cssi/SciSciGPT-SciSciNet huggingface dataset:
Classification of maxillectomy defects: a systematic review and criteria necessary for a universal description.

Statement of problem Maxillectomy defects are complex and involve a number of anatomic structures. Several maxillectomy defect classifications have been proposed with no universal acceptance among surgeons and prosthodontists. Established criteria for describing the maxillectomy defect are lacking. Purpose This systematic review aimed to evaluate classification systems in the available literature, to provide a critical appraisal, and to identify the criteria necessary for a universal description of maxillectomy and midfacial defects. Material and methods An electronic search of the English language literature between the periods of 1974 and June 2011 was performed by using PubMed, Scopus, and Cochrane databases with predetermined inclusion criteria. Key terms included in the search were maxillectomy classification, maxillary resection classification, maxillary removal classification, maxillary reconstruction classification, midfacial defect classification, and midfacial reconstruction classification. This was supplemented by a manual search of selected journals. After application of predetermined exclusion criteria, the final list of articles was reviewed in-depth to provide a critical appraisal and identify criteria for a universal description of a maxillectomy defect. Results The electronic database search yielded 261 titles. Systematic application of inclusion and exclusion criteria resulted in identification of 14 maxillectomy and midfacial defect classification systems. From these articles, 6 different criteria were identified as necessary for a universal description of a maxillectomy defect. Multiple deficiencies were noted in each classification system. Though most articles described the superior-inferior extent of the defect, only a small number of articles described the anterior-posterior and medial-lateral extent of the defect. Few articles listed dental status and soft palate involvement when describing maxillectomy defects. Conclusions No classification system has accurately described the maxillectomy defect, based on criteria that satisfy both surgical and prosthodontic needs. The 6 criteria identified in this systematic review for a universal description of a maxillectomy defect are: 1) dental status; 2) oroantral/nasal communication status; 3) soft palate and other contiguous structure involvement; 4) superior-inferior extent; 5) anterior-posterior extent; and 6) medial-lateral extent of the defect. A criteria-based description appears more objective and amenable for universal use than a classification-based description.
Sex difference in urinary concentrating ability of rats with water deprivation

Our previous demonstration of sexual dimorphism in the antidiuretic response to exogenous vasopressin prompted us to investigate the response to moderately high levels of endogenous vasopressin stimulated by water deprivation in conscious rats. After 24 h water deprivation, urine flow was significantly higher and urine osmolality lower in females than in males. Plasma concentrations of vasopressin were higher in females than in males after water deprivation, but plasma osmolality did not differ. Gonadectomy, which had no effect in dehydrated males, decreased urine flow and increased urine osmolality in females to levels observed in intact and gonadectomized males. Spontaneous water intake was also measured and found to be lower in males and estrous females than in females in the other phases of the estrous cycle. These observations support the concept that there is a gender difference in the antidiuretic responsiveness to endogenous vasopressin, that this difference is dependent upon the ovarian hormones, and that it may lead to differences in consumptive behavior.
Informational Dynamics of ‘Might’ Assertions

We investigate, in a logical setting, the proposal that assertion primarily functions to express and coordinate doxastic states and that ‘might’ fundamentally expresses lack of belief. We provide a formal model of an agent’s doxastic state and precise assertability conditions for an associated formal language. We thereby prove that an arbitrary assertion (including a complex of ‘might’ and ‘factual’ claims) always succeeds in expressing a well-defined doxastic state. We then propose a fully general and intuitive doxastic update operation as a model of an agent coming to accept an arbitrary assertion. We provide reduction axioms for some novel update operations related to this proposal.
Energy and Mass Transfer during Binary Droplet Collision

The present study focuses on binary droplet interactions over a wide range of Weber numbers and impact parameters. The formulation is based on the complete set of conservation equations for both the liquid and surrounding gas phases. An improved volume-of-fluid (VOF) technique, augmented by an adaptive mesh refinement (AMR) algorithm, is used to track the liquid/gas interfaces. Detailed information about the droplet dynamics, including collision, deformation, coalescence, separation, and mass and energy transfer, is obtained systematically. Various underlying processes of droplet dynamics are investigated by analyzing the overall energy budget. In addition, an advanced visualization technique using the Ray-tracing methodology is implemented to gain direct insight into the detailed physics of droplet interaction. Theories are also established to predict the droplet behavior after collision. Good agreement is achieved with simulation and experimental results.
Immunoelectrophoresis on cellulose acetate membranes.

An immunoelectrophoretic technic that uses a standard cellulose acetate membrane as supporting medium is described. Measured volumes of sample and antiserum are applied directly to the membrane surface. Immunodiffusion takes place between two contacting glass plates and within plastic wrapping. Good immunoelectrophoretograms can be obtained with standard clinical laboratory equipment and minimal amounts of costly antisera, and without special skills.
Requirements for marketing authorization of antiretroviral drugs

The technical requirements for marketing authorization of antiretroviral drugs are very important,and they are urgently demanded in China now.This article introduced FDA's and EMEA's consideration on this aspect,hoping to give some suggestions for investigation and approval of antiretroviral drugs in China.
Femtosecond Studies of Colloidal Metal Nano-Particles

Metal nano-particles have interesting electronic and optical properties relative to bulk metals due to their small size and extremely large surface-to-volume ratio. Of fundamental importance are the effects of particle size and surface on the electronic relaxation dynamics. Our recent studies of Ag and Au colloidal particles have established, at a qualitative level, that the small size renders electronic relaxation slower than in bulk while the large surface area, coupled with surface adsorbates and defects, facilitates electronic relaxation. To understand the size dependence and surface dependence of electronic relaxation at a quantitative level, we have extended the study to Au particles in a broader range of sizes and in organic solvents and to Pt particles. In this paper we report new results that provide further insight into the influence of particle size and the liquid-solid interface on electronic relaxation in metal nano-particles.
Photodegradation of UV filters oxybenzone and sulisobenzone in wastewater effluent and by dissolved organic matter

Organic UV-filters are key ingredients found in sunscreens, cosmetics and plastic goods. Concerns have been raised about potential ecological and human health effects of certain organic UV filters that are currently FDA approved for use in the United States. Here, we investigate the photochemical fate of two of these compounds, oxybenzone and sulisobenzone. Both oxybenzone and sulisobenzone have previously been detected in surface waters, seawater, and treated wastewater effluent. Direct photolysis is found to be unimportant for these compounds, however, enhanced photodegradation of oxybenzone and sulisobenzone was observed under simulated solar irradiation in solutions of International Humic Substance Society standards (Pony Lake fulvic acid and Suwannee River natural organic matter), filtered wastewater effluent (Southerly Wastewater Treatment Plant in Lockbourne, OH), and Scioto River water (Columbus, OH) at pH 7. Quenching experiments with isopropanol revealed that the main pathway for degradation appears to be reaction with the hydroxyl radical (OH). Observed degradation rates were 2–3 times slower than estimates calculated using literature reported second-order rate constants and measured hydroxyl radical steady-state concentrations for Suwannee River natural organic matter, Pony Lake fulvic acid and Scioto waters. The Southerly sample, however, exhibited nearly identical expected and observed rate constants, which we take to indicate the presence of unidentified reactive species that can react with oxybenzone and sulisobenzone. Values obtained in this work were used to calculate second-order rate constants for oxybenzone and sulisobenzone with the hydroxyl radical, as well as to estimate environmental half-lives for these compounds. Near surface 24-h averaged half-lives of 3.0 and 4.0 days were calculated for oxybenzone and sulisobenzone, respectively. When extrapolated to an environmentally representative water column, these same 24-h averaged half-lives increased to 2.4 and 3.5 years, respectively.
Research: How to Set Up a Research Project

An academic career in surgery is associated with new discovery, teaching the new generation, and affecting health reform, as well as nurturing personal and professional development. Commencement of an academic career is not clearly defined and can be challenging, thus mentorship is often necessary. This chapter helps to cover the basics of how to start an academic career. It describes how to start a research project and identify topics for new research, including how to develop a protocol and obtain permission to conduct research at the institutional level. In addition, it lists what resources one will need to be successful and how to obtain sources of funding, from governmental grants to private funding. This information is geared toward new faculty in order to help them start an academic career.
Hypertension in Women: Recent Advances and Lingering Questions.

Cardiovascular disease (CVD) is the leading cause of death in women in every major developed country and most emerging countries.1,2 Hypertension, the most common modifiable risk factor for CVD, is estimated to occur in 85.7 million adults in the United States (44.9 million women and 40.8 million men).3 Elevated blood pressure (BP) >140/90 mm Hg is associated with a shorter life expectancy overall, shorter life expectancy free of CVD, and more years lived with CVD.3–5 Hypertension is less common in women, compared with men, in those younger than 65 years of age, but is more common in elderly (65 years and older) women than men. In the United States, between 2011 and 2014, the prevalence of hypertension in women and men by age group was 8% versus 11% (20–34 years), 23% versus 23% (35–44 years), 33% versus 36% (45–54 years), 56% versus 58% (55–64 years), 66% versus 64% (65–74 years), and 81% versus 73% (≥75 years).3 Globally, the prevalence of hypertension differs between sexes. Mills et al6 conducted a systematic analysis of population-based studies from 90 countries with 968 419 individuals to estimate the prevalence of hypertension in various countries grouped by income. Women in middle-/low-income countries, across all age groups, had a higher prevalence of hypertension compared with high-income countries. Awareness rates were higher in women than in men in both high-income countries (72% women versus 62% men) and middle-/low-income countries (45% women versus 31% men). Furthermore, women in both high-income countries (62% women versus 49% men) and middle-/low-income countries (36% women versus 22% men) reported a higher rate of antihypertensive medication use compared with men, and hypertension control rates (BP <140/90 mm Hg) were higher in women than in men in both high-income countries (52% women versus 49% men) and middle-/low-income countries …
Dynamic enhancer function in the chromatin context

