cssi/SciSciGPT-SciSciNet huggingface dataset:
Rapidly evolving myopathy with myosin-deficient muscle fibers

Five patients with rapidly evolving, severe weakness had an unusual myopathy with virtually complete loss of myosin in 5 to 40% of muscle fibers. Three of the 5 patients began to develop weakness 1 to 2 weeks after lung transplantation. The fourth became weak after a febrile illness. The fifth presented with diabetic ketoacidosis and weakness. All patients had received corticosteroid therapy. In all cases the weakness was progressive and led to severe disability, with respiratory failure in 4 patients. Initial diagnostic testing did not localize an underlying cause for the weakness. Creatine kinase was normal or minimally elevated. Electromyography generally showed mildly myopathic or nondiagnostic changes. However, muscle biopsy revealed numerous small angular fibers with no myosin ATPase staining at any pH. Immunocytochemical staining and ultrastructural studies confirmed a severe loss of myosin in many fibers. This rapidly evolving myopathy with myosin-deficient muscle fibers appears to be different clinically and pathologically from previously described syndromes involving rapidly progressive weakness. Slow recovery over a period of months is the most common outcome.
Cluster assembly of hierarchical nanostructures

In the past few years, atom clusters with diameters in the range of 2–20 nm of a variety of materials, including both metals and ceramics, have been synthesized by evaporation and condensation in high-purity gases and subsequently consolidated in situ under ultrahigh vacuum conditions to create nanophase materials. These new ultrafine-grained materials have properties that are often significantly different and considerably improved relative to those of their coarser-grained counterparts owing to both their small grain-size scale and the large percentage of their atoms in grain boundary environments. Since their properties can be engineered during the synthesis and processing steps, cluster-assembled materials appear to have significant potential for the introduction of a hierarchy of both structure and properties. Some of the recent research on nanophase materials related to properties and scale are reviewed and some of the possibilities for synthesizing hierarchical nanostructures via cluster assembly are considered.
Less Than Total Excision of Infected Prosthetic PTFE Graft Does Not Increase the Risk of Reinfection.

Background:Traditional treatment of infected polytetrafluoroethylene (PTFE) grafts consist of removal of the entire prosthesis. Closure of the native vessels may compromise vascular patency. We examined the outcomes for patients in whom a PTFE remnant of an infected graft was retained on the vessel.Methods:We reviewed the operating room log from 2000 to 2011 and identified all patients who had partial removal of an infected PTFE graft used for hemodialysis or peripheral bypass. These patients were examined for subsequent complications.Results:Twenty-seven patients underwent 30 partial graft excisions with mean follow-up of 27 months. A total of 17% (5 of 30) of the partial graft resection procedures resulted in complications. Of 48 total remnants left behind at the arterial or venous anastomoses, reinfection occurred in 15%.Conclusions:Leaving a well-incorporated small 1-to 5-mm PTFE remnant at the arterial or venous anastomoses can be performed safely with a low risk of complications.
Potential Exploration Targets for Roxby Downs-Olympic Dam Type Mineral Deposits: ABSTRACT

The Olympic Dam deposit near Roxby Downs, central South Australia, appears to be another type of sediment-hosted stratabound ore deposit. It contains copper, gold, silver, uranium, and rare earths, and in terms of present market prices, is valued at over $100 billion, making it one of the world's most valuable deposits. When brought on line in 1988, the projected production of 4,000 tons/year of U3O8 as a by-product will have a significant impact on the world uranium market. The deposit is hosted in middle Proterozoic rocks in a deep, small basin within the Gawler craton, and is overlain by 350 m (1,148 ft) of unmineralized late Proterozoic miogeoclinical Adelaidean sediments on the Stuart shelf. The nearest host rocks are no closer than 150 km (93 mi). According to Western Mining Corporation, the discovery resulted from regional considerations, with target selection being decided by nearly superimposed gravity and magnetic highs identified from detailed geophysical studies. The present study is a synthesis and integration of large amounts of geological, geophysical, and geochemical data available from the South Australian Department of Mines and Energy, mining companies, and universities. The presence of a probable analog deposit at Mt. Painter, approximately 270 km (168 mi) east-northeast of Olympic Dam, available for field study and sampling, makes possible the testing of ideas and hypotheses. The exposed Gawler craton and surface and drill core samples from Mt. Painter have supplied materials for further study. Plate tectonic reconstructions of the Gawler craton make it possible to apply Olympic Dam genetic models to other continents. The present study undertakes this application to the United States resulting in several areas being interesting targets. End_of_Article - Last_Page 853------------
Effects of heartbeat and respiration on macaque fMRI: Implications for functional connectivity

The use of functional magnetic resonance imaging (fMRI) in non-human primates is on the increase. It is known that the blood-oxygen-level-dependent (BOLD) signal varies not only as a function of local neuronal energy consumption but also as a function of cardiac and respiratory activity. We mapped these cyclic cardiac and respiratory artifacts in anesthetized macaque monkeys and present an objective analysis of their impact on estimates of functional connectivity (fcMRI). Voxels with significant cardiac and respiratory artifacts were found in much the same regions as previously reported for awake humans. We show two example seeds where removing the artifacts clearly decreased the number of false positive and false negative correlations. In particular, removing the artifacts reduced correlations in the so-called resting state network. Temporal bandpass filtering or spatial smoothing may help to reduce the effects of artifacts in some cases but are not an adequate replacement for an algorithm that explicitly models and removes cyclic cardiac and respiratory artifacts.
Nitric oxide stimulates the activity of a 72-kDa neutral matrix metalloproteinase in cultured rat mesangial cells

We recently demonstrated that stimulation of inducible nitric oxide synthase (iNOS) activity reduced the accumulation of collagen and fibronectin in cultured rat mesangial cells. Therefore, we examined whether nitric oxide (NO) influenced the activity of a 72 kDa neutral matrix metalloproteinase by these cells in vitro. Enzyme activity was assessed in a biotin-avidin ELISA and by zymography. Exposure of mesangial cells to the cytokines, interferon (IFN)-gamma and lipopolysaccharide (LPS), increased gelatinolytic activity by 325 +/- 60% (P < 0.025). Co-incubation with 20 mM L-arginine caused a further increase in matrix metalloproteinase levels. Addition of L-NAME, an inhibitor of iNOS, reversed the IFN-gamma/LPS-induced rise in gelatinolytic activity. Incubation with the exogenous NO donor, S-nitroso-N-acetyl-D,L-penicillamine (SNAP), resulted in a dose dependent increase in metalloproteinase activity (P < 0.01). The NO-induced changes in metalloproteinase activity were also demonstrable by zymography. These data indicate that NO modulates the activity of a 72 kDa neutral matrix metalloproteinase and suggest that altered NO production may contribute to the development of glomerulosclerosis and tubulointerstitial fibrosis in chronic renal disease states.
Antineutrophil cytoplasmic antibodies, autoimmune neutropenia, and vasculitis.

Objectives Reports of an association between antineutrophil cytoplasmic antibodies (ANCA) and autoimmune neutropenia have rarely included cases of proven vasculitis. A case of ANCA-associated vasculitis (AAV) with recurrent neutropenia is described and relevant literature on the association between ANCA, neutropenia, and vasculitis is reviewed. Methods Longitudinal clinical assessments and laboratory findings are described in a patient with AAV and recurrent episodes of profound neutropenia from December 2008 to October 2010. A PubMed database search of the medical literature was performed for articles published from 1960 through October 2010 to identify all reported cases of ANCA and neutropenia. Results A 49-year-old man developed recurrent neutropenia, periodic fevers, arthritis, biopsy-proven cutaneous vasculitis, sensorineural hearing loss, epididymitis, and positive tests for ANCA with specificity for antibodies to both proteinase 3 and myeloperoxidase. Antineutrophil membrane antibodies were detected during an acute neutropenic phase and were not detectable in a postrecovery sample, whereas ANCA titers did not seem to correlate with neutropenia. An association between ANCA and neutropenia has been reported in 74 cases from 24 studies in the context of drug/toxin exposure, underlying autoimmune disease, or chronic neutropenia without underlying autoimmune disease. In these cases, the presence of atypical ANCA patterns and other antibodies were common; however, vasculitis was uncommon and when it occurred was usually limited to the skin and in cases of underlying toxin exposure. Conclusions ANCA is associated with autoimmune neutropenia, but systemic vasculitis rarely occurs in association with ANCA and neutropenia. The interaction between neutrophils and ANCA may provide insight into understanding both autoimmune neutropenia and AAV.
Brief Report: In-Home Family Therapy for Adolescents with Poorly Controlled Diabetes: Failure to Maintain Benefits at 6-Month Follow-Up

Objective To examine 6-month follow-up data on the effectiveness of in-home Behavioral Family Systems Therapy (BFST) for adolescents with poorly controlled diabetes, using a pilot and feasibility study. Methods Eighteen adolescents with poorly controlled diabetes received ten 90-min sessions of in-home BFST. Diabetes-related functioning, general family functioning, and health status were assessed at baseline, immediately following treatment and 6-months after the treatment. Results Although the initial posttreatment follow-up evaluation indicated decreases in general family conflict, diabetes-related family conflict, and behavior problems, evaluation at a 6-month follow-up (N = 17) demonstrated that initial posttreatment improvements were no longer present for any of the variables assessed. Metabolic control remained unchanged from baseline to initial posttreatment as well as at 6-month follow-up. Conclusions A plausible explanation for this finding is that participating families were experiencing distress that required longer-term treatment for enduring results, beyond what was employed in this study. Further research is necessary before in-home BFST can be considered an effective psychosocial intervention for adolescents with poorly controlled diabetes.
Permanent-Magnet Helicon Discharge Array

Industrial applications of plasmas often require uniform coverage of large areas, such as in plasma coatings, display panels, and semiconductor wafers. A single source would have to be very large, but an array of small sources can be much more compact and yet cover an arbitrarily large area. Such sources can be inductively coupled plasmas (ICPs) which are powered by radio-frequency generators. Helicon-wave sources have been found to create higher plasma densities than ICPs at the same power, but these require a dc magnetic field, which normally would entail large and heavy electromagnets and their dc power supplies. Annular permanent magnets can produce helicon plasmas if used in the innovative way described here. An eight-tube array of such sources has been built and tested.
Global Software Development: Who Does It?

In today's world, software development is increasingly spread across national and geographic boundaries. There is limited empirical evidence about the number and distribution of people in a large software company who have to deal with global software development (GSD). Is GSD restricted to a select few in a company? How many time zones do engineers have to deal with? Do managers have to deal with GSD more than individual engineers? What are the benefits and problems that engineers see with GSD? How have they tried to improve GSD coordination? These are interesting questions to be addressed in an empirical context. In this paper, we report on the results of a large-scale survey of software engineers at Microsoft Corporation. We found that a very high proportion of engineers are directly involved with GSD. In addition, more than 50% of the respondents regularly collaborate with people more than three time zones away. Engineers also report that communication difficulties around coordination are the most critical, yet difficult to solve issues with GSD.
Insulin and IGF-I induce pronounced hypertrophy of skeletal myofibers in tissue culture

Skeletal myofibers differentiated from primary avian myoblasts in tissue culture can be maintained in positive nitrogen balance in a defined serum-free medium for at least 6-7 days when embedded in a three-dimensional collagen gel matrix. Incubation of established myofiber cultures for 3-7 days with insulin (1 microM) or insulin-like growth factor I (IGF-I, 32 nM) stimulates both cell hyperplasia and myofiber hypertrophy. Mean myofiber diameter increases 71-98%. Insulin-like growth factor II stimulates cell hyperplasia but not myofiber hypertrophy. Cell growth results from a 42-62% increase in total protein synthesis and a 28-38% decrease in protein degradation. Myosin heavy-chain content increases 183-258% because of a 55% stimulation of myosin synthesis and 33-61% inhibition of degradation. Associated with myofiber hypertrophy is a 87-148% increase in the number of myofiber nuclei per unit myofiber length. The results indicate that insulin and IGF-I, but not IGF-II, can induce rapid myofiber hypertrophy in vitro, most likely by stimulating myoblast proliferation and/or fusion to established myofibers.
Serine 307 on insulin receptor substrate 1 is required for SOCS3 and TNF-α signaling in the rMC-1 cell line.

Purpose To establish the key insulin receptor substrate 1 (IRS-1) structural elements required in this insulin regulatory pathway, we investigated the effects of substituting alanine for serine 307 in IRS-1 on the ability of tumor necrosis factor-α (TNF-α) and a related mediator, suppressor of cytokine signaling 3 (SOCS3), to phosphorylate IRS-1 and regulate insulin signaling in the rat retinal Muller cell (rMC-1) cell line. Methods rMC-1 cells were grown in normal (5 mM) or high (25 mM) glucose medium and transfected with either normal IRS-1(Ser307)plasmid or a mutated IRS-1(Ser307Ala) plasmid. Cells were also treated with recombinant TNF-α or SOCS3 to induce increased levels of these proteins. Results In cells with IRS-1(Ser307Ala), TNF-α and SOCS3 failed to phosphorylate IRS-1. Likewise, resulting downstream effects, including changes in phosphorylation of insulin receptor(Tyr960), antiapoptotic Akt phosphorylation, and proapoptotic cleavage of caspase 3 were also blocked. We also report for the first time that SOCS3 and TNF-α are reciprocally stimulatory leading to a mutual enhancement of levels of both factors, thus forming a potential positive feedback loop that contributes to insulin receptor resistance. Conclusions Increases in TNF-α and SOCS3 are triggered by high glucose and through reciprocal stimulation of expression of these two factors, which in turn could be major drivers of insulin resistance and related cell death. The demonstration that a single phosphorylation site is key for these pathways suggests that drugs targeted to this site might be effective in protecting against diabetic damage to the retina.
Disorders of Muscle Membranes: The Periodic Paralyses

The periodic paralyses are a group of syndromes characterized by episodic attacks of muscular paralysis, usually accompanied by changes in the potassium content of serum and skeletal muscles. These conditions can occur either spontaneously through familial inheritance or secondary to electrolyte imbalance and endocrine disorder. The exact mechanism of the paralysis has not been fully determined, but it is clear that the defect lies in the skeletal muscle itself, since it fails to contract on either indirect (nerve) or direct stimulation during the attacks.(1)
Intrapartum Neuraxial Analgesia and Breastfeeding Outcomes: Limitations of Current Knowledge

Although numerous studies have addressed the relationship between intrapartum neuraxial analgesia, particularly epidural fentanyl, and breastfeeding, substantial study design limitations have precluded the current literature from furnishing strong, clinically significant conclusions. Lack of randomized controlled trials, nonstandardization of breastfeeding evaluations across studies, and failure to control for confounding variables all pose significant problems. Further research is needed to elucidate the specific relationship between neuraxial opioids and breastfeeding and, if there are significant associations, whether these drugs act directly on neonatal brain tissue to attenuate exhibition of breastfeeding behaviors. In this review, I will detail the deficiencies of the current literature and make recommendations for future research.
Correlation of immunohistochemical markers with patient prognosis in breast carcinoma: a quantitative study.

In a series of 46 cases of primary mammary ductal carcinoma, immunohistochemical markers of differentiation (casein, human placenta] lactogen, alphalactalbumin, pregnancy specific beta-1 glycoprotein, secretory component, CEA, and peanut lectin agglutinins [PLA]), were quantitated via point–counting. An immunoperoxidase bridge (PAP) was used to identify all except the PLA, in which an avidin–biotin complex with alkaline phosphatase development was employed. For none of the markers was there any difference in the quantity present in tumors of patients who had recurred versus the tumors of patients who had enjoyed a minimum of five years disease-free survival. Nonneoplastic epithelium was only rarely positive for these markers. Although eventually surmounted, technical problems significantly hampered application of morphometry to this histochemical material. The authors conclude that these markers have little relationship to differentiation toward mammary duct epithelium and that they do not provide significant prognostic information in patients with breast cancer.
The Utilities Problem

Any problem with this many variations must have roots which go way back in history. In fact, most published references to the problem characterize it as "very ancient." However, the earliest published reference to the problem known to this author dates only as far back as 1917. In that year, the English puzzlist H. E. Dudeney included the utility problem in his book Amusements in Mathematics [3, Problem 251]. Dudeney himself characterizes the problem as "old as the hills, .... much older than electric lighting, or even gas," yet he gives no earlier sources. Sam Loyd, Jr., claimed that his father, an American contemporary of Dudeney, "brought out" the utility problem in 1900 [1, p. 142]. Loyd does not claim that his father invented the puzzle,
Theoretical and experimental investigation of matrix effects observed in emission spectra of binary mixtures of sodium and copper and magnesium and copper pressed powders

Abstract The goal of this work was to investigate the matrix effect of copper in the presence of sodium or magnesium in a laser-induced plasma. Varying amounts of copper were mixed and pressed with a constant amount of sodium or magnesium and a stearic acid binder. Experimental parameters such as delay time and laser pulse energy were varied to observe trends in the emission intensity of the Na I 588.99 nm, Na I 589.59 nm, Mg I 277.98 nm, and Mg II 279.08 nm lines. Experimental observations are supported by theoretical calculations and modeling that show the Na I and Mg I emission intensities increase in the presence of copper while the Mg II line intensity decreases due to the increase in electron density (Ne) of the plasma when copper is added. The increase in electron density changes the population of the atomic species within the plasma through an increase in recombination of ions with electrons, shifting the populations toward more neutral states, providing an explanation for the observed matrix effects found in these, and many previous, studies.
Observation of electromagnetically induced transparency

We report the results of an experiment showing how an opaque atomic transition in neutral Strontium may be rendered transparent to radiation at its resonance frequency. This is accomplished by applying an electromagnetic coupling field (Fig. 1) between the upper state 4d5d1D2 of the transition and another state 4d5p1D2; of the atom. When the Rabi frequency of the coupling field exceeds the inhomogeneous width of the 5s5p1P1–4d5d1D2; transition, the medium becomes transparent on line center.
Fountain coding for efficient TPEG data reception on data carousel transmission

TPEG is a standard which specify the traffic and travel information. This paper applies a fountain coding mechanism to DSMCC that speed up TPEG XML reception time in transmission signal unstable regions. Sometimes the broadcaster encodes TPEG services as XML format and transmitting XML based TPEG services on unidirectional data carousel transportation such as DSMCC. But in receiver, packet loss occurred when moving vehicle travels around undulating terrain or other signal unstable regions. The receiver data carousel decoder must spend a long time waiting for the specific lost received until this data packet retransmit in the next cycle. This paper proposes fountain coding mechanism on data carousel to overcome the restriction of data carousel protocol in unidirectional broadcasting environment. The experiment shows good improvement of available data block reception time which enhances the service quality of ATIS (Advanced Traveler Information Systems).
STABILITY OF MULTIPLE INLETS

A computational framework is presented to evaluate the stability of two inlets connecting the same bay to the ocean. It is assumed that both inlets are scoured in alluvial material. The main ingredients in the stability analysis are the closure surface and the equilibrium stress surface. The closure surface of an inlet is defined as the relation between the tidal maximum of the bottom stess and the cross-sectional areas of both inlets. The equilibrium stress surface of an inlet is the relation between the tidal maximum of the bottom stress and the cross-sectional area of that inlet at the time the inlet is in equilibrium with its hydraulic environment. The method is applied to Pass Cavallo and the entrance to the Matagorda Shipping channel further referred to as Matagorda Inlet. Both inlets connect Matagorda bay to the Gulf of Mexico.
Polysome Fractionation to Analyze mRNA Distribution Profiles

Eukaryotic cells adapt to changes in external or internal signals by precisely modulating the expression of specific gene products. The expression of protein-coding genes is controlled at the transcriptional and post-transcriptional levels. Among the latter steps, the regulation of translation is particularly important in cellular processes that require rapid changes in protein expression patterns. The translational efficiency of mRNAs is altered by RNA-binding proteins (RBPs) and noncoding (nc)RNAs such as microRNAs (Panda et al., 2014a and 2014b; Abdelmohsen et al., 2014). The impact of factors that regulate selective mRNA translation is a critical question in RNA biology. Polyribosome (polysome) fractionation analysis is a powerful method to assess the association of ribosomes with a given mRNA. It provides valuable information about the translational status of that mRNA, depending on the number of ribosomes with which they are associated, and identifies mRNAs that are not translated (Panda et al., 2016). mRNAs associated with many ribosomes form large polysomes that are predicted to be actively translated, while mRNAs associated with few or no ribosomes are expected to be translated poorly if at all. In sum, polysome fractionation analysis allows the direct determination of translation efficiencies at the level of the whole transcriptome as well as individual mRNAs.
In search of a resident-centered handoff tool: Discovering the complexity of transitions of care.

Abstract Introduction Transfer of a patient's care between providers is a significant potential for medical errors. Given the potential for patient safety breeches we sought to investigate residents' perceptions of handoffs at our institution. Methods Residents completed an online survey assessing the effectiveness of handoffs and what they thought was necessary for safe and informative transition communication. Thematic analysis was used to identify critical themes. Results 78% of residents reported formal training in handoff delivery. 90% stated they were effective in delivering handoffs; however they scored 41% of handoffs they received as less than effective. 11 themes emerged, the most commonly described requirement was “important events” from the previous shift. Only 16% of residents used an established formal handoff tool. Conclusions In a survey of surgical residents they view themselves as very effective at delivering handoffs, but judge nearly half of handoffs they receive as ineffective. Multiple handoff tools exist but residents rarely use them. In an era of increasing transitions of care, efforts targeting improvement of handoff effectiveness will require education beyond checklists and mnemonics.
Before the End of Apartheid

To appreciate and understand the transformation of South Africa, this chapter reviews the early 1990s, at the beginning of the end of apartheid rule. It focuses on the people who were instrumental in engineering the end of apartheid and provides a glimpse into the political landscape, the economic challenges, the condition of the higher education system, and the role of women at the time.
A 7.2 keV spherical x-ray crystal backlighter for two-frame, two-color backlighting at Sandia's Z Pulsed Power Facility.

Many experiments on Sandia National Laboratories’ Z Pulsed Power Facility—a 30 MA, 100 ns rise-time, pulsed-power driver—use a monochromatic quartz crystal backlighter system at 1.865 keV (Si He α ) or 6.151 keV (Mn He α ) x-ray energy to radiograph an imploding liner (cylindrical tube) or wire array z-pinch. The x-ray source is generated by the Z-Beamlet laser, which provides two 527-nm, 1 kJ, 1-ns laser pulses. Radiographs of imploding, thick-walled beryllium liners at convergence ratios CR above 15 [ C R = r i ( 0 ) / r i ( t ) ] using the 6.151-keV backlighter system were too opaque to identify the inner radius r i of the liner with high confidence, demonstrating the need for a higher-energy x-ray radiography system. Here, we present a 7.242 keV backlighter system using a Ge(335) spherical crystal with the Co He α resonance line. This system operates at a similar Bragg angle as the existing 1.865 keV and 6.151 keV backlighters, enhancing our capabilities for two-color, two-frame radiography without modifying the system integration at Z. The first data taken at Z include 6.2-keV and 7.2-keV two-color radiographs as well as radiographs of low-convergence (CR about 4-5), high-areal-density liner implosions.
Risk Assessment: Law, Theory, and Implementation

There are many areas of the law in which predictions of the potential for violence play a significant role. For example, United States v. Salerno (1986) discussed the issue of the potential for violence with regard to decisions made during bail hearings. Further, decisions regarding probation/parole often entail a concern for whether the person will pose a risk to others. Since the landmark case of Lessard v. Schmidt (1972), the process of civil commitment has been based on the concept of “danger to self or others” by reason of mental illness. Of the 32 states in which the death penalty is permitted, 26 of them allow information related to an individual’s potential for future violence to be presented to help the jury to determine the appropriate sentence: death or life in prison. As we shall see, the research in this area is limited in terms of the ability to predict violent behavior; yet the question—“Doctor, will this man be dangerous?”—is frequently asked of clinicians who serve as expert witnesses. Despite the paucity of research to back up the validity of such forecasts, many have no compunction about rendering their opinions.
Concurrent Pneumocystis jirovecii and pulmonary histoplasmosis in an undiagnosed HIV patient

Concurrent Pneumocystis jirovecii (PJ) and pulmonary histoplasmosis (PHP) are rare in a single HIV individual. We present a challenging case of concomitant PJ and PHP in a young HIV individual. A 44-year-old man presented to the emergency department with progressive pulmonary symptoms. He was hypoxic with bilateral pulmonary opacities on chest radiograph. CT of the chest showed a geographical pattern of ground-glass attenuation. He started receiving intravenous antibiotics in addition to oral Bactrim for suspected PJ. He also began receiving itraconazole, given suspected PHP with recent bat-droppings exposure. HIV test was positive, though history was negative; the CD4 count was 5 cells/mm3 Later, he developed respiratory failure without clinical improvement. First bronchoalveolar lavage (BAL) failed to confirm opportunistic pathogens. Repeat BAL revealed PJ but no Histoplasma. Histoplasma antigens were positive, confirming histoplasmosis. The patient died despite aggressive treatment with intravenous Bactrim and amphotericin B.
Personal Area Networks: Changing the Way We Work

This paper explores how different mobile communications technologies combined together have the potential to significantly change the way we work. Mobile telephony combining satellite and terrestrial cellular systems already has transformed the way people work by allowing “anytime, anywhere” telephone calling and text messaging. However, wireless data has not met the “anytime, anywhere” criteria due to problems with cost, power consumption, compatibility, and bit rate. Not all information should be available anytime, anywhere. The key is to provide information conveniently as quickly and easily as possible when needed and where needed. The evolution of different mobile technologies that consider different needs for timeand space-related information is providing a new capability, personal area networks (PANs), with the potential to change the way we work.
Behavioral Management of the Child with Diabetes

Insulin-dependent diabetes mellitus (IDDM) is the most common endocrine disorder of childhood. Pancreatic failure produces a disturbance in the normal insulin mechanism. This results in an inability of the body to oxidize and use carbohydrates. Onset symptoms include fatigue, excessive thirst, increased urination, and weight loss despite increased eating. Although the child’s food consumption supplies adequate blood glucose, the body is unable to utilize this sugar because of the absence of insulin and because blood glucose levels become abnormally high. The body reacts as if it is in a state of starvation and begins to break down fats. Increased urination is exhibited as the Kidneys attempt to eliminate the high levels of fatty acids. The child feels tired, weak, hungry, and thirsty (Johnson, 1984).
Diagnosis and Surgical Management of Ocular Motility Syndromes

• Children with duction deficits and abnormal head posture are likely to have an identifiable ocular motility syndrome.
Differential Wear of Enamel: A Mechanism for Maintaining Sharp Cutting Edges

Mammals are characterized by unilateral dental occlusion, complex molar patterns and highly organized enamel. The variety of molar types that evolved during the long history of mammals represents adaptations to different diets. In this chapter we wish to discuss the adaptive features of the tribosphenic molars of several insectivorous mammals.
Historical Perspective of Occupational and Environmental Lung Disease

Occupational and environmental lung disease has a long and complicated history. A more complete grasp of that history, and particularly the technological and social forces that have shaped it, better informs our understanding these issues, past, present, and going forward. Whenever a disease outbreak occurs, whether it is bronchiolitis obliterans from diacetyl use as a flavorant in microwavable popcorn or silicosis from sandblasting denim jeans or asthma from indoor air pollution due to household cleaning product use, putting these events in their historical context is critical. That context includes elements of biography related to important personages in this field, but the history of technology as it has introduced novel exposures and new risks for disease is as important to this story. So too, changing sociopolitical forces have shaped how medicine has viewed diseases in workers as well as the nature of environmental exposures. This chapter will place the story of occupational and environmental lung disease in the context of these three themes: the key historical figures that contributed to the development of the field, the technologic changes that have led to an ever-shifting burden of disease, and the sociopolitical forces that helped set priorities in the field.
Conclusions and Future Experiments

In this thesis, I describe and experimentally demonstrate various QKD protocols based on time-bin qudits that can generate a secret key at high rates, mainly relying on the greater information content of high-dimensional quantum photonic states and multiplexed single-photon detection schemes.
Differential neuroimaging indices in prefrontal white matter in prenatal alcohol-associated ADHD versus idiopathic ADHD.

BACKGROUND Attention deficit-hyperactivity disorder (ADHD) is common in fetal alcohol spectrum disorders (FASD) but also in patients without prenatal alcohol exposure (PAE). Many patients diagnosed with idiopathic ADHD may actually have ADHD and covert PAE, a treatment-relevant distinction. METHODS We compared proton magnetic resonance spectroscopic imaging (MRSI; N = 44) and diffusion tensor imaging (DTI; N = 46) of the anterior corona radiata (ACR)-a key fiber tract in models of ADHD-at 1.5 T in children with ADHD with PAE (ADHD+PAE), children with ADHD without PAE (ADHD-PAE), children without ADHD with PAE (non-ADHD+PAE), and children with neither ADHD nor PAE (non-ADHD-PAE, i.e., typically developing controls). Levels of choline-compounds (Cho) were the main MRSI endpoint, given interest in dietary choline for FASD; the main DTI endpoint was fractional anisotropy (FA), as ACR FA may reflect ADHD-relevant executive control functions. RESULTS For ACR Cho, there was an ADHD-by-PAE interaction (p = 0.038) whereby ACR Cho was 26.7% lower in ADHD+PAE than in ADHD-PAE children (p < 0.0005), but there was no significant ACR Cho difference between non-ADHD+PAE and non-ADHD-PAE children. Voxelwise false-discovery rate (FDR)-corrected analysis of DTI revealed significantly (q ≤ 0.0101-0.05) lower FA in ACR for subjects with PAE (ADHD+PAE or non-ADHD+PAE) than for subjects without PAE (ADHD-PAE or non-ADHD-PAE). There was no significant effect of ADHD on FA. Thus, in overlapping samples, effects of PAE on Cho and FA were observed in the same white-matter tract. CONCLUSIONS These findings point to tract focal, white-matter pathology possibly specific for ADHD+PAE subjects. Low Cho may derive from abnormal choline metabolism; low FA suggests suboptimal white-matter integrity in PAE. More advanced MRSI and DTI-and neurocognitive assessments-may better distinguish ADHD+PAE from ADHD-PAE, helping identify covert cases of FASD.
Long-term social dysfunction after trauma: What is the prevalence, risk factors, and associated outcomes?

Abstract Background Social functioning—the ability to participate in organized or informal family, friend, or peer groups and communal activities—is intertwined with physical and emotional health. Although trauma can have a lasting effect on both the physical and emotional well-being of patients, little is known about the long-term impact of injury on social functioning. We sought to determine the prevalence of, risk factors for, and outcomes associated with long-term social dysfunction after trauma. Methods Adults with moderate-to-severe injuries managed at three Level I trauma centers were contacted at 6 to 12 months after injury to inquire about social dysfunction. Demographics, socioeconomic parameters, and injury-related and hospital course information were also obtained. A stepwise backward logistic regression model was fitted to determine independent risk factors of social dysfunction, and multiple logistic regression models were used to determine associations between social dysfunction and post-traumatic stress disorder, functional limitations, and return to work. Results Of the 805 screened patients, 45.2% reported social dysfunction. Patients with social dysfunction were more likely to be African American, be Medicaid beneficiaries, be of lower education, require mechanical ventilation, be discharged less often to home, have a lower mean age and had longer hospital stays. In multivariable analysis, low education, longer hospital stay, past psychiatric illness, and African-American race independently increased the risk for social dysfunction. Furthermore, patients with social dysfunction were more likely to screen positive for post-traumatic stress disorder (odds ratio: 16.25 [95% confidence interval: 9.49–27.85]), be experiencing functional limitations (odds ratio: 2.80 [95% confidence interval: 1.76-4.44]), and to not have returned to work (odds ratio: 5.65 [95% confidence interval: 3.92–8.14]). Conclusion Lower educational attainment, long hospital stay, past pyschiatric illness, and African-American race appear to predispose to social dysfunction after trauma, which in turn is associated with a positive post-traumatic stress disorder screen, functional limitations, and delayed return to work.
Left ventricular adaptation following orthotopic heart transplantation in children: A speckle tracking echocardiographic imaging study

BACKGROUND Evolution of left ventricle (LV) function in the pediatric OHT population has not been well described. Our hypothesis was that, in children following OHT without any rejection, there would be progressive normalization of LV size and function over 2 years. METHODS LV function was evaluated using STE and conventional echo parameters at five time points in pediatric OHT patients without any rejection in the first 2 years following OHT and normal controls. LV global peak systolic longitudinal strain (LVPLS) and strain rate, LV peak systolic radial and circumferential strain (LVRS and LVCS), and strain rate were analyzed. RESULTS We had twenty two patients with median age at OHT of 1.27 years ( IQR 0.19, 5.6 years). The LVPLS (mean ± SD) was abnormal in the post-OHT echocardiograms at 1 week (-12.4 ± 3.7) and 1 month (-13.9 ± 3.7) and significantly improved at 6 months (-15.8 ± 3.2), 1 year (-15.7 ± 3.1), and 2 years (-17.8 ± 2.8). However, LVPLