cssi/SciSciGPT-SciSciNet huggingface dataset:
The mathematician's control toolbox for management of type 1 diabetes

Blood glucose levels are controlled by well-known physiological feedback loops: high glucose levels promote insulin release from the pancreas, which in turn stimulates cellular glucose uptake. Low blood glucose levels promote pancreatic glucagon release, stimulating glycogen breakdown to glucose in the liver. In healthy people, this control system is remarkably good at maintaining blood glucose in a tight range despite many perturbations to the system imposed by diet and fasting, exercise, medications and other stressors. Type 1 diabetes mellitus (T1DM) results from loss of the insulin-producing cells of the pancreas, the beta cells. These cells serve as both sensor (of glucose levels) and actuator (insulin/glucagon release) in a control physiological feedback loop. Although the idea of rebuilding this feedback loop seems intuitively easy, considerable control mathematics involving multiple types of control schema were necessary to develop an artificial pancreas that still does not function as well as evolved control mechanisms. Here, we highlight some tools from control engineering used to mimic normal glucose control in an artificial pancreas, and the constraints, trade-offs and clinical consequences inherent in various types of control schemes. T1DM can be viewed as a loss of normal physiologic controls, as can many other disease states. For this reason, we introduce basic concepts of control engineering applicable to understanding pathophysiology of disease and development of physiologically based control strategies for treatment.
Human monocyte spreading in vitro--inducers and effects on Fc and C3 receptors.

Abstract Human peripheral blood monocytes undergo cytoplasmic spreading following attachment to a glass surface. The extent of spreading is greater in the presence of antigen-antibody complexes, manganese, subtilisin and dithiothreitol. The human blood monocyte spreads more rapidly than the mouse peritoneal macrophage and is not inhibited by serum. Fc receptor activity is diminished when spreading is induced by antigen-antibody complexes and is not affected by other inducers. The binding of erythrocytes coated with C3 and the ingestion of latex particles are not inhibited during cytoplasmic spreading.
Biased tadpoles: a fast algorithm for centralizers in large matrix groups

Centralizers are an important tool in in computational group theory. Yet for large matrix groups, they tend to be slow. We demonstrate a O(√|G|(1/loge)) black box randomized algorithm that produces a centralizer using space logarithmic in the order of the centralizer, even for typical matrix groups of order 1020 . An optimized version of this algorithm (larger space and no longer black box) typically runs in seconds for groups of order 1015 and minutes for groups of order 1020. Further, the algorithm trivially parallelizes, and so linear speedup is achieved in an experiment on a computer with four CPU cores. The novelty lies in the use of a biased tadpole, which delivers an order of magnitude speedup as compared to the classical tadpole algorithm. The biased tadpole also allows a test for membership in a conjugacy class in a fraction of a second. Finally, the same methodology quickly finds the order of a matrix group via a vector stabilizer. This allows one to eliminate the already small possibility of error in the randomized centralizer algorithm.
Thoughts About Conceptual Models, Theories, and Literature Reviews:

This essay focuses on various types of literature reviews, including scoping reviews, realist reviews, and integrative reviews. As contributions to understanding the state of nursing science about a particular topic, each literature review should be but rarely is guided by a nursing conceptual model, and the research findings should be but rarely are interpreted as theories that were generated or tested. Examples that are exceptions to usual literature reviews are given.
RNF8 regulates active epigenetic modifications and escape gene activation from inactive sex chromosomes in post-meiotic spermatids

Sex chromosomes are uniquely subject to chromosome-wide silencing during male meiosis, and silencing persists into post-meiotic spermatids. Against this background, a select set of sex chromosome-linked genes escapes silencing and is activated in post-meiotic spermatids. Here, we identify a novel mechanism that regulates escape gene activation in an environment of chromosome-wide silencing in murine germ cells. We show that RNF8-dependent ubiquitination of histone H2A during meiosis establishes active epigenetic modifications, including dimethylation of H3K4 on the sex chromosomes. RNF8-dependent active epigenetic memory, defined by dimethylation of H3K4, persists throughout meiotic division. Various active epigenetic modifications are subsequently established on the sex chromosomes in post-meiotic spermatids. These RNF8-dependent modifications include trimethylation of H3K4, histone lysine crotonylation (Kcr), and incorporation of the histone variant H2AFZ. RNF8-dependent epigenetic programming regulates escape gene activation from inactive sex chromosomes in post-meiotic spermatids. Kcr accumulates at transcriptional start sites of sex-linked genes activated in an RNF8-dependent manner, and a chromatin conformational change is associated with RNF8-dependent epigenetic programming. Furthermore, we demonstrate that this RNF8-dependent pathway is distinct from that which recognizes DNA double-strand breaks. Our results establish a novel connection between a DNA damage response factor (RNF8) and epigenetic programming, specifically in establishing active epigenetic modifications and gene activation.
Length of Stay for Older Adults Residing in Nursing Homes at the End of Life

OBJECTIVES: To describe lengths of stay of nursing home decedents. DESIGN: Retrospective cohort study. SETTING: The Health and Retirement Study (HRS), a nationally representative survey of U.S. adults aged 50 and older. PARTICIPANTS: One thousand eight hundred seventeen nursing home residents who died between 1992 and 2006. MEASUREMENTS: The primary outcome was length of stay, defined as the number of months between nursing home admission and date of death. Covariates were demographic, social, and clinical factors drawn from the HRS interview conducted closest to the date of nursing home admission. RESULTS: The mean age of decedents was 83.3±9.0; 59.1% were female, and 81.5% were white. Median and mean length of stay before death were 5 months (interquartile range 1–20) and 13.7±18.4 months, respectively. Fifty-three percent died within 6 months of placement. Large differences in median length of stay were observed according to sex (men, 3 months vs women, 8 months) and net worth (highest quartile, 3 months vs lowest quartile, 9 months) (all P<.001). These differences persisted after adjustment for age, sex, marital status, net worth, geographic region, and diagnosed chronic conditions (cancer, hypertension, diabetes mellitus, lung disease, heart disease, and stroke). CONCLUSION: Nursing home lengths of stay are brief for the majority of decedents. Lengths of stay varied markedly according to factors related to social support.
Optimising medication for Parkinson's disease patients with dysphagia

In addition to movement disorders, Parkinson's disease (PD) is associated with several nonmotor symptoms, including dysphagia (swallowing difficulties). Dysphagia can make the consumption of solid medicines difficult, which potentially contributes to the poor adherence that is common among people with PD. However, patients may be reluctant to admit that they experience dysphagia. Community nurses should actively enquire into swallowing difficulties among all patients, not only those with PD, and should work with pharmacists and other members of the multidisciplinary team to help optimise medication management to help improve adherence.
A Computational Analysis of Bone Formation in the Cranial Vault in the Mouse

Bones of the cranial vault are formed by the differentiation of mesenchymal cells into osteoblasts on a surface that surrounds the brain, eventually forming mineralized bone. Signaling pathways causative for the cell differentiation include the actions of extracellular proteins driven by information from genes. We assume that the interaction of cells and extracellular molecules which are associated with cell differentiation can be modeled using Turing’s reaction-diffusion model, a mathematical model for pattern formation controlled by two interacting molecules (activator and inhibitor). In this study we hypothesize that regions of high concentration of an activator develop into primary centers of ossification, the earliest sites of cranial vault bone. In addition to the Turing model, we use another diffusion equation to model a morphogen (potentially the same as the morphogen associated with formation of ossification centers) associated with bone growth. These mathematical models were solved using the finite volume method. The computational domain and model parameters are determined using a large collection of experimental data showing skull bone formation in mouse at different embryonic days in both of normal and defect conditions. The results show that the relative locations of the five ossification centers that form in our model occur at the same position as those identified in experimental data. As bone grows from these ossification centers, sutures form between the bones.
Oral and Pharyngeal Reflexes in the Mammalian Nervous System: Their Diverse Range in Complexity and the Pivotal Role of the Tongue

The oral cavity and pharynx are anatomically separate but functionally integrated regions of the head. The two regions are involved in complex motor responses that include feeding, chewing, swallowing, speech, and respiration. The multiple sensory receptors that innervate these two regions provide the first link in reflexes that control muscles of the entire head, upper gastrointestinal tract, and airway. Most of the reflexes affect the diversity of muscles that compose the tongue, which is vital to all stages of feeding and which continually affects the patency of the airway. Oral-pharyngeal reflexes are evident in the mammalian fetus and continually emerge as the animal or human matures. Some of the first reflexes in the oral region are geared toward nourishment. As the central nervous system matures and the oral and pharyngeal regions develop morphologically, new reflexes develop. Many of these reflexes are protective both of the tissue in the oral cavity, such as the tongue, and of the upper airway in preventing aspiration. While simple reflexes can be evoked in isolation, most reflexes combine with more complex oral and pharyngeal responses such as chewing and vocalization. Oral-pharyngeal reflexes demonstrate a range in complexity. Some sensory stimuli will evoke a series of responses, as is often evident in the infant, and other stimuli will evoke a complex multiple-level recruitment of muscles in a sequence, as in pharyngeal swallowing. Certain sensory inputs evoke an entire motor behavior pattern, such as taste avoidance or facial expression. The oral-pharyngeal reflexes are critical to maintaining life and ultimately serve functions that the oral and pharyngeal regions have in common, such as communication, feeding, and breathing.
An Antisense Oligonucleotide Reverses the Footshock-Induced Expression of Fos in the Rat Medial Prefrontal Cortex and the Subsequent Expression of Conditioned Fear-Induced Immobility

The immediate-early genes, including c-fos, have been proposed to be involved in learning and memory. In this report, we examine stress-induced Fos-like immunoreactivity (Fos-li) in subregions of the prefrontal cortex during a conditioned fear paradigm. During the acquisition phase, the rats were conditioned to fear a formerly neutral tone by pairing the tone with a mild footshock. The rats were then tested for fearful behavior by reexposure to the tone without additional footshock. During acquisition, Fos-li was increased in the medial prefrontal cortex (infralimbic and prelimbic) but not the anterior cingulate and M1 motor cortex. However, during the extinction phase, no significant increase in Fos-li was observed in any region. These findings indicate that acquisition, but not extinction, of conditioned fear is associated with an increase in Fos-li in subregions of the medial prefrontal cortex. In other animals, an antisense oligonucleotide directed against the c-fos mRNA was injected into the infralimbic/prelimbic cortex 12 or 72 hr before the acquisition session. Antisense treatment given 12, but not 72, hr earlier suppressed Fos production without altering behavior during the acquisition session. Three days after the acquisition session, rats were tested for fearful behavior as before. The antisense oligonucleotide blockade of Fos production during acquisition was associated with a significantly less fearful response during the extinction session. These results support a role for Fos in the medial prefrontal cortex during the acquisition of aversive learning.
Lack of Association of Rare Functional Variants in TSC1/TSC2 Genes with Autism Spectrum Disorder

Background: Autism spectrum disorder (ASD) is reported in 30 to 60% of patients with tuberous sclerosis complex (TSC) but shared genetic mechanisms that exist between TSC-associated ASD and idiopathic ASD have yet to be determined. Through the small G-protein Rheb, the TSC proteins, hamartin and tuberin, negatively regulate mammalian target of rapamycin complex 1 (mTORC1) signaling. It is well established that mTORC1 plays a pivotal role in neuronal translation and connectivity, so dysregulation of mTORC1 signaling could be a common feature in many ASDs. Pam, an E3 ubiquitin ligase, binds to TSC proteins and regulates mTORC1 signaling in the CNS, and the FBXO45-Pam ubiquitin ligase complex plays an essential role in neurodevelopment by regulating synapse formation and growth. Since mounting evidence has established autism as a disorder of the synapses, we tested whether rare genetic variants in TSC1, TSC2, MYCBP2, RHEB and FBXO45, genes that regulate mTORC1 signaling and/or play a role in synapse development and function, contribute to the pathogenesis of idiopathic ASD. Methods: Exons and splice junctions of TSC1, TSC2, MYCBP2, RHEB and FBXO45 were resequenced for 300 ASD trios from the Simons Simplex Collection (SSC) using a pooled PCR amplification and next-generation sequencing strategy, targeted to the discovery of deleterious coding variation. These detected, potentially functional, variants were confirmed by Sanger sequencing of the individual samples comprising the pools in which they were identified. Results: We identified a total of 23 missense variants in MYCBP2, TSC1 and TSC2. These variants exhibited a near equal distribution between the proband and parental pools, with no statistical excess in ASD cases (P > 0.05). All proband variants were inherited. No putative deleterious variants were confirmed in RHEB and FBXO45. Three intronic variants, identified as potential splice defects in MYCBP2 did not show aberrant splicing upon RNA assay. Overall, we did not find an over-representation of ASD causal variants in the genes studied to support them as contributors to autism susceptibility. Conclusions: We did not observe an enrichment of rare functional variants in TSC1 and TSC2 genes in our sample set of 300 trios.
RelaxReplay: record and replay for relaxed-consistency multiprocessors

Record and Deterministic Replay (RnR) of multithreaded programs on relaxed-consistency multiprocessors has been a long-standing problem. While there are designs that work for Total Store Ordering (TSO), finding a general solution that is able to record the access reordering allowed by any relaxed-consistency model has proved challenging. This paper presents the first complete solution for hard-ware-assisted memory race recording that works for any relaxed-consistency model of current processors. With the scheme, called RelaxReplay, we can build an RnR system for any relaxed-consistency model and coherence protocol. RelaxReplay's core innovation is a new way of capturing memory access reordering. Each memory instruction goes through a post-completion in-order counting step that detects any reordering, and efficiently records it. We evaluate RelaxReplay with simulations of an 8-core release-consistent multicore running SPLASH-2 programs. We observe that RelaxReplay induces negligible overhead during recording. In addition, the average size of the log produced is comparable to the log sizes reported for existing solutions, and still very small compared to the memory bandwidth of modern machines. Finally, deterministic replay is efficient and needs minimal hardware support.
Ensuring Accuracy Within the Medicare Physician Fee Schedule: An Example From Radiation Oncology

The authors suggest that one solution to ensure CMS pursues its policy goals separately from its RVU-setting initiative would be for Congress to reign in the ACA and codify a directive to preferentially use empirical data.
Crystallization processes in poly(ethylene terephthalate) as modified by polymer additives and fiber reinforcement

The effect of fiber reinforcement on the crystallization kinetics of poly(ethylene terephthalate), or PET, was investigated using differential scanning calorimetry. The objective of the study was to determine how the effects of fiber reinforcement on PET crystallization are modified by the presence of polymer nucleating and plasticizing additives. Undirectional fiber composites were prepared using aramid and glass fibers in PET. The rate of crystallization of PET, as reflected by crystallization half-time, is seen to depend on reinforcing fiber type, crystallization temperature, and presence of nucleant or plasticizer. Howerver, degree of crystallinity of PET is largely unaffected by the presence of additives and reinforcing fibers. Crystallization kinetics are analyzed using the Avrami model for PET volume crystallized as a function of time. Avrami plots for PET and fiber-reinforced PET exhibit two linear regions, possibly corresponding to primary and secondary crystallization. The crystalline morphology of fiber-reinforced PET was also studied using polarized light microscopy. Results concerning nucleation density and growth morphology are used in explaining differences seen in crystallization kinetics in fiber-reinforced systems. © 1994 John Wiley & Sons, Inc.
Larval morphologies and potential developmental modes of eight sea spider species (Arthropoda: Pycnogonida) from the southern Oregon coast

Larvae of eight sea spiders from three families (Ammotheidae, Pycnogonidae and Phoxichilidiidae) are described for the first time. The external morphology of the first larval stage of each species is presented in detail using scanning electron microscopy photographs in order to determine the mode of postembryonic development. Three types of larval development are apparent in the species examined. The species Achelia gracilipes, Eurycyde spinosa, Pycnogonum rickettsi and Pycnogonum stearnsi (families Ammotheidae and Pycnogonidae) have larval morphologies indicative of an ‘ectoparasitic’ development. Morphological characteristics of Achelia simplissima and Achelia chelata (family Ammotheidae) larvae suggest an ‘endoparasitic’ development, while larvae of the species Anoplodactylus viridintestinalis (family Phoxichilidiidae) have traits implying an ‘encysting’ postembryonic mode of development. Larvae of the species Nymphopsis spinosissima have unusual morphological characteristics that may be indicative of a new developmental mode.
Remarks on Closing Session of Conference

Apart from having a conceptually excellent theme, the conference titled “Urban Regeneration and the Environmental Challenge” include speakers and delegates who identified major key issues for very intelligent discussion. Such top quality conferences should be held more regularly, even annually, in locations not restricted to the United States and the United Kingdom.
Nanosecond biphasic pulse generators for biomedical applications

Summary form only given. Intense nanosecond electric pulses act on cells by charging their membranes to voltages which may cause membrane permeabilization by creating nanopores1. Previous studies were mostly focused on the effects of monophasic pulses, which have been shown to permeabilize the cell membrane mainly on the anode side of the cells2. Biphasic pulses, on the other hand, are expected to affect both sides of the cell thereby potentially increasing the efficiency of membrane permeabilization. However, depending on the pulse duration, it is also possible that the biological effect created by one part of the biphasic pulse may be reversed by the part of the biphasic pulse with opposite polarity, reducing the efficiency compared to that of monophasic pulses. In order to explore which effect dominates for bipolar pulses, more biological studies need to be conducted. We have constructed several types of nanosecond bipolar pulse generators with impedances of either 200 Ω or 10 Ω. They have been used for loads with an electrode gap on the microscope (200 Ω) or electroporation cuvettes (10 Ω). For the microscope pulser, the pulses are generated either by means of a transmission line with a single switch3 or a fourswitch H-bridge DC-AC converter 4. The maximum voltage is 1 kV, but by stacking a number of MOSFET switches we have increased the pulse voltage up to 5 kV. For the pulse generator with electroporation cuvettes as load, only the transmission line technique is used. To enable the high voltage charging and switching, a pair of 10 ns, 10 Ω strip lines are immersed in transformer oil, and an oil spark gap is used as a switch. The integration of oil transmission line and oil switch allows for high speed pulse generation. The switch breakdown time and voltage jitter are studied by pulse charging and DC charging.
Role of cytokine signaling in group B Streptococcus-stimulated expression of human beta defensin-2 in human extraplacental membranes.

Problem Group B Streptococcus (GBS) is a leading cause of neonatal morbidity and mortality. We tested the hypothesis that the choriodecidua plays a role in GBS-stimulated human beta defensin(HBD)-2 increases in amnion cells through a secreted factor of choriodecidual origin. Method of study Human amnion epithelial cells were treated with choriodecidual GBS-conditioned medium, live GBS, lipoteichoic acid (LTA), or lipopolysaccharide (LPS), with and without IL-1 inhibitors. Results Choriodecidual tissue punches released IL-1α and IL-1β in response to GBS and this medium significantly stimulated release of HBD-2 by amnion cell cultures. Inhibitors of IL-1 significantly impaired the release of HBD-2 from amnion cells treated with GBS choriodecidual conditioned medium. Direct stimulation of amnion cells with GBS, LTA, or LPS did not increase HBD-2 release. Conclusion Paracrine signaling involving IL-1 of choriodecidual origin is likely a critical driver for amnion HBD-2 increases in response to GBS infection of extraplacental membranes.
Structural basis for ATP-dependent DnaA assembly and replication-origin remodeling

In bacteria, the initiation of replication is controlled by DnaA, a member of the ATPases associated with various cellular activities (AAA+) protein superfamily. ATP binding allows DnaA to transition from a monomeric state into a large oligomeric complex that remodels replication origins, triggers duplex melting and facilitates replisome assembly. The crystal structure of AMP-PCP–bound DnaA reveals a right-handed superhelix defined by specific protein-ATP interactions. The observed quaternary structure of DnaA, along with topology footprint assays, indicates that a right-handed DNA wrap is formed around the initiation nucleoprotein complex. This model clarifies how DnaA engages and unwinds bacterial origins and suggests that additional, regulatory AAA+ proteins engage DnaA at filament ends. Eukaryotic and archaeal initiators also have the structural elements that promote open-helix formation, indicating that a spiral, open-ring AAA+ assembly forms the core element of initiators in all domains of life.
Posttreatment Feeding Affects Mortality of Bed Bugs (Hemiptera: Cimicidae) Exposed to Insecticides.

Insecticide sprays and dusts are used for controlling bed bugs, Cimex lectularius L. In natural environments, bed bugs have daily access to hosts after they are exposed to insecticides. The established laboratory insecticide bioassay protocols do not provide feeding after insecticide treatments, which can result in inflated mortality compared with what would be encountered in the field. We evaluated the effect of posttreatment feeding on mortality of bed bugs treated with different insecticides. None of the insecticides tested had a significant effect on the amount of blood consumed and percent feeding. The effect of posttreatment feeding on bed bug mortality varied among different insecticides. Feeding significantly reduced mortality in bed bugs exposed to deltamethrin spray, an essential oil mixture (Bed Bug Fix) spray, and diatomaceous earth dust. Feeding increased the mean survival time for bed bugs treated with chlorfenapyr spray and a spray containing an essential oil mixture (Ecoraider), but did not affect the final mortality. First instars hatched from eggs treated with chlorfenapyr liquid spray had reduced feeding compared with nymphs hatched from nontreated eggs. Those nymphs hatched from eggs treated with chlorfenapyr liquid spray and successfully fed had reduced mortality and a higher mean survival time than those without feeding. We conclude that the availability of a bloodmeal after insecticide exposure has a significant effect on bed bug mortality. Protocols for insecticide efficacy testing should consider offering a bloodmeal to the treated bed bugs within 1 to 3 d after treatment.
Solution-based indirect affinity selection mass spectrometry--a general tool for high-throughput screening of pharmaceutical compound libraries.

We show here that an automated solution-based affinity selection mass spectrometry (ASMS) system can be built exclusively from commercially available parts. The value of this technology lies in the throughput (∼1 × 105 compounds/day) coupled with a low hit rate. The system, being a binding assay, requires little development time yielding a fast timeline between target availability and hit identification. In addition, the use of exact mass simplifies the hit identification. We demonstrate this system using carbonic anhydrase as the target and a library of 144,000 proprietary compounds.
Inorganic aging of the plasma layer of tissue cultures.

SummaryThe adsorption of calcium phosphate complexes to plasma substrates, and the conditions required for their removal, indicate that the plasma gel is the site of an ionic exchange in which preferentially adsorbed ions may greatly alter the desired ionic balance. This process is one of the factors which causes plasma to become growth inhibitory during prolonged maintenance of cells in this type of substrate.
A Technique Employing Bio-Plastic in the Excavation of Burrows of Ground-Nesting Bees

Bio-plastic, a thermosetting polyester resin, was found superior to plaster of Paris for making casts of nests of ground-nesting bees, with respect both to the results obtained and to time saved. Its method of employment is described. A third material, rubber latex, was found entirely unsuitable for making casts of these nests.
Soil applications of systemic insecticides for control of the green peach aphid on peppers

Systemic insecticides were incorporated into the soil of pepper fields, next to the plant row. None of the materials evaluated provided a sufficiently rapid and effective reduction of the green peach aphid, Myzus persicae (Sulzer), to indicate that this method of application has potentialities for remedial control of a prevailing infestation on peppers. However, Di-Syston®( O,O -diethyl S -[2-(ethylthio)ethyl] phosphorodithioate) which was slow-acting, provided highly effective control of the green peach aphid for up to 3 months after application. The benefits derived from soil applications of systemic insecticides in the preservation of insect parasites and predators are discussed.
Adding the patient’s voice to our understanding of collaborative goal setting: How do patients with diabetes define collaborative goal setting?:

BackgroundPatient reports of collaborative goal setting have repeatedly been associated with improved health outcomes, and the American Diabetes Association specifically encourages collaborative go...
ID: 10: FRAGMENTED QRS DOES NOT PREDICT ONSET OF HEART FAILURE WITH PRESERVED EJECTION FRACTION IN PATIENTS WITH DIASTOLIC DYSFUNCTION

Background Depolarization and repolarization ECG abnormalities such as fragmented QRS and wide frontal QRS-T angles are associated with heart failure with preserved ejection fraction (HFpEF) and are associated with adverse outcomes. However, no studies have investigated whether these abnormalities are present in asymptomatic diastolic dysfunction and whether these abnormalities are predictive of the development of HFpEF in subjects with diastolic dysfunction. The goal of this study is to determine whether fQRS and widening of the QRS-T angle precedes the development of HFpEF in patients with diastolic dysfunction. Methods This retrospective cohort study included 100 subjects with diastolic dysfunction and an ejection fraction >50% as reported on transthoracic echocardiography (TTE) who were free of HF at baseline. We analyzed 12-lead ECGs to determine fQRS and frontal QRS-T angle. Patients with QRS>120 ms, bundle branch block pattern, or incomplete right bundle branch block were excluded. The subjects were divided into two groups: Group 1 (n=53) included subjects who were known to progress to HFpEF and Group 2 (n=47) included patients who remained asymptomatic. Results There was no significant difference in the proportion of patients with fQRS in Group 1 compared to Group 2 (33/41 vs. 35/42, p=0.78). The difference was also not significant when comparing hypertensive patients in Group 1 versus Group 2 (28/35 vs. 24/30, p=1.0), as well as patients without hypertension in both groups (5/6 vs. 11/12, p=1.0). On average, the QRS-T angle was wider in Group 1 (64.6) compared to Group 2 (51.7). Conclusion In patients with asymptomatic diastolic dysfunction, fragmented QRS is present in both patients who progress to HFpEF as well as patients who remain asymptomatic. This suggests that fragmented QRS is associated with diastolic dysfunction, but does not predict the development of heart failure symptoms. The frontal QRS-T angle may be a useful measurement in predicting which patients go on to develop HFpEF. However, larger prospective studies are needed to further investigate this relationship.
Stability and normal zone propagation in YBCO CORC cables

In this study, a two layer conductor on round core cable was tested for stability and normal zone propagation at 77 K in a liquid nitrogen bath. The cable was instrumented with voltage taps and wires on each strand over the cable’s central portion (i.e. excluding the end connections of the cable with the outside world). A heater was placed in the central zone on the surface of the cable, which allowed pulses of various powers and durations to be generated. Shrinking (recovering) and expanding (not recovering) normal zones have been detected, as well as stationary zones which were in thermal equilibrium. Such stationary thermal equilibrium zones did not expand or contract, and hit a constant upper temperature while the heater current persisted; they are essentially a form of Stekly stability. Overall, the cable showed a high degree of stability. Notably, it was able to carry a current of 0.45Ic cable with maximum temperature of 123 K for one minute without damage.
Acute intracranial hemorrhage in a cirrhotic controlled with recombinant factor VIIa

Human factor VIIa is a vitamin K-dependent glycoprotein consisting of 406 amino acids having a molecular weight of 50 kDa (1). Factor VIIa is the initiating factor in the conversion of prothrombin to thrombin via the extrinsic pathway (1). Specifically, factor VIIa forms a complex with tissue factor that activates factor X and factor IX, which in turn forms a multimolecular complex with factor V, which then converts prothrombin to thrombin on the surface of platelets with the resultant production of fibrin monomers. The resultant fibrin undergoes self-polymerization until a critical size is achieved and the protein becomes insoluble as the hemostatic plug or clot. Recently, recombinant human factor VIIa (rhFVIIa) has become commercially available for the treatment of hemophiliacs with antibodies to factor VIII or factor IX and individuals who are congenitally factor VIIdeficient (1). Even more recently, rhFVIIa has been used to control bleeding in cases of trauma in both hemophiliacs as well as nonhemophiliac patients (2–9). This use of rhFVIIa in surgical and trauma units has raised the possibility that rhFVIIa might also be clinically useful in other medical situations. Herein, we report a case of a 68-year-old man with a severe coagulopathy due to alcohol-associated cirrhosis, who experienced a spontaneous acute intracranial hemorrhage and was treated with rhFVIIa with cessation of the intracranial bleeding with clinical and radiological stabilization of his intracranial injury.
Using the TAT to Assess the Relation Between Gender Identity and the Use of Defense Mechanisms

The purpose of this study is to explore whether 2 different dimensions of personality, when assessed at an implicit level with the Thematic Apperception Test (TAT; Murray, 1943 ) will show a theoretically meaningful coherence not demonstrated when 1 is assessed at an implicit level and the other at an explicit level. Gender identity and defense mechanisms were assessed implicitly using the TAT. Gender identity was compared with a self-report measure of gender-related attributes assessed at the explicit level. The results showed a theoretically meaningful coherence when different dispositions were assessed at the same level, but a lack of agreement when similar dispositions were assessed at different levels. The study is based on a secondary analysis of data from 2 previously published papers (Cramer, 1998 ; Cramer & Westergren, 1999 ).
SPATIAL AND TEMPORAL DISTRIBUTIONS OF ATMOSPHERIC MOISTURE IN A SMALL MIDWESTERN CITY

Location, timing, and intensities of urban atmospheric moisture anomalies in the relatively small city of Lawrence, Kansas are mapped, explained, and compared with previously studied cities. Forty-five urban-rural dew point distributions were obtained during mornings, afternoons, and evenings in August, September, and October. A meteorologically-equipped auto was used to traverse an 88.5-km route through the major land uses in the city and surrounding countryside. Rural dew points exceeded urban values much more frequently than the reverse. On several dates, a reversal of the urban-rural dew point relationship occurred; in the afternoon, rural dew points were greater than urban values, but at night urban values exceeded those in rural areas. Lowest values often corresponded with the most developed sections of the city, and the central business district exerted the most consistent influence on dew points. Greatest gradients developed on the periphery of the developed area. Pattern complexity was generally ...
Repair of Morgagni Hernia in Adults with Primary Closure and Mesh Placement: First Robotic Experience

Abstract Introduction: Morgagni hernia (MH) is an uncommon type of diaphragmatic hernia, especially in adults. Laparoscopic or thorascopic approaches have been described in adults. There are few reported cases using the Da Vinci robot in children and no previously described cases in adults. We report our early experience and technique using the robotic approach for MH repair in adults and its potential advantages. Method: Robotic repair of MH was performed in 3 female patients. Four trocars were used to gain access to the abdomen. The hernia contents were reduced, the sac excised, and the defect closed primarily. A 4 × 6 inch bioabsorbable coating mesh was used in 2 patients and a biologic mesh in 1 for reinforcement. Results: Robotic repair of MH was technically successful in all 3 patients. The average operative time was 199.3 minutes, and difficult hernia exposure in one case caused prolonged surgical time. There were no intraoperative complications. Additional interventions, including a repair of a tr...
Civil Society and the Legitimacy of the WTO Dispute Settlement System

INTRODUCTION he legitimacy of a rule or an institution is important because it may encourage voluntary compliance with the rule or the institution’s decisions, while the lack of legitimacy may be used as an excuse for noncompliance. Legitimacy is especially critical within the context of international law, as the international community lacks effective enforcement tools. This Article focuses on the legitimacy of the World Trade Organization’s (“WTO”) dispute settlement system. As the coverage of the WTO Agreement expands and its enforcement intensifies, its impact on the lives of citizens becomes more extensive and profound. The dispute settlement system has been criticized for enforcing the WTO Agreement without due regard to the nontrade interests and values of civil society. Given that citizens have become important stakeholders in international trade disputes, critics demand that the dispute settlement system reflect the concerns of not only States and businesses, but also civil society.
Use of complement binding assays to assess the efficacy of antibody mediated rejection therapy and prediction of graft survival in kidney transplantation.

Abstract Background The Luminex® single antigen bead assay (SAB) is the method of choice for monitoring the treatment for antibody-mediated rejection (AMR). A ⩾50% reduction of the dominant donor-specific antibody (IgG-DSA) mean fluorescence intensity (MFI) has been associated with improved kidney allograft survival, and C1q-fixing DSA activity is associated with poor outcomes in patients with AMR. We aimed to investigate if C1q-DSA can be used as a reliable predictor of response to therapy and allograft survival in patients with biopsy-proven AMR. Methods We tested pre- and post-treatment sera of 30 kidney transplant patients receiving plasmapheresis and low-dose IVIG for biopsy-proven AMR. IgG-DSA and C1q-DSA MFI were measured and correlated with graft loss or survival. Patients were classified as nonresponders (NR) when treatment resulted in Results Differences in the percentage of patients deemed NR depended upon the end-point criterion (73% by reduction in IgG-DSA MFI vs. 50% by persistent C1q-DSA activity). None of the seven patients with Conclusions A rapid reduction of DSA concentration below the threshold required for complement activation is associated with better graft survival, and C1q-DSA is a better predictor of outcomes than IgG-DSA MFI reduction.
Anterior Temporal Artery-to-Anterior Cerebral Artery Bypass: Anatomic Feasibility of a Novel Intracranial-Intracranial Revascularization Technique.

Background Complex aneurysms of the anterior cerebral artery (ACA) may require a bypass procedure as part of their surgical management. Most current bypass paradigms recommend technically demanding side-to-side anastomosis of pericallosal arteries or use of interposition grafts, which involve longer ischemia times. The purpose of this study is to assess the feasibility of an anterior temporal artery (ATA) to ACA end-to-side bypass. Methods Fourteen cadaveric specimens (17 ATAs) were prepared for surgical simulation. The cisternal course of the ATA was freed from perforating branches and arachnoid. The M3-M4 junction of the ATA was cut, and the artery was mobilized to the interhemispheric fissure. The feasibility of ATA bypass to the precommunicating and postcommunicating ACA was assessed in relation to the cisternal length and branching pattern of the middle cerebral artery. Results Successful anastomosis was feasible in 14 ATAs (82%). Three ATAs did not reach the ACA. These ATAs were branching distally and originated from the M3 (opercular) middle cerebral artery. In specimens where bypass was not feasible, the average cisternal length of the ATA was significantly shorter than the rest. Conclusions ATA-ACA bypass is anatomically feasible and may be a useful alternative to other revascularization techniques in selected patients. It is technically simpler than A3-A3 in situ bypass. ATA-ACA bypass can be performed through the same pterional exposure used for the ACA aneurysms, sparing the patient an additional interhemispheric approach, required for the A3-A3 anastomosis.
Genomic Tools for Analyzing Transcriptional Regulatory Networks

In this chapter, we described how genomic tools can be used to construct and analyze transcription networks. We focus on the ChIP-chip technique as this genomic tool has proven to be a powerful method for identifying the genomic targets of transcription factors. We discuss bioinformatics methods that can be used to analyze ChIP-chip data and discover the DNA motifs bound by a transcription factor. Finally, we describe bioinformatics tools, such as Athena, that can be used to visualize and analyze transcription factor binding sites. We have shown that integrating the analysis of transcription factor binding data with information about gene function or expression can be a powerful tool for deciphering transcriptional networks.
Development and implementation of a risk identification tool to facilitate critical care transitions for high-risk surgical patients.

Quality problem Patients recently discharged from the intensive care unit (ICU) are at high risk for clinical deterioration. Initial assessment Unreliable and incomplete handoffs of complex patients contributed to preventable ICU readmissions. Respiratory decompensation was responsible for four times as many readmissions as other causes. Choice of solution Form a multidisciplinary team to address care coordination surrounding the transfer of patients from the ICU to the surgical ward. Implementation A quality improvement intervention incorporating verbal handoffs, time-sensitive patient evaluations and visual cues was piloted over a 1-year period in consecutive high-risk surgical patients discharged from the ICU. Process metrics and clinical outcomes were compared to historical controls. Evaluation The intervention brought the primary team and respiratory therapists to the bedside for a baseline examination within 60 min of ward arrival. Stakeholders viewed the intervention as such a valuable adjunct to patient care that the intervention has become a standard of care. While not significant, in a comparatively older and sicker intervention population, the rate of readmissions due to respiratory decompensation was 12.5%, while 35.0% in the control group (P = 0.28). Lessons learned The implementation of this ICU transition protocol is feasible and internationally applicable, and results in improved care coordination and communication for a high-risk group of patients.
Dynamics in the Decompositions Approach to Quantum Mechanics

In Harding (Trans. Amer. Math. Soc. 348(5), 1839–1862 1996) it was shown that the direct product decompositions of any non-empty set, group, vector space, and topological space X form an orthomodular poset Fact X. This is the basis for a line of study in foundational quantum mechanics replacing Hilbert spaces with other types of structures. Here we develop dynamics and an abstract version of a time independent Schrodinger’s equation in the setting of decompositions by considering representations of the group of real numbers in the automorphism group of the orthomodular poset Fact X of decompositions.
A Class of Center-Free Resource Allocation Algorithms 1

Abstract This paper presents a class of resource allocation algorithms derived as a projected gradient on a subspace parametrized by a communication constraint. The algorithms have the distinguishing characteristic of converging to the optimal allocation while completely eliminating the need for a coordinating center. Furthermore, during the iteration process the objective function monotonically increases toward its maximum while the allocation always remains feasible. Finally, this paper presents a finite step initialization procedure which yields an initial allocation that has properties required by this class of algorithms.
Deuterium Relaxation and Molecular Motion in Channel Clathrates

The use of magnetic resonance techniques in studies of structure and molecular dynamics of inclusion compounds has increased dramatically in recent years. Considering the importance of many types of clathrates in catalysis this is to be expected. Considering the inherent charming physical chemical properties of many clathrates, it is surprising that physical chemists among the magnetic resonance community have waited so long to take an in depth look at the properties of these materials. It turns out that deuterium NMR is very well suited for investigating the dynamics of clathrates.
An Improved Set of Transformations

In the last chapter we presented a set of transformations BT complete for arbitrary equational theories E, but which were prohibitively inefficient. In this chapter we present a restricted version of BT, called T, which solves these problems, and prove its completeness.
Integrating Proteomics and Transcriptomics for Systematic Combinatorial Chimeric Antigen Receptor Therapy of AML

Summary Chimeric antigen receptor (CAR) therapy targeting CD19 has yielded remarkable outcomes in patients with acute lymphoblastic leukemia. To identify potential CAR targets in acute myeloid leukemia (AML), we probed the AML surfaceome for overexpressed molecules with tolerable systemic expression. We integrated large transcriptomics and proteomics datasets from malignant and normal tissues, and developed an algorithm to identify potential targets expressed in leukemia stem cells, but not in normal CD34 + CD38 − hematopoietic cells, T cells, or vital tissues. As these investigations did not uncover candidate targets with a profile as favorable as CD19, we developed a generalizable combinatorial targeting strategy fulfilling stringent efficacy and safety criteria. Our findings indicate that several target pairings hold great promise for CAR therapy of AML.
Aerosolizing Lipid Dispersions Enables Antibiotic Transport Across Mimics of the Lung Airway Surface Even in the Presence of Pre-existing Lipid Monolayers.

Abstract Background: Secondary lung infections are the primary cause of morbidity associated with cystic fibrosis lung disease. Aerosolized antibiotic inhalation is potentially advantageous but has limited effectiveness due to altered airway aerodynamics and deposition patterns that limit drug access to infected regions. One potential strategy to better reach infected areas is to formulate aerosols with surfactants that induce surface tension gradients and drive postdeposition drug dispersal via Marangoni transport along the airway surface liquid (ASL). Since this relies on surfactant-induced surface tension reduction, the presence of endogenous lipid monolayers may hinder drug dispersal performance. Methods: Tobramycin solutions were formulated with dipalmitoylphosphatidylcholine (DPPC), a major component of endogenous pulmonary surfactant, to drive postdeposition aerosol dispersal across a model ASL based on a liquid layer or “subphase” of aqueous porcine gastric mucin (PGM) solution with predeposited D...