cssi/SciSciGPT-SciSciNet huggingface dataset:
In-hospital Neonatal Falls: An Unintended Consequence of Efforts to Improve Breastfeeding

In-hospital neonatal falls are increasingly recognized as a postpartum safety risk, with maternal fatigue contributing to these events. Recommendations to support rooming-in may increase success with breastfeeding; however, this practice may also be associated with maternal fatigue. We report a cluster of in-hospital neonatal falls associated with a hospital program to improve breastfeeding, which included rooming-in practices. Metrics related to breastfeeding were prospectively collected by chart audit or patient survey while ongoing efforts to improve breastfeeding occurred (September 2015-August 2017). Falls were identified through the hospital adverse event reporting system from January 2011 to February 2018. Medical records were reviewed to determine factors associated with the falls, including time of event, pain medication administration, hours of life at fall, method of delivery, or other notable factors that may have contributed to the fall event. Three fall events occurred within 1 year of commencing improvement efforts as process and outcome metrics associated with breastfeeding improved. All events were associated with mothers falling asleep while feeding their infant, and all occurred between midnight and 6 am Falls occurred from 38.0 to 75.7 hours after birth. No sedating pain medications were administered within 4 hours of any event. In 2 of 3 cases, mothers experienced notable ongoing social stressors. Rooming-in was the most significant change involved in our health care delivery during the programmatic effort to improve breastfeeding. Monitoring for in-hospital neonatal falls may be needed during projects aimed at improving breastfeeding, particularly if rooming-in practices are involved.
A case of broken bones and systems: The threat of irresponsible testimony

A 2-month-old healthy baby presented to the emergency room with an arm that was not moving and was found to have multiple and extensive fractures of her long bones. An extensive medical work-up was done, and the hospital's multidisciplinary child abuse team was consulted, including child protection, genetics, radiology, and general pediatrics. It was determined that the history, clinical findings, radiographic findings, and laboratory findings were consistent with child abuse. Child protection services removed the child from the home, and for the next 10 months, the infant was well, and did not sustain a single new fracture. At a civil proceeding to determine the infant's custody, an expert witness for the defense concluded that the child had hypermobile Ehlers-Danlos syndrome and low vitamin D. He stated that because of these conditions, the baby was vulnerable to fractures with routine handling. This is a personal story of a clinical geneticist who explored fracture fact versus fracture fiction and learned about the difference between responsible and irresponsible testimony. This story gives insight into how physicians can prepare to transition from the clinic to the courtroom. It is also a story about how medical experts must and should remain unbiased, evidence-based, and committed to accuracy and truth.
Empty Discarded Pack Data and the Prevalence of Illicit Trade in Cigarettes in California

Illicit trade in tobacco products (ITTP) creates many harms including reduced tax revenues; damages to the economic interests of legitimate actors; funding for organized-crime and terrorist groups; negative effects of participation in illicit markets, such as violence and incarceration; and reduced effectiveness of smoking-reduction policies, leading to increased damage to health. To study the prevalence of tax avoidance and ITTP, we analyze a large, novel set of data from empty discarded pack (EDP) studies. In EDP studies, teams of researchers collect all cigarette packs discarded in publicly accessible spaces of selected neighborhoods. Packs are examined for the absence of local tax stamps, signs of non-authentic packaging or stamps, and other indications of potential tax evasion or counterfeit product. We describe the data and analyze the prevalence of ITTP in three California metropolitan areas. Data from 2011 to 2015 are available, yielding 32,000 observations. Each observation includes dozens of variables covering the brand, location to the ZIP code level, tax status, counterfeit status, and other information about the pack. There is modest evidence of tax avoidance (up to 19.8% of packs in San Diego) and illicit trade (no more than 10% in Los Angeles, 17% in San Francisco, or 20% in San Diego under the broadest assumptions), which includes bootlegging, counterfeits, cigarettes produced for illicit-market sales, and cigarettes without any tax stamps. California increased its excise tax on cigarettes by $2 per pack (to $2.87) on April 1, 2017; these data will inform future studies of the effect of this increase on ITTP. In our econometric investigation, we explore the determinants of ITTP. Prices in other states matter a lot: A dollar increase per hour of driving time in the price differential with other states is associated with a 36 to 49 percentage point higher probability that tax was not paid for a pack. Tax avoidance also rises with the proximity of licensed cigarette retailers (at least where they are most common). Other parts of the variation in ITTP are due to the differing demographic makeup of the areas. Income, at least in some ranges, was found to have a negative impact on tax avoidance. The fraction of the population that is Black has a negative effect on tax avoidance, compared to the omitted race/ethnicity category of Whites. The median age of the area has an inverted U-shaped impact on avoidance.
Diabetes Management in the United States

In the United States, diabetes affects approximately 10% of the population, and in 2017, this equated to an estimated 30.3 million Americans with diabetes. Type 2 or insulin-independent diabetes accounts for the majority (~90–95%) of cases in the United States. Furthermore, approximately one-third of US adults have prediabetes, an identifiable precursor phase in which blood glucose levels are above normal but not yet in the diagnostic range for diabetes, and one’s risk of developing type 2 diabetes increases five to twelvefold.
Defining and Predicting Opioid and Cocaine Treatment Response.

AbstractBackground: Treatment with methadone is effective in reducing heroin use, HIV risk, and death; however, not all patients respond to treatment. Better outcomes may emerge with personalized t...
Rapid determination of aminoglycosides in pharmaceutical preparations by electrospray ionization mass spectrometry

Aminoglycosides are broad-spectrum antibiotics often employed to combat Gram-negative bacterial infections. A technique based on electrospray-ionization mass spectrometry (ESI-MS) was developed for rapid determination of aminoglycosides. This method, which does not require prior chromatographic separation, or derivatization and extensive sample preparation steps, was deployed to estimate gentamicin, tobramycin, and amikacin in pharmaceutical formulations. Upon gas-phase collisional activation, protonated gentamicin, tobramycin, and amikacin undergo a facile loss of their respective “C” ring moiety to produce characteristic ions of m/z 322, 324, and 425, respectively. The mass spectral peak intensities for these specific product ions were monitored either by a flow-injection analysis selected-ion monitoring (FIA-SIM) time-intensity method or by a mass spectrometric internal-standard method. The linear dynamic ranges of detection for both methods were evaluated to be 10–1000 ng/mL for gentamicin, 25–2500 ng/mL for tobramycin, and 10–1000 ng/mL for amikacin. The internal-standard mass spectrometric method afforded lower intra-day and inter-day variations (2.3–3.0% RSD) compared to those from FIA-SIM method (4.5–5.0% RSD). This method was applied as a potential alternative procedure to determine gentamicin in commercial pharmaceutical samples and to monitor the release of gentamicin from “self-defensive” tannic acid-based layer-by-layer films into phosphate buffer solutions at different pHs.
Crystal structure of 1-propanethiol–Co2(dobdc) from laboratory X-ray powder diffraction data

Laboratory X-ray powder diffraction was used to solve and refine the crystal structures of appended guest molecules within the pores of metal–organic frameworks (MOFs). Herein, we report the crystal structure of 1-propanethiol adsorbed in the pores of Co2(dobdc) (dobdc4– = 2,5-dioxido-1,4-benzenedicarboxylate, MOF-74). Soaking the activated MOF in neat 1-propanethiol resulted in the formation of 1-propanethiol–Co2(dobdc). The thiol appendant MOF maintained the crystal symmetry, with a rhombohedral space group R-3 and unit-cell parameters a = 25.9597(9) A, c = 6.8623(5) A, and V = 4005.0(4) A3. As expected, the thiol sulfur formed a bond with the open cobalt metal site. The alkane chain was directed toward the center of the pore, participating in numerous van der Waals weak interactions with neighboring molecules. For the final Rietveld refinement, soft restrains were applied using bond distances obtained by periodic density functional theory (DFT) geometry optimization.
Vertebrectomy for Spinal Metastases

In the era of modern medicine, treatment options for metastatic spine tumors include radiation, radiation plus chemotherapy, stereotactic radiosurgery, hormonal therapy, or surgical decompression followed by radiation. Because of this, traditional vertebrectomy is now only indicated in very specific circumstances.
Extensive Review of Persuasive System Design Categories and Principles: Behavioral Obesity Interventions

In this extensive review of behavioral digital obesity interventions, we reviewed randomized control trials aimed at weight loss or maintaining weight loss and identifying persuasive categories and principles that drive these interventions. The following databases were searched for long-term obesity interventions: Medline, PsycINFO, Academic Search Complete, CINAHL and Scopus. The inclusion criteria included the following search terms: obesity, overweight, weight reduction, weight loss, obesity management, and diet control. Additional criteria included randomized control trial, ≥ 6 months intervention, ≥ 100 participants and must include persuasive technology. Forty-six publications were in the final review. Primary task support was the most frequently utilized persuasive system design (PSD) category and self-monitoring was the most utilized PSD principle. Behavioral obesity interventions that utilized PSD with a behavior change theory more frequently produced statistically significant weight loss findings. Persuasive technology and PSD in digital health play a significant role in the management and improvement of obesity especially when aligned with behavior change theories. Understanding which PSD categories and principles work best for behavioral obesity interventions is critical and future interventions might be more effective if they were based on these specific PSD categories and principles.
Synergistic but separable sensory changes in postural tachycardia syndrome and chronic migraine.

Up to 90% of patients with postural tachycardia syndrome (PoTS) report headaches, and comorbid migraine headaches are common. Given this, pathophysiological interaction is possible, which may reveal key aspects of disease expression and treatment opportunities. We hypothesized that PoTS subjects—both with and without migraine—would show features of central sensitization, including allodynia and photophobia. Eighty participants were evaluated, including 30 PoTS, 30 chronic migraine (CM), and 20 non-headache healthy controls (NH), using tilt table testing, psychophysical assessment of sensory sensitivity thresholds, and an online questionnaire to assess measures of headache burden and associated symptoms. Clinical characteristics and sensory thresholds were compared between disease groups and controls, as well as in a subgroup analysis within the PoTS group, based on headache phenotype. Sensory sensitivity thresholds were significantly lower and symptom scores were higher in both the PoTS and CM groups compared to controls. However, the patterns of expression differed between PoTS and CM, with pain threshold reductions in the forearm only of PoTS subjects (non-trigeminal sensory sensitization), compared to both periorbital and forearm sites in CM. Unexpectedly, light sensitivity thresholds were significantly lower in PoTS than in both CM and NH. These findings reveal an underappreciated aspect of disease burden in PoTS, and suggest network sensitization similar to, but separable from, that of migraine. The presence of both photophobia and allodynia in PoTS is reflective of exteroceptive rather than strictly interoceptive disruption, and expands our fundamental understanding of the disorder.
Tumor type, epilepsy burden, and seizure documentation: experiences at a single center neuro-oncology clinic.

Background Patients with both primary and metastatic brain tumors have significant seizure burden due to their tumor. The management of tumor-related epilepsy (TRE) and optimizing antiepileptic drug (AED) regimens requires collaboration between neurologists and seizure specialists, which is facilitated by seizure documentation in clinic notes. We aim to describe seizure incidence in patients seen in neuro-oncology clinical practice. Further, in the subset of those patients with TRE, we aim to analyze seizure documentation. Methods This is a retrospective review of patients with a primary or metastatic brain tumor seen in a neuro-oncology clinic in October 2019. Patients with TRE were included in the analysis of seizure documentation. These notes were analyzed for inclusion of seizure descriptors, terminology, AED regimens, and changes in management. Results Of the full cohort of 356 patients, 199 (55.9%) had TRE. Anaplastic astrocytomas had the highest percentage of patients with TRE. The analysis of seizure documentation in patients with TRE revealed that the majority of notes (90.9%) mentioned seizures. Fewer notes (39.6%) provided additional descriptions of the seizures or commented on AED regimens (58.3%). In notes for patients who had seizures within the previous 6 months, seizure descriptors were more likely. Conclusions This study defines the TRE burden in a cohort of patients seen in neuro-oncology clinic. Among patients with TRE, our study shows that documentation of many aspects of the characteristics and management of patient seizures can be improved, which would facilitate further analysis of impact on patient care as well as future research.
Successful Systemic Treatment Outcomes of Lichen Planus: A Single-Center Retrospective Review.

Lichen planus (LP) affects up to 4% of adults and can cause significant distress and morbidity, especially to those with persistent disease. As many as 20% of patients with LP may exhibit widespread or recalcitrant disease necessitating systemic treatment options. We sought to evaluate the effectiveness of systemic treatments for severe and recalcitrant LP not responsive to topical corticosteroids or calcineurin inhibitors. Over a 10-year period, 374 patients with cutaneous and mucosal LP were evaluated at a major regional tertiary medical center; 94 qualified for inclusion in the study. In all, 26 (28%) patients achieved remission, 52 (55%) experienced stable disease control, and 16 (17%) failed all attempted treatments. Among medications most trialed, intramuscular triamcinolone (IM TAC), hydroxychloroquine, and methotrexate were most successful with 79%, 61%, and 42% respective response rates. In contrast, oral corticosteroids and dapsone were less frequently successful at rates of 24% and 20%. IM TAC represented the highest level of treatment success and was statistically significant compared to other systemic treatments (P < 0.01). Among adjuvant therapies, intralesional triamcinolone (IL TAC) demonstrated higher success (71%) than oral corticosteroids (29%). Based on this multi-year evaluation, we recommend that clinicians consider IM TAC as a first-line systemic option for severe or refractory LP, with hydroxychloroquine as the steroid-sparing treatment of choice. For patients requiring adjuvant therapy, IL TAC should be considered to hasten response and symptom relief. Patients with severe or widespread disease may benefit from earlier initiation of systemic therapy to prevent significant morbidity and impact on daily function. This article is protected by copyright. All rights reserved.
Moral injury and suicidal behavior among US combat veterans: Results from the 2019–2020 National Health and Resilience in Veterans Study

BACKGROUND Recent research suggests that exposure to potentially morally injurious experiences (PMIEs) may be associated with increased risk for suicidal behavior among US combat veterans, but population-based data on these associations are scarce. This study examined the association between PMIEs with current suicidal ideation (SI), lifetime suicide plans (SP), and suicide attempts (SA) in a contemporary, nationally representative sample of combat veterans. METHODS Data were analyzed from the 2019-2020 National Health and Resilience in Veterans Study, which surveyed a nationally representative sample of US combat veterans (n = 1321). PMIEs were assessed using the Moral Injury Events Scale (MIES). Multivariable logistic regression analyses were conducted to examine associations between MIES total scores and specific types of PMIEs with suicidal behavior. RESULTS Thirty-six point three percent of veterans reported at least one PMIE. Perceived transgressions by self, others, and betrayal were associated with SI, SP, and SA (odds ratios [ORs] = 1.21-1.27, all p s < .05), after adjusting for sociodemographic, trauma, and psychiatric characteristics. MIES total scores were significantly, albeit weakly, associated with SP (OR = 1.03, p < .01), but not SI/SA. Depression, posttraumatic stress disorder (PTSD), and age emerged as the strongest correlates of SI/SP/SA (14.9%-38.1% of explained variance), while PMIEs accounted for a comparatively modest amount of variance (3.3%-8.9%). CONCLUSIONS Reports of potentially morally injurious experiences are prevalent among US combat veterans, and associated with increased risk for suicidal behavior, above and beyond severity of combat exposure, PTSD, and depression. Implications for clinical practice and future research are discussed, including the need for methodological advancements in the measurement of moral injury.
Endocrine Control of Calcium Metabolism and Parturient Hypocalcemia in Dairy Cattle