Enhancers serve as critical regulatory elements in higher eukaryotic cells. The characterization of enhancer function has evolved primarily from genome-wide methodologies, including chromatin immunoprecipitation (ChIP-seq), DNase-I hypersensitivity (DNase-seq), digital genomic footprinting (DGF), and the chromosome conformation capture techniques (3C, 4C, and Hi-C). These population-based assays average signals across millions of cells and lead to enhancer models characterized by static and sequential binding. More recently, fluorescent microscopy techniques, including fluorescence recovery after photobleaching, fluorescence correlation spectroscopy, and single molecule tracking (SMT), reveal a highly dynamic binding behavior for these factors in live cells. Furthermore, a refined analysis of genomic footprinting suggests that many transcription factors leave minimal or no footprints in chromatin, even when present and active in a given cell type. In this study, we review the implications of these new approaches for an accurate understanding of enhancer function in real time. In vivo SMT, in particular, has recently evolved as a promising methodology to probe enhancer function in live cells. Integration of findings from the many approaches now employed in the study of enhancer function suggest a highly dynamic view for the action of enhancer activating factors, viewed on a time scale of milliseconds to seconds, rather than minutes to hours. WIREs Syst Biol Med 2018, 10:e1390. doi: 10.1002/wsbm.1390 This article is categorized under: Analytical and Computational Methods > Computational Methods Laboratory Methods and Technologies > Genetic/Genomic Methods Laboratory Methods and Technologies > Imaging.
The Double Asteroid Redirection Test (DART) mission electric propulsion trade

Mitigation of a hazardous NEO can be accomplished by deflecting it so that it misses the Earth. Strategies to deflect an asteroid include impacting it with a spacecraft (a kinetic impactor), pulling it with the gravity of the mass of a spacecraft (a gravity tractor), using the blast of a nearby nuclear explosion, and modifying the surface or causing ablation by various means including lasers or particle beams. None of these approaches has been tested on a NEO. The AIDA mission is a proposed international collaboration to demonstrate kinetic deflection, the most mature technique for mitigating the impact hazard of a Near Earth Object (NEO). AIDA consists of two mission elements, the NASA Double Asteroid Redirection Test (DART) mission and the ESA Asteroid Impact Mission (AIM). The main objectives of the DART mission, which includes the spacecraft kinetic impact and an Earth-based observing campaign, are to: • Perform a full scale demonstration of the spacecraft kinetic impact technique for deflection of an asteroid, by targeting an object large enough to qualify as a Potentially Hazardous Asteroid (that is, larger than 100 m); • Measure the resulting asteroid deflection, by targeting the secondary member of a binary NEO and measuring the period change of the binary orbit; • Understand the hypervelocity collision effects on an asteroid, including the long-term dynamics of impact ejecta; validate models for momentum transfer in asteroid impacts, inferring physical properties of the asteroid surface and sub-surface. The DART target is the secondary member of the binary asteroid 65803 Didymos, with the impact scheduled to occur in September, 2022. The DART impact on the secondary member of the Didymos binary at ∼7 km/s will alter the binary orbit period by at least 4 minutes, assuming a simple transfer of momentum to the target. The period change may be significantly greater, as the momentum transferred to the target asteroid may exceed the incident momentum of the kinetic impactor, possibly by a large factor. The AIM spacecraft will characterize the asteroid target and monitor results of the impact in situ at Didymos, but the period change can be determined accurately solely with ground-based observatories, an approach that is only feasible because of the choice of a binary system as target. DART held its Mission Concept Review on May 21, 2015. At MCR, the DART concept had only expensive and potentially risky launch options. During Phase A, the project explored the possibility of being a secondary payload on a commercial Geosynchronous Transfer Orbit (GTO) launch with electric propulsion (EP) as an approach to reduce mission cost, eliminate the launch vehicle risk, and demonstrate the NASA Evolutionary Xenon Thruster (NEXT) engine. NASA determined that DART would use this approach, and the EP-based concept was presented at the DART System Requirements Review on Aug 30, 2016. This paper summarizes the trade that resulted in adoption of the new design.
The Rule of Freedom: Rabelais, Bakhtin, Abhinavagupta

Transgressive laughter is best understood through the principle of ‘freedom’ (svātantrya), the central concern of Rabelais, Bakhtin, and Abhinavagupta. The medieval Christian dispensation revolved around the opposition, alternation, and complementarity between the stern, ascetic, otherworldly spiritual ideal of the Church and the periodic extended license of the popular carnival that rejuvenated this world of piety by rendering it topsy-turvy. Through Rabelais, the unschooled obscene clamor of the primordial folk found unvarnished expression in early Renaissance literature. Even while cultivating a superior and exclusive literate world, the medieval elites had fully participated in the unseemly carnivalesque laughter. Age-old festivals parodying and profaning ecclesiastical rites held in the vicinity of, and with the implicit sanction of, the Church were officiated by the lower clergy. As Bhairava-incarnate, Abhinavagupta’s praxis of transgressive sacrality offers a more adequate framework for understanding the still Christian project formulated by Rabelais through the Abbey of Theleme: “Do what thou wilt!”.
Kinematic fixtures to enable multi-material printing and rapid non-destructive inspection during two-photon lithography

