differences in the extent and mechanism of transposon repression exist between species. Mutations in piwi genes lead to the upregulation of transposon mRNAs. It is hypothesized that this increased transposon mobilization leads to genomic instability and thus sterility, although no causal link has been established between transposon upregulation and genome instability. An alternative scenario could be that piwi mutations directly affect genomic instability, and thus lead to increased transposon expression. We propose that the PIWI/piRNA pathway controls genome stability in several ways: suppression of transposons, direct regulation of chromatin architecture and regulation of genes that control important biological processes related to genome stability. The PIWI/piRNA pathway also regulates at least some, if not many, protein-coding genes, which further lends support to the idea that piwi genes may have broader functions beyond transposon repression. An intriguing possibility is that the PIWI/piRNA pathway is using transposon sequences to coordinate the expression of large groups of genes to regulate cellular function.
If I Could Turn Back Time: Re-Lawyering the 'War on Terror'

[Note: An updated version of this paper is posted separately under the title “Playing by the Rules: Combating al Qaeda Within the Law of War.” This version will remain online as a courtesy to those referred here by citations in other works.] Although the so-called "War on Terror" is in its seventh year, key legal issues such as the precise identification of the adversary, permissible geographic scope of the conflict, and proper classification and treatment of detainees remain largely unresolved. Military victory is no longer possible, but good faith application of authority from the law of war can complement criminal law in combating the threat while meriting international public support through restoration of the rule of law. Even if the Geneva Conventions do not apply to this conflict as treaty law, customary international law, including many Geneva rules, would, providing potential solutions to some of the difficulties in countering the terrorist threat. If the conflict is validly limited to the scope authorized by Congress, the military (but not the CIA) can legally target members of al Qaeda and hold them preventively without any requirement for criminal trials. But detention conditions must meet international standards which are currently being violated. Good faith adherence to law of war rules also better protects civil liberties than proposed solutions such as national security courts offering less due process than regular federal trials. Such measures start down a slippery slope of compromising legal standards on the basis of expediency. Following the law of war can facilitate the Obama Administration achieving its stated goal of closing Guantanamo without compromising national security.
Spectral estimation via selective harmonic amplification: a canonical decomposition for state-covariances

The value of the state-covariance constitutes a generalized interpolation constraint on the spectrum of the input signal. We explore this basic fact by considering singular spectra which are consistent with state-covariance estimates. Accordingly, we present a canonical decomposition for state-covariances. The special case where the covariance matrices are Toeplitz reduces to the well-known Caratheodory-Fejer-Pisarenko (CFP) theorem which underlies modern subspace-based signal estimation techniques. As an application of the theory, we present two alternative methods for identifying spectral lines in a time-series (generalizations of MUSIC and ESPRIT respectively), we identify spectral envelopes consistent with covariance data (suitable generalizations of the Capon method of maximum likelihood), and we construct a canonical spectrum which is dual to the CFP decomposition and generates spectra made up of absorption lines instead (i.e., notches). Our method relies on selecting a suitably designed input-to-state filter to enhance resolution over any preselected harmonic interval by amplifying the contribution of components in such an interval on the state covariance.
Device applications of beam crystallized silicon-on-insulators

The properties of CW beam recrystallized thin polysilicon films on insulating substrates will be presented. MOSFET devices and simple ICs processed on this material have electrical characteristics similar to devices fabricated on single crystal material, offering significant promise for future applications.
Protein folding pathways of adenylate kinase from E. coli: hydrostatic pressure and stopped-flow studies.

Adenylate kinase (AKe) from E. coli is a small, single-chain, monomeric enzyme with no tryptophan and a single cysteine residue. We have constructed six single-Trp mutants of AKe to facilitate optical studies of these proteins and to specifically examine the interrelationship between their structure, function, dynamics, and folding reactions. In this study, the effects of hydrostatic pressure on the folding reactions of AKe were studied. The native structure of AKe was transformed to a non-native, yet pressure stable, conformation by hydrostatic pressure of about 300 MPa. This pressure lability of AKe is rather low for a monomeric protein and presumably may be attributed to substantial conformational flexibility and a correspondingly large volume change. The refolding of AKe after pressure-induced denaturation was reversible under ambient conditions. At low temperature (near 0 °C), the refolding process of pressure- exposed AKe mutants displayed a significant hysteresis. The observation of a slow refolding rate in the 193 region and a faster folding rate around the active site (86, 41, 73 regions) leads us to suggest that in the folding process, priority is afforded to functional regions. The slow structural return of the 193 region apparently does not hinder the more rapid return of enzymatic activity of AKe. Circular dichroism studies on the pressure-denatured Y193W mutant show that the secondary structure (calculated from far-UV spectra) returned at a rapid rate, but the tertiary structure alignment (calculated from near-UV spectra) around the 193 region occurred more slowly at rates comparable to those detected by fluorescence intensity. Denaturation of AKe mutants by guanidine hydrochloride and subsequent refolding experiments were also consistent with a much slower refolding process around the 193 region than near the active site. Fast refolding kinetic traces were observed in F86W, S41W, and A73W mutants using a fluorescence detection stopped-flow rapid mixing device, while only a slow kinetic trace was observed for Y193W. The results suggest that the differences in regional folding rates of AKe are not derived from the specific denaturation methods, but rather are inherent in the structural organization of the protein.
Quality measurement and improvement in rheumatology: rheumatoid arthritis as a case study.