Calcium plays a key role in many fundamental biologic processes including neuromuscular excitability, membrane permeability and blood coagulation in addition to being an essential structural component of the skeleton. The precise control of calcium ions in extracellular fluids is vital, therefore, to the health of animals and man. To maintain a constant concentration of calcium, despite marked variations in intake and excretion, endocrine control mechanisms have evolved that primarily consist of the interactions of three major hormones. Although the direct roles of parathyroid hormone, calcitonin and vitamin D frequently are emphasized in the control of blood calcium, other hormones such as adrenal corticosteroids, estrogens, thyroxine, somatotrophin and glucagon may contribute to the maintenance of calcium homeostasis under certain conditions. The objectives of this report are: (a) to summarize and illustrate some recent findings on the structure and function of calcium control mechanisms under normal and pathologic conditions; and (b) to relate these findings where indicated to the pathogenic mechanisms of parturient hypocalcemia and paresis in dairy cattle.
Genetic characteristics and response to systemic therapies of acral lentiginous melanoma at a tertiary care center-a retrospective review.

Abstract Background Acral lentiginous melanoma (ALM) is an aggressive subtype of cutaneous malignant melanomas that accounts for 50-80% of melanomas in ethnic minorities. Studies on the genetic profile of these tumors largely result from cohorts in Europe, Asia, and Latin America, few inclusive of Black patients. Objective We aim to describe the clinicopathological and genetic characteristics in a diverse cohort of ALM patients. Methods A retrospective analysis of 93 patients with a pathology confirmed diagnosis of ALM between March 1984 and October 2020 was conducted at a large tertiary care center. Melanoma mutation panel testing for frequently mutated regions of the BRAF, NRAS, KIT and PIK3CA genes were reviewed in patient records when available. Results Of the 93 patients identified, 62.4% were Caucasian, 25.8% Black, 4.30% Hispanic, 4.30% Asian, and 3.22% identified as other. Fourteen of 17 patients receiving targeted or immunologic agents experienced disease progression during treatment, including all patients with a BRAF V600E mutation. Limitations This was a single-center retrospective analysis. Conclusion Response to targeted and immunologic therapies in ALM patients was overwhelming poor, particularly in BRAF V600E-mutated tumors in contrast to the positive prognosis associated with BRAF V600E mutations in other advanced cutaneous melanoma subtypes.
The monitoring of pesticides in water matrices and the analytical criticalities: A review

Abstract In this review, we examined the European legislative context on water protection concerning pesticide residues monitoring and the relevant National Action Plans and strategies that were undertaken in European countries to better identify and manage the problem in water bodies. Furthermore, we illustrated the development of analytical methodologies and criticalities connected to determine pesticide residues in water matrices, including sampling, sample preparation approaches, instrumental analyses and specific applications emphasising those works published after 2015. Details about sampling strategies, analytical feasibility, official methods, degradation products and behaviour in the environment for a subset of 160 pesticides are also provided.
What Does the Market Know

I measure how much information market participants have about (1) firm fundamentals and (2) managers' misreporting incentives, and the effects of the market's information on earnings quality and price efficiency. The market knows 81.9% of fundamental and 57.3% of misreporting incentives information available to managers. A 1% increase in the market's fundamental information will increase earnings quality by 1.29% and price efficiency by 1.70%. A 1% increase in the market's misreporting incentives information will decrease earnings quality by 0.38% and increase price efficiency by 0.17%. Reported earnings differ from true earnings by 91.7% of standard deviation of true earnings. An average firm is mispriced by $0.35 billion due to information asymmetry.
Novel Resistance Mutations to ALK Tyrosine Kinase Inhibition Arising During Cell-Culture Drug Selections in T-Cell Lymphoma

Anaplastic Large Cell Lymphoma (ALCL) is a rare T-cell lymphoma. The Anaplastic Lymphoma Kinase (ALK)-positive molecular subtype of ALCL is driven by constitutive activation of the ALK tyrosine-kin...
Abstract 20364: Successful Ablation of Ventricular Fibrillation in Malignant Bileaflet Mitral Valve Prolapse Syndrome

Introduction: Although the vast majority of mitral valve prolapse (MVP) is benign, women with bileaflet MVP (biMVP), complex ventricular ectopy (VE), and abnormal T waves may comprise the recently described malignant biMVP syndrome. The mechanism of ventricular arrhythmia is unknown. To further characterize the arrhythmic substrate, we reviewed our center’s ablation experience in 6 biMVP patients with prior cardiac arrest and recurrent ICD shocks for drug refractory ventricular fibrillation (VF). Methods and Results: Six women with biMVP (median age 31.5 [range 24.2 - 58.7] years, EF 65 [45 - 67]%, all ≤moderate mitral regurgitation) experienced 6 (3 - 25) appropriate ICD shocks over 4.8 (2.8 - 10.7) years and underwent index ablation between 2/2007 - 10/2013. All had multiple VE morphologies (median 7 [3 - 24]) with variable coupling intervals but with a predominant VE trigger for the VF. A median 2 (1 - 4) VE foci were ablated. Sites of successful ablation of VF-triggering and other dominant VE were left ventricular papillary muscles [PM] (1 anterior, 1 posterior, 1 both), fascicles (1 anterior, 1 posterior), or both (1 both PM and posterior fascicle). Outflow tract VE was also present and targeted (1 left, 1 right)i. Two underwent repeat ablation (288 and 312 days) for recurrent complex VE without shocks, with different foci to the index ablation (1 posterior fascicle, 1 both fascicles). The VF-triggering VE in all patients was confirmed as originating from within the left fascicular system, which in 3/6 was at a papillary muscle. Acute procedural success was seen in all with no complications to date. A VF storm occurred within 24 hours of ablation in a single patient. At follow-up of a mean 662 (47 - 2099) days, 1 patient received a single shock (p=0.03 vs. preablation). Symptomatic VE was reduced in all; while 3/6 continue Class 1c antiarrhythmics and 5/6 have beta blockade. Conclusion: Malignant biMVP syndrome is characterized by fascicular and papillary muscle PVCs that trigger ventricular fibrillation, yet in all patients, the VE is multifocal. Ablation of at least one focus appears to improve symptoms and reduce shocks.
C-reactive protein in the serum in nephrosis and acute glomerulonephritis.

C-reactive protein in the serum and the erythrocyte sedimentation rate were followed serially in 13 patients with acute nephritis and in 9 patients with the nephrotic syndrome. Although a positive C-reactive protein test was always associated with evidence of infection, obvious infection in a few instances was not accompanied by a positive test. Determination of C-reactive protein is valuable in determining the presence of infection in patients with acute nephritis and the nephrotic syndrome, especially in the latter where hormone therapy may mask many signs of infection.
Interior structure of Saturn

We summarize the principal observational data that constrain interior models of Saturn, and explain why they are relevant. We discuss the behavior of hydrogen, Saturn's major constituent, at pressures on the order of 0.1 to 10 Mbar and temperatures on the order of 10^4 K. Possible behavior and distributions of minor constituents are also considered, along with processes for their transport. We interpret Saturn’s external gravitational and magnetic fields in terms of interior structure, and discuss the relationship between atmospheric zonal flows and the deep interior. The constraint imposed by tidal evolution considerations is evaluated. Calculations for the thermal evolution of Saturn are presented, both with a lid without consideration of possible gravitational unmixing. Possible scenarios for Saturn's mode of origin and their implications for presently observed atmospheric abundances are discussed.
Immunochemical differences among Methanosarcina mazei S-6 morphologic forms.

Methanosarcinae are the only archaeobacteria known to undergo major morphologic changes during growth involving unicellular and multicellular forms, and Methanosarcina mazei S-6 is the only strain for which three distinct forms, packets, single cells, and lamina, have so far been observed. It is reported that two pairs of these forms, either packets and single cells or single cells and lamina, grew and interconverted in medium with the same composition, Ca2+ and Mg2+ concentrations, and growth substrate, and that the two forms in each pair displayed distinctive differences revealed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblotting, the same growth medium-substrate notwithstanding. Images
Phase diagram, morphology development and vulcanization induced phase separation in blends of syndiotactic polypropylene and ethylene–propylene diene terpolymer

Abstract Miscibility phase diagram in blends of syndiotactic polypropylene (sPP) and ethylene–propylene diene terpolymer has been established by means of differential scanning calorimetry, light scattering and optical microscopy. In descending order of temperature, the olefinic blends reveal a complex phase diagram involving a lower critical solution temperature (LCST), a single phase region followed by a depression of melting transition and a crystal transition (crystallization) of sPP. Below the liquid–solid crystal coexistence line, phase separation occurs in competition with crystallization of sPP in the blends. Temporal evolution of structure factors and the emergence of phase separated domains in these blends have been investigated by time-resolved light scattering and optical microscopy following several temperature quenches from a single phase into the LCST immiscibility gap. The temporal evolution of structure factors has been analyzed in the context of nonlinear dynamical scaling laws. Vulcanization induced phase separation has been undertaken at various temperatures in the single-phase region. Of particular interest is that the higher the reaction temperature (i.e. the faster the chemical reaction), the smaller the domain size.
Requirement of UAP56, URH49, RBM15, and OTT3 in the expression of Kaposi sarcoma-associated herpesvirus ORF57

Transport of mRNA from the nucleus to the cytoplasm is mediated by cellular RNA export factors. In this report, we examined how RNA export factors UAP56 and URH49, and RNA export cofactors RBM15 and OTT3, function in modulating KSHV ORF57 expression. We found that knockdown of each factor by RNAi led to decreased ORF57 expression. Specifically, reduced expression of either UAP56 or RBM15 led to nuclear export deficiency of ORF57 RNA. In the context of the KSHV genome, the near absence of UAP56 or RBM15 reduced the expression of both ORF57 and ORF59 (an RNA target of ORF57), but not ORF50. Collectively, our data indicate that the expression of KSHV ORF57 is regulated by cellular RNA export factors and cofactors at the posttranscriptional level.
Delayed Cranial Nerve Palsy After Coiling of Carotid Cavernous Sinus Aneurysms: Case Report

OBJECTIVE Detachable endovascular coils have become a common treatment strategy for carotid cavernous sinus aneurysms (CCAs), but previously unrecognized postprocedure complications may emerge as longer follow-up data are accumulated. In this report, the authors document the first known cases of delayed cranial neuropathy following CCA coiling in 3 patients, all of whom present at least a year postprocedure without aneurysm regrowth. The potential mechanisms underlying this syndrome are discussed as well as their implications on the selection and optimal endovascular management of CCA patients. CLINICAL PRESENTATION Three previously healthy females aged 50, 60, and 62 underwent CCA coiling at our institution and subsequently developed ipsilateral cranial nerve palsies at 56, 28, and 14 months, respectively, post-procedure. At presentation, all 3 patients had a new, recurrent area of flow in their CCA without changes in aneurysm size. INTERVENTION One patient declined further treatment. In the other 2 patients, a stent was placed across the aneurysm neck, and one patient underwent additional coiling. Unfortunately, all 3 patients remained symptomatic at their latest follow-up. CONCLUSION Because of the intimate anatomic environment of the cavernous sinus, neural elements within it may be particularly susceptible to persistent mass or dynamic effects exacerbated by remnant or recurrent flow across the neck of a coiled aneurysm. These 3 cases prompted the authors to advocate for more aggressive efforts to achieve and maintain CCA occlusion. Furthermore, when such efforts are unsuccessful, consideration of traditional carotid occlusion strategies with or without bypass is warranted.
Metabolism: Growth in the fat lane.

Analysis of endothelial cells, which are involved in blood-vessel formation, unexpectedly reveals that proliferation in this cell type depends on fatty-acid oxidation to support DNA synthesis. See Article p.192 Peter Carmeliet and colleagues identify a crucial role for the oxidation of fatty acids in endothelial cells during angiogenesis. They show that fatty acids provide the carbons for the de novo synthesis of nucleotides, and hence fatty acid oxidation stimulates vessel sprouting by increasing endothelial cell proliferation. Pharmacological blockade of fatty acid oxidation can reduce pathological angiogenesis in a mouse model of retinopathy of prematurity.
Safety and Outcomes Following Resection of Colorectal Liver Metastases in the Era of Current Perioperative Chemotherapy

Preoperative chemotherapy is increasingly utilized in the treatment of colorectal liver metastases (CRLM). Although this strategy may improve resectability, long-term advantages of preoperative chemotherapy for resectable CRLM are less clear. The objective of this study is to report safety and outcomes when perioperative chemotherapy is routinely added to surgery for CRLM. A retrospective review of patients undergoing liver resections for CRLM during 2003–2011 in single academic oncology center. Demographic data, tumor characteristics, chemotherapy, surgical details, complications and survival were analyzed. The study included 157 patients that underwent 168 liver operations. One hundred eighteen patients (70 %) underwent preoperative chemotherapy (75 % oxaliplatin-based). Preoperative portal vein embolization was utilized in 16 (10.1 %) patients. Overall survival (OS) was 89, 57, and 27 % at 1, 3, and 5 years, respectively (median survival—42.8 months). Eleven (7 %) patients had repeat resections for liver recurrence. Thirty-day mortality was 1.26 %, morbidity—24 % (6 %—liver related). Complications were not significantly different in patients that had preoperative chemotherapy. On a multivariate analysis advanced age and >3 lesions predicted poor OS, while advanced age, lesions >5 cm, synchronous lesions, margin-positivity and resection less than hepatectomy were associated with decreased DFS. Our results suggest that even with chemotherapy and resection only a subset of patients remain disease-free after 5 years. However, even in a high-risk patient with multiple lesions, preoperative chemotherapy can be administered safely without apparent increase in postoperative complications. Perioperative chemotherapy should be considered particularly in patients with multifocal or large lesions, synchronous disease and short disease-free interval.
Microstructure evolution during annealing of an amorphous TiAl sheet

Abstract An amorphous, 150 μm thick freestanding sheet of a TiAl-based alloy was produced by physical vapor deposition (PVD). The following phase transformations were observed after different stages of crystallization of the amorphous sheet and analyzed using differential thermal analysis, X-ray diffraction, and transmission electron microscopy: amorphous→body centered cubic (β)→hexagonal close-packed (α)?→tetragonal (γ)+ordered α2. The β phase was formed as near-spherical particles that were evenly distributed in the amorphous phase and the size of these particles was approximately 90 nm. Formation of the α phase by decomposition of β and the remaining amorphous phases led to a very fine feathery-like microstructure arranged in colonies of approximately 100 nm in size. Interface boundaries between the α phase particles were poorly defined. The transformation of the metastable α phase into a mixture of the γ and α2 phases led to formation of an equiaxed γ-grain structure with the grain size of approximately 150 nm.
Determining anisotropic real-analytic conductivities by boundary measurements

If an electrical potential is applied to the surface of a solid body, the current flux across the surface depends on the conductivity in the interior of the body. We want to consider the inverse problem of determining the conductivity by these boundary measurements
A preliminary study of vocal communication in wild long-tailed macaques (Macaca fascicularis). I. Vocal repertoire and call emission

Vocal communication in wild long-tailed macaques (Macaca fascicularis) is described in terms of (1) a preliminary vocal repertoire and the situations in which calls occur in the natural habitat of this species and (2) quantitative measurement of the natural occurrence of calls in the field. Although a number of calls are relatively discrete (e.g., a male loud call), gradation is pronounced for both wide-spectrum (“harsh”) and narrow-spectrum (“clear”) vocal signals. Thirteen general types of harsh calls are identified provisionally as elements of the vocal repertoire. The exact number of discrete clear calls contributing to the vocal repertoire could not be ascertained precisely, but these calls were classified operationally into six broadly acoustically different classes in order to measure natural vocal behavior. Vocalizations tended to occur in temporal “clusters” during sample, periods. Narrow-band clear or “coo” calls were more frequently performed by macaques than wide-band harsh calls. The possible functional implications of the correlated occurrence of multiple vocal signals are discussed.
Diel ontogenetic shift in parasitic activity in a gnathiid isopod on Caribbean coral reefs

Ontogenetic niche shifts are characteristic of organisms with complex life cycles such as many marine invertebrates. Research has focused primarily on changes in habitat or diet. However, ontogenetic changes can also occur in the temporal pattern of foraging. Gnathiid isopods feed on fish blood throughout their larval stages and are the primary food item for cleaning organisms on coral reefs. At sites in Australia and the Caribbean, gnathiid larvae exhibit size-related differences in diel activity. However, it is unclear whether this is due to interspecific or intraspecific variation in behavior. Fish were deployed in cages near sunset on shallow reefs off St. John, U.S. Virgin Islands and allowed to be infected with larval gnathiids. Larvae collected from fish retrieved near midnight developed into adults, with most developing into females. In contrast, approximately 80% of gnathiids collected after first light developed into second or third stage larvae, and nearly all of the remaining, large, individuals developed into males. Comparison of ITS2 gene regions from individuals collected in emergence traps from the same reefs during the day versus during the night revealed no differences in this highly variable region. Thus, gnathiid larvae at this locality shift their time of activity as they develop, and larvae developing into males remain active over a longer time period than those developing into females.
A quiet time empirical model of equatorial vertical plasma drift in the Peruvian sector based on 150 km echoes

[1] Equatorial vertical plasma drift is an important consequence of the E and F region dynamos. Understanding the climatology of vertical drift can provide significant insight into many ionospheric phenomena. In this study we present the first empirical model of vertical plasma drifts at 150 km altitude, observed by the Jicamarca Unattended Long-term studies of the Ionosphere and Atmosphere (JULIA) coherent scatter radar located in Peru. The model, called JULIA Vertical Drift Model (JVDM), describes the local time, seasonal, and solar flux behavior of the equatorial vertical drifts in the Peruvian sector. The model is valid from 0800 through 1600 local time, which is typically when JULIA makes vertical drift measurements. During very high solar flux conditions, however, the model is unreliable before 1000 local time owing to a lack of JULIA data. The model includes a climatology of the 150 km equatorial vertical drifts as well as an estimate of the day-to-day variability, which can be significant. The daytime drifts typically peak between 1000 and 1200 LT and have amplitudes of 25–30 m/s ± 10 m/s. The model has been validated against the global empirical model of Scherliess and Fejer, with a total rms difference of under 4 m/s for 1000 to 1600 LT. This model will allow researchers to study daily variations in the equatorial electric field by subtracting the climatological mean. Model coefficients and software are available online at http://geomag.org/models and http://www.earthref.org.
Mapping the Global Conformation of the Phi29 Packaging RNA Dimer Using Deer Distance Constraints

The insertion of bacteriophage phi29 genomic DNA into its preformed procapsid requires the DNA packaging motor, which is the strongest known biological motor. The packaging motor is an intricate ring-shape protein/RNA complex. The RNA component, called the packaging RNA (pRNA), is indispensable for motor function, and may play an essential role in motor ATPase activity. Current structural information on pRNA is limited, which hinders our effort on understanding motor function. Here, we use site-directed spin labeling and pulse EPR spectroscopy to map the global structure of a pRNA dimer that has been shown to be a functional intermediate in assembling the ring-shaped pRNA complex in the packaging motor. In our studies, nitroxide pairs were attached to specific sites of a truncated monomeric pRNA construct, the labeled monomers were then assembled into dimers in the presence of Mg2+, and inter-nitroxide distances were measured using DEER (Double Electron-Electron Resonance) spectroscopy. In parallel, an unbiased pool of models that contains variable pRNA conformations was generated, which treats pRNA as a 3-way junction construct, and a set of corresponding inter-nitroxide distances was predicted for each model. Intra-molecular DEER distances were used to obtain the monomeric structures of pRNA in dimer, which are then used to build the structural pool for pRNA dimers. A very small number of models were selected. We expect that this work will provide much-needed structural information regarding pRNA, as well as establishing a new methodology for analyzing global conformations in complex RNAs.
A quark model calculation of the weak parity violating asymmetry in high-energy proton-nucleon scattering

Abstract We perform a quark-model calculation of the parity-violating asymmetry in high-energy polarized proton-unpolarized nucleon scattering. Strong interaction enhancement has been taken into account using both renormalization group techniques and precise one-loop calculations. Essential high-twist (bound state) contributions to the asymmetry have been included. Our results indicate large (∼10−6) positive values for the parity-violating asymmetry at high energy, in agreement with the experimental results of Lockyer et al.
Gender differences in using alcohol to cope with depression.

Abstract To examine gender differences in alcohol consumption as a function of mood and expectancies, 32 nondepressed and 32 moderately depressed male and female social drinkers were compared during a 15-minute taste-rating session. Results indicated that depressed subjects tended to consume more alcohol than nondepressed subjects and men consumed more alcohol than women. Depressed men drank more and drank more per sip than all other subjects. Three depressed men consumed more than all other subjects. Depression and anxiety decreased over time for all subjects. However, a Sex × Depression × Time interaction showed that only depressed men and nondepressed women were substantially less depressed after drinking. The nondepressed women, compared to the depressed men, consumed less alcohol and reported a greater increase in positive mood. Men expected more global positive effects from drinking than women, suggesting the tension reduction hypothesis (TRH) is mediated by gender-specific expectancies.
Restoration of Tumor Oxygenation After Cytotoxic Therapy by A Perflubron Emulsion/Carbogen Breathing

Female, Fisher 344 rats bearing 13762 mammary carcinoma implanted subcutaneously in a hind limb were treated with standard therapeutic single doses of antitumor treatments of several types including: 1) antitumor alkylating agents (cisplatin, cyclophosphamide); 2) natural products (adriamycin, taxol and etoposide); 3) antimetabolites (5-flourouracil); 4) hypoxic cell selective agents (mitomycin C, SR-4233) as well as 5) fractionated radiation therapy (3 Gray daily for 5 days). The oxygen levels in the tumors were measured in the absence of treatment and 24 hrs. after treatment using an Eppendorf p02 histograph. Fifty- to sixty-points were measured per tumor and 8-10 tumors comprised each group. The tumors were more hypoxic post treatment with every anticancer drug or radiation. The percent of p02 readings < or = 5 mmHg in the untreated tumors ranged from 85% (x-rays) to 59% (etoposide). Administration of the perflubron emulsion (8 ml/kg) and carbogen breathing (95% O2/5% CO2) increased the oxygenation of the tumors such that the percent of pO2 readings < or = 5 mmHg was 32% in the untreated controls and ranged from 27% (x-rays) to 56% (adria) in the treated tumors. These results indicate that administration of a perflubron emulsion/carbogen can increase the oxygen content of tumors when hypoxia is the result of cytotoxic therapy.
Development of a comorbidity index for use in obstetric patients.

OBJECTIVE:To develop and validate a maternal comorbidity index to predict severe maternal morbidity, defined as the occurrence of acute maternal end-organ injury, or mortality.METHODS:Data were derived from the Medicaid Analytic eXtract for the years 2000–2007. The primary outcome was defined as the
Readability of Health Related Quality of Life Instruments in Urology

Purpose: The average American adult reads at a fifth to eighth-grade level, with wide variability, presenting challenges for the assessment of self-reported health related quality of life. We identified the health related quality of life instruments used in patients with urological diseases and evaluated their readability.Materials and Methods: We focused on the most burdensome urological diseases, based on total expenditures in the United States. We then identified disease specific instruments by systematically searching PubMed®, the Cochrane Database of Systematic Reviews, Google™, Google Scholar™, the Patient Reported Outcome and Quality of Life Instruments Database (Mapi Research Institute, Lyon, France) and Yahoo!® for health related quality of life studies in patients with these urological conditions. Where disease specific instruments were lacking, we noted the general health related quality of life measures most commonly used. For each instrument, we calculated the median Flesch-Kincaid grade leve...