Abstract Two-photon lithography (TPL) is a polymerization based technique that enables additive manufacturing of millimeter scale parts with submicron features. TPL equipment is often based on retrofitted optical microscopes that lack precise registration capabilities. Consequently, slow and error-prone visual alignment to fiducials is necessary if registration to pre-existing features is required. Herein, we have designed, built, and tested precise kinematic fixtures that are repeatable to within ±315 nm (3σ value) and passively register the build surface to TPL equipment with an accuracy of ±1.7 μm. This enables one to sequentially print with multiple materials by building the structures directly on top of the kinematic fixtures. In addition, the same fixtures passively register to an X-ray computed tomography (CT) system to enable non-destructive 3D inspection that is integrated with the fabrication process. These fixtures (i) provide a practical means to handle micro-scale parts during non-destructive imaging, (ii) reduce the set-up time for X-ray CT from more than an hour to less than a few minutes, and (iii) eliminate operator uncertainty from the multi-material printing and imaging process. As such, these fixtures enable new printing and imaging functionalities that are critical for high-quality additive manufacturing of multi-material polymer parts with microscale and submicron features.
Potential interferences in certain pesticide residue analyses from organochlorine compounds occurring naturally in plants.

Analytical determination of residual amounts of pesticides applied for the protection of livestock or crops is beset with a multitude of problems resulting from interfering substances. Cleanup procedures attempt to separate and concentrate the sought-for-chemical in usually submicrogram amounts from the thousands of other organic compounds present in the sample extractives. Segregation of the pesticide residue is rarely complete and the final analytical sample still usually contains a mixture of components. When a nonspecific analytical procedure is used, naturally occurring substances can grossly interfere in the determination of the applied chemical. This was clearly shown by Gunther et al. ( 1966) in the determination of organochlorine pesticide residues in plants by total combustion followed by direct potentiomet-ric titration of the released chloride ion. The interfering substances were identified as chloride salts of lecithins, a class of phospholipids universally distributed in all living organisms. These lecithin chlorides accompanied the pesticide residues through all the normal organic-solvent extraction and cleanup procedures and were determined as pesticide in the quantitation step. If the same determinations were made by gas chromatography (Gunther and Barkley 1966), the lecithin chlorides did not interfere since they were nonvolatile.
Improvement of the Nutritional Quality of Legume Proteins with Special Emphasis on Soybean Protein

Legume seeds are an important source of protein for humans and domestic animals, but the protein is not efficiently utilized because of a deficiency of methionine and cyst(e)ine. Efforts to improve the nutritional quality of legume seed protein has focused on the storage proteins and protease inhibitors. Possible ways of improving legume seed quality include: 1) finding high-methionine cultivars; 2) increasing the level of the larger storage protein and decreasing the amount of the smaller storage protein; 3) inserting storage proteins genes modified to code for more methionine into the genome; 4) inserting a high-methionine gene into the genome. A search for high-methionine cultivars has not been successful. It has been possible to increase the content of the larger storage protein which has more methionine with a concomitant decrease in the smaller storage protein. No one has reported inserting high-methionine genes into a legume genome, though it has been accomplished with tobacco. It has also been possible to raise the content of Bowman-Birk protease inhibitor in soybean and thus increase cyst(e)ine content.
Successful Use of Female Donors in Heart Transplantation: A Single Center Experience

Purpose Female donors are underutilized in heart transplantation, primarily due to data showing that using female donors for male recipients leads to increased mortality. Starting in 2015, our program utilized a more liberal donor policy including greater acceptance of female donors in an attempt to increase transplant volume. Our purpose was to assess the characteristics of female donors and resulting 1-year survival in heart transplant recipients. Methods We retrospectively identified 125 patients (80% male) who underwent heart transplantation at our institution from January 2015 to September 2017. Recipients were divided into 2 groups based on whether they received a female donor or male donor. Baseline characteristics for both donors and recipients were recorded. The primary endpoint was 1-year survival. Results Female donors were used in 53 heart transplant recipients (42% of total population). Clinical characteristics and results are shown in the table (*p Conclusion Female donors were used successfully in heart transplant recipients with excellent 1-year survival. Using larger and oversized female donors may have been one factor in mitigating the possible increased risk of using these donors, particularly in male recipients.
Feeding ecology of salmon in eastern and central Gulf of Alaska

Abstract Diet habits of five Pacific salmon species caught in the marine waters of the eastern and central regions of the Gulf of Alaska (GOA) were analyzed for spatial, interannual, seasonal, and ontogenetic differences. By making comparative analysis of diet variability over several years and marine conditions, between the eastern and central GOA ecosystems, during summer and fall, and between juvenile and adult salmon, we add to the understanding of the role of salmon in the GOA ecosystem. Diet composition differences were significant between all salmon/age-class pairs except for juvenile pink and sockeye salmon (no diet difference). The diets with the strongest separation (difference) were between either piscivorous salmon (Chinook or coho) and any planktivorous salmon (chum, sockeye or pink). Interannual differences in diet were also prevalent (all tested pairs were significant), followed by size-based ontogenetic diet changes between juveniles and adults, seasonal differences, and regional differences (eastern vs. central GOA). Lower and upper trophic level productivity in the GOA varied over the study period which influenced the type and amount of prey available to both piscivorous and planktivorous salmon. The year 2011 was an anomalously low production year in the GOA and this was reflected in poor feeding rate (stomach fullness) and condition factor. In contrast, foraging conditions during 2013 allowed for a positive condition factor for all juvenile salmon across the GOA even with low stomach fullness. Juvenile salmon in 2012 and 2014 had average feeding rates and condition factor. Interannual differences in the type of prey consumed, feeding rate, and condition factor often co-varied across region. These findings suggest that juvenile, immature, and maturing salmon growth and condition can be influenced by bottom-up forces in the ocean which may ultimately affect run timing and survival rate.
JAK2 V617F Mutation Allele Burden (MAB) and Its Correlation with Hematologic Characteristics in Myeloproliferative Neoplasms

Abstract Detection of the JAK2 V617F somatic mutation has become standard care for diagnosing myeloproliferative neoplasms (MPN), including polycythemia vera (PV), essential thrombocythemia (ET) and primary myelofibrosis (PMF). However, quantitation of V617F mutation allele burden (MAB) is not routinely evaluated, and the V617F MAB data are less frequently reported in the United States MPN population. We studied the correlation between V617F MAB and hematologic characteristics in our South Texas MPN patient population using a clinically validated allelic discrimination quantitative PCR (AD-qPCR) assay. DNA was extracted from blood or bone marrow (BM) samples using the EZ1 DNA Blood Kit (Qiagen). AD-qPCR was performed on the ABI Prism 7900HT Sequence Detection System using TaqMan MGB probes (Applied Biosystems). The quantity of V617F MAB was determined by the comparative CT method (ΔΔCt method). The type of MPN, complete blood count (CBC) data, and clinical status were correlated with the V617F MAB. CBC data were collected on or near the date of JAK2 V617F MAB testing. Correlation and means comparison between V617F MAB and clinical data were analyzed by the Pearson correlation coefficient and t - Test, respectively. Of 638 blood and BM samples tested for V617F MAB due to clinical suspicion of MPN, 43 patients with detectable V617F allele and available hematologic data were included in this study. Fifteen of 43 patients had more than one specimen tested for the V617F MAB. For each of these 15 patients, only one representative V617F MAB result was included in this study. Among 43 MPN patients, 21 were diagnosed as PV, 18 ET, 4 myelofibrosis (3 PMF and 1 PV that progressed to fibrotic stage). Overall, the mean V617F MAB is higher in PV patients than ET patients (37.5% versus 19.2%). The mean V617F MAB of the 4 myelofibrosis patients is 55.2%. In PV patients, V617F MAB is positively correlated to hematocrit (HCT) level (R=0.72, P 50%. Compared to patients with lower V617F MAB ( 50%) have significantly higher HCT, RBC, HGB, and WBC (Table 1) count. In ET patients, V617F MAB is positively correlated to RBC (R=0.61, P 20%) versus those with lower V617F MAB ( Our study indicates that in PV patients, the V617F MAB was positively correlated with HCT, RBC, HGB as well as WBC, and a MAB greater than 50% reflected a more severe disease status. For ET and PMF, a larger scale study is needed to draw meaningful conclusions. Our data from a South Texas MPN population supports that JAK2 V617F MAB may provide meaningful insight into the clinical status of PV patients. Download : Download high-res image (181KB) Download : Download full-size image Disclosures No relevant conflicts of interest to declare.
Use of Cardiopulmonary Bypass for Treatment of Malignant Hyperthermia.

Abstract MALIGNANT HYPERTHERMIA (MH) is a well-described and known complication of modern anesthesia, with volatile anesthestics and succinylcholine recognized as triggering agents. Incidence rates vary, but it is estimated to occur in 1:50,000-100,000 individuals undergoing general anesthesia 1. The authors present a case of a patient undergoing a surgical mitral valve replacement who develops Malignant Hyperthermia during separation from cardiopulmonary bypass (CPB}, with urgent return to CPB as a method for the successful treatment of hyperkalemia, hyperthermia, acidemia and hypercarbia. This suggests the potential for CPB or Extracorporeal Membrane Oxygenation (ECMO) as a possible treatment for the symptoms of MH. Consent was obtained from the patient prior to submission of this case report.
Conflicts of Interest and Academic Research

This chapter discusses financial conflicts of interest in academic research. After exploring the definition of conflicts of interest, the chapter focuses on the manner in which conflicts are addressed by policies promulgated by the U.S. federal government, research institutions and scholarly journals. It concludes with suggestions for further research and policy analysis.
Management of Patient with Pituitary Tumor (Cushing’s Disease)

Transsphenoidal surgery (TSS) is performed in removal of the majority of pituitary tumors, although transcranial surgery may be needed in the case of a large pituitary tumor with no or a minor intrasellar component present. Careful review of preoperative imaging studies, endocrinological profiles, neurological deficits, and systemic involvements secondary to abnormal hormone secretion is essential. It is important to understand the anatomical boundaries encountered during TSS, especially those nerves and vasculatures at risk of injury. The main goals of intraoperative anesthetic management are to maintain hemodynamic stability and cerebral perfusion, facilitate surgical exposure, and ensure a prompt emergence for neurological examination. It is critical to avoid any maneuvers that might add positive pressure to nasopharyngeal airway for the risk of cerebrospinal fluid leak and subsequent meningitis postoperatively. Diabetes insipidus may occur in PACU and warrants prompt workup and treatment.
40 – Ligand-Gated Ion Channels

Publisher Summary This chapter discusses ligand-gated ion channels, which are membrane proteins that are fundamental signaling molecules in neurons. The chapter is divided into three topic areas. The first topic briefly reviews the categories of ligand-gated ion channels. The basic physiological properties and general molecular structure of the ligand-gated channels are then discussed using examples from the muscle nicotinic acetylcholine receptor (AChR) and the N-methyl-D-aspartate (NMDA)-type glutamate receptor. The third section reviews the features of neuronal ligand-gated channels that are responsible for fast synaptic transmission, with an emphasis on the distinctive characteristics of each class of channel. The molecules are localized in the plasmalemma and on intracellular organelles and can be gated by both intracellular and extracellular ligands. Studies using the technique of voltage and patch-clamp recording have examined the three basic features of an ion channel—gating, conductance, and selective permeability. Ligand-gated ion channels can be described by kinetic models involving binding of two or more ligand molecules that induce a conformational change in the protein. Many of the genes coding for these channels have been cloned. The primary structure of the ACh, GABA and glycine channel subunits, deduced from the primary amino acid sequence, is highly homologous. Glutamate channels comprise a separate, but related family of channel subunits. Each of the neurotransmitter-gated channels appears to comprise of a hetero-oligomeric complex, which is comprised of four or five closely related subunits surrounding a central ion pore. AChR subunits have four transmembrane domains with the second transmembrane domain lining the pore. The glutamate subunits have three transmembrane domains and a re-entrant loop domain that forms a portion of the pore. Ligand-gated ion channels are also highly regulated by allosteric and covalent modifications. Allosteric regulation constitutes an important mechanism for drug action in the brain. Recent progress in the study of ligand-gated ion channel function and structure has answered many long-standing questions, but has also raised many new and interesting issues concerning the function of this important class of membrane proteins.
Comparison of Parotidectomy With Observation for Treatment of Pleomorphic Adenoma in Adults.

Importance There is no consensus regarding optimal management of pleomorphic adenoma in adults. Objectives To compare parotidectomy with observation for the management of pleomorphic adenoma in patients 50 years or older by age. Design and Setting This decision analytical model was performed from November 21, 2019, to June 15, 2020, using a Markov model. Model variables and ranges were selected based on a literature review. A 1-way sensitivity analysis was performed to evaluate the age threshold at which each algorithm, either upfront elective parotidectomy or observation, would be favored. A Monte Carlo probabilistic sensitivity analysis using variable ranges was then performed 5 times with patients in the model assigned a starting age of 50, 60, 70, 80, and 90 years to assess how age at diagnosis would be associated with the model results. Main Outcomes and Measures Model outcomes were measured with quality-adjusted life-years (QALYs). Results In the study models, the age thresholds at which observation became more beneficial than parotidectomy were 88.5 years for patients with superficial lobe tumors (5.37 QALYs in favor of parotidectomy below this age, and 5.37 QALYs in favor of observation above this age) and 83.4 years for patients with deep lobe tumors (7.51 QALYs in favor of surgery below this age, and 7.51 QALYs in favor of observation above this age). There was no significant difference in outcomes between parotidectomy and observation among patients aged 70 to 80 years. Conclusions and Relevance This study suggests that the outcomes associated with parotidectomy and observation are similar at 70 years or older among patients with pleomorphic adenoma and that observation may be the favorable treatment in that age group.
Telehealth, friend and foe for health care social work

The author describes her experience as a health care social worker with the proliferation of telehealth as the standard medium of intervention with patients since the onset of the COVID-19 pandemic...
The direct and indirect effects of copper on vector-borne disease dynamics.

Abstract Metal pollution is a growing concern that affects the health of humans and animals globally. Copper is an essential insect micronutrient required for respiration, pigmentation and oxidative stress protection but can also act as a potentially toxic trace element. While several studies have focused on the negative fitness effects of copper on the aquatic larvae of mosquitoes, the effects of larval copper exposure on adult mosquito fitness (i.e., survival and fecundity) and their ability to transmit parasites (i.e., vector competence) remains unclear. Here, using a well-studied model vector-parasite system, the mosquito Aedes aegypti and parasite Dirofilaria immitis, we show that sublethal copper exposure in larval mosquitoes alters adult female fecundity and vector competence. Specifically, mosquitoes exposed to copper had a hormetic fecundity response and mosquitoes exposed to 600 μg/L of copper had significantly fewer infective parasite larvae than control mosquitoes not exposed to copper. Thus, exposure of mosquito larvae to copper levels far below EPA-mandated safe drinking water limits (1300 μg/L) can impact vector-borne disease dynamics not only by reducing mosquito abundance (through increased larval mortality), but also by reducing parasite transmission risk. Our results also demonstrated that larval copper is retained through metamorphosis to adulthood in mosquitoes, indicating that these insects could transfer copper from aquatic to terrestrial foodwebs, especially in urban areas where they are abundant. To our knowledge this is the first study to directly link metal exposure with vector competence (i.e., ability to transmit parasites) in any vector-parasite system. Additionally, it also demonstrates unequivocally that mosquitoes can transfer contaminants from aquatic to terrestrial ecosystems. These results have broad implications for public health because they directly linking contaminants and vector-borne disease dynamics, as well as linking mosquitoes and contaminant dynamics.
Mobile Type VI secretion system loci of the gut Bacteroidales display extensive intra-ecosystem transfer, multi-species sweeps and geographical clustering

The human gut microbiota is a dense microbial ecosystem with extensive opportunities for bacterial contact-dependent processes such as conjugation and type VI secretion system (T6SS)-dependent antagonism. In the gut Bacteroidales, two distinct genetic architectures of T6SS loci, GA1 and GA2, are contained on integrative and conjugative elements (ICE). Despite intense interest in the T6SSs of the gut Bacteroidales, there is only a superficial understanding of their evolutionary patterns, and of their dissemination among Bacteroidales species in human gut communities. Here, we combine extensive genomic and metagenomic analyses to better understand their ecological and evolutionary dynamics. We identify new genetic subtypes, document extensive intrapersonal transfer of these ICE to Bacteroidales species within human gut microbiomes, and most importantly, reveal frequent population sweeps of these newly armed strains in multiple species within a person. We further show the distribution of each of the distinct T6SSs in human populations and show there is geographical clustering. We reveal that the GA1 T6SS ICE integrates at a minimal recombination site leading to their integration throughout genomes and their frequent interruption of genes, whereas the GA2 T6SS ICE integrate at one of three different tRNA genes. The exclusion of concurrent GA1 and GA2 T6SSs in individual strains is associated with intact T6SS loci and with an ICE-encoded gene. By performing a comprehensive analysis of mobile genetic elements (MGE) in co-resident Bacteroidales species in numerous human gut communities, we identify 177 MGE that sweep through multiple Bacteroidales species within individual gut microbiomes. We further show that only eight MGE demonstrate multi-species population sweeps in as many human gut microbiomes as the GA1 and GA2 ICE. These data underscore the ubiquity and rapid dissemination of mobile T6SS loci within Bacteroidales communities and across human populations.
Language and Sentiment Regarding Telemedicine and COVID-19 on Twitter: Longitudinal Infodemiology Study.

Background: The COVID-19 pandemic has necessitated a rapid shift in how individuals interact with and receive fundamental services, including health care. Although telemedicine is not a novel technology, previous studies have offered mixed opinions surrounding its utilization. However, there exists a dearth of research on how these opinions have evolved over the course of the current pandemic. Objective: This study aims to evaluate how the language and sentiment surrounding telemedicine has evolved throughout the COVID-19 pandemic. Methods: Tweets published between January 1, 2020, and April 24, 2021, containing at least one telemedicine-related and one COVID-19–related search term (“telemedicine-COVID”) were collected from the Twitter full archive search (N=351,718). A comparator sample containing only COVID-19 terms (“general-COVID”) was collected and sampled based on the daily distribution of telemedicine-COVID tweets. In addition to analyses of retweets and favorites, sentiment analysis was performed on both data sets in aggregate and within a subset of tweets receiving the top 100 most and least retweets. Results: Telemedicine gained prominence during the early stages of the pandemic (ie, March through May 2020) before leveling off and reaching a steady state from June 2020 onward. Telemedicine-COVID tweets had a 21% lower average number of retweets than general-COVID tweets (incidence rate ratio 0.79, 95% CI 0.63-0.99; P=.04), but there was no difference in favorites. A majority of telemedicine-COVID tweets (180,295/351,718, 51.3%) were characterized as “positive,” compared to only 38.5% (135,434/351,401) of general-COVID tweets (P<.001). This trend was also true on a monthly level from March 2020 through April 2021. The most retweeted posts in both telemedicine-COVID and general-COVID data sets were authored by journalists and politicians. Whereas the majority of the most retweeted posts within the telemedicine-COVID data set were positive (55/101, 54.5%), a plurality of the most retweeted posts within the general-COVID data set were negative (44/89, 49.4%; P=.01). Conclusions: During the COVID-19 pandemic, opinions surrounding telemedicine evolved to become more positive, especially when compared to the larger pool of COVID-19–related tweets. Decision makers should capitalize on these shifting public opinions to invest in telemedicine infrastructure and ensure its accessibility and success in a postpandemic world.
The role of dyadic interactions in the mixed-mating strate- gies of the mangrove rivulus Kryptolebias marmoratus

The mangrove rivulus Kryptolebias marmoratus a small cyprinodont fish native to tropical and subtropical waters from Florida to Brazil, is one of two known self-fertilizing, hermaphroditic vertebrates of which K. marmoratus displays an- drodioecy, a complex system of reproduction in which hermaphrodites and males are present. This study describes the behavioral repertoires observed during dyadic interactions in the laboratory. Kryptolebias marmoratus exhibited 23 distinctive acts or be- haviors. Acts were divided into four categories: aggressive, submissive, neutral, and reproductive. Leading and following behav- iors played important roles in the behavioral repertoires of these fish. In hermaphrodite-male dyads, males exclusively initiated the reproductive process and actively pursued hermaphrodites. When hermaphrodites were paired, there was no evidence that they behaved like other simultaneous hermaphrodites that alternate sexual roles (e.g. serranids). Hermaphrodites were extremely ag- gressive towards one another, and the aggressor established dominance rapidly. Male-male dyads were divided into two subdivi- sions based on the presence or absence of the caudal ocellus on one fish. A caudal ocellus on one male appeared to signal the pos- sibility of a potential mating partner to males lacking it. Pairings of males without an ocellus were similar to hermaphro- dite-hermaphrodite dyads in that both members of the pair were aggressive towards one another. These observations may be in- dicative of interactions taking place in natural communities or assemblages of fish in which both males and hermaphrodites occur and provide evidence on the role of dyadic interactions in the mixed-mating strategies (Current Zoology 56 (1): 6-17, 2010).
Chapter 23 HHV-6: response to antiviral agents

Publisher Summary Human herpesvirus-6 (HHV-6) was originally isolated from patients with acquired immunodeficiency syndrome (AIDS) and a variety of lymphoproliferative disorders, as well as from normal individuals. This chapter discusses the information that has been developed concerning the response of HHV-6 to antiviral agents, problems that are associated with determining the sensitivity of HHV-6 and approaches that should be taken these types of studies. It is apparent that while some progress has been made, there is a considerable amount of research that needs to be done to determine the response of HHV-6 to antiviral agents. This chapter also discusses the studies directed towards determining the response of HHV-6 to antiviral agents. These studies focus on an antiviral agent that has been demonstrated to be effective in treating infections caused by various herpesviruses and HIV-1. These compounds are phosphonoacetic acid, phosphonoformic acid, azidothymidine, acyclovir, and ganciclovir. A diagrammatic representation of these compounds has also been shown in the chapter.
Factors Related to Dryland Grain Sorghum Yield Increases: 1939 through 1997

Grain yields of dryland (nonirrigated) grain sorghum [Sorghum bicolor (L.) Moench], a major crop in the southern Great Plains, more than tripled in studies at the USDA-ARS Conservation and Production Research Lab., Bushland, TX, during the period from 1939 to 1997. Our objectives were to document the yield increases that occurred and to determine factors primarily responsible for the yield increases. Factors evaluated were annual precipitation, growing-season rainfall, soil water content at planting, soil water use, growing-season evapotranspiration, and year of record. For the report, we assembled 502 treatment-years of grain yield data from 37 studies. For the 1939-1997 period, grain yields increased about 50 kg ha -1 annually. Yields increased 139% during the 1956-1997 period, with 46 of those percentage units resulting from use of improved hybrids, based on results of a uniformly managed 40-year study. The remaining 93 percentage units for that period were attributed to other factors, primarily to soil water at planting. Increases in soil water at planting resulted from changes in management practices with time, mainly the adoption of improved crop residue management practices after about 1970.
Presumptive Criminals: U.S. Criminal Law and HIV-Related Aggravated Assaults

In choosing to criminalize the attempted spread of the Human Immunodeficiency Virus (HIV), several United States jurisdictions not only ignore the public health harms associated with their draconian approach, but also commit logical and due process errors in their prosecutions, thus discriminating against the HIV-positive population. In this chapter, I consider a common case where jurisdictions use aggravated assault—an assault by means likely to produce grievous bodily harm or death. By looking at several cases in depth, I show that certain courts use a guilt-by-association rule, sweeping in all HIV-positive individuals under the criminal law regardless of the likelihood of transmission, which is a key element in any aggravated assault charge. Many courts do not distinguish between those who have high viral loads and those who virtually cannot transmit the disease at all—namely, those who are on highly active antiretroviral therapy, have an undetectable viral load, use condoms, and have no sexually transmitted infections. The chapter concludes by highlighting the discriminatory effect of criminalization.