In recent years, we have seen significant efforts to understand health care quality in the United States, including rheumatic diseases. Health care reform, as demonstrated through the Affordable Care Act (ACA) and Health Information Technology for Economic and Clinical Health (HITECH) Act, has further accelerated this rapidly evolving field. (1) The formidable tasks of improving quality, enhancing equity, and ensuring value in U.S. health care, remain largely unsolved. Rheumatologists are affected by programs aimed at driving quality improvement, including performance measurement, public reporting, and tiered payment systems. Many of these programs have focused on rheumatoid arthritis (RA), a condition with rising prevalence and increasing health care costs. In this paper, we review the literature regarding quality measurement and improvement in RA with four aims: 1) to define quality in RA, 2) to delineate the history of RA quality indicator/ measure development, 3) to outline lessons learned from prior RA quality measurement experiences, and 4) to frame the future of RA quality initiatives. In reviewing this literature, we strive to highlight both the achievements and failures in developing and implementing quality measures for RA.
Numerical Simulation of Laser Glazing and Laser Deposition Processes Using Coupled Temperature-Displacement FEM Models

Predicting the changes in the temperature, displacement and stress fields during Laser Powder Deposition (LPD) is of particular importance. To create a FEM model of LPD, it is convenient to consider first Laser Glazing (LG) since it does not involve the addition of material. Once an adequate approach has been identified to model the thermal aspects associated with the effect of the laser, the complexity of adding material can be included. In this paper coupled temperature-displacement FEM models of LG and LPD developed using the commercial FEM code ABAQUS/Standard are presented. In the case of LG, a model based on the sequentially coupled thermo-mechanical theory was used to predict the temperature distribution, deformations and stresses in a rectangular plate on which the laser moved along a straight path. The results for the temperature distribution were validated using Rosenthal’s solution and experiments performed using the same material and processing parameters. For LPD, the model was developed using fully coupled thermo-mechanical theory and it was limited to thin-wall builds deposited on a plate with dimensions comparable to the wall thickness. To add material, new elements were sequentially introduced in the mesh. Qualitatively, the results obtained with the model were promising.Copyright © 2009 by ASME
Qualitatively invertible matrices

Abstract Our purpose is to describe the properties of the class of n × n matrices such that some or all of the signs of the nonzero elements of the inverse matrix can be determined based only upon the knowledge of the signs of the matrix being inverted. Applications of such matrices can be found in the study of the testibility of economic theory, the stability of economic systems and the general ‘quality’ of solutions to large computer models.
Low-resistance Pd/Ir/Au ohmic contacts on p-GaAsSb

Ohmic contacts based on Pd/Ir/Au metallisations have been formed on highly doped (5×1019 cm−3) p-type GaAsSb. Typical hole mobility in the MOCVD-grown p-GaAsSb was measured to be 50 cm2/Vs. Electrical characteristics of ohmic contacts were measured utilising the transfer length method. The ohmic contact exhibited specific contact resistivity less than 10−8 Ω-cm2 and transfer length less than 100 nm. X-ray photoelectron spectroscopy study was also utilised to investigate the interactions between the multilayer metallisations and the ternary GaAsSb compound semiconductor.
“We Are with Family”: Black Lesbian Couples Negotiate Rituals with Extended Families

This qualitative work explores Black lesbian couples’ experiences with rituals and how the negotiation of these events is predetermined by rules and foundational expectations of families of origin and extended families. Symbolic interaction and Black feminist theories guided the theoretical understanding of the study, while grounded theory methodology was utilized for the data analysis. Eleven couples (22 individuals) from the Southeastern and Midwestern regions of the United States participated in this research. Participants discussed attending and/or creating three distinct types of rituals: (1) family of origin and extended family rituals (e.g., holiday gatherings or family reunions), (2) couples’ daily or common rituals (e.g., housewarming parties or family dinners), and (3) couples’ wedding or commitment ceremonies. While feeling a sense of belonging in extended family rituals, based on racial identity and connection to family, participants also concurrently de-sexualized their current relationship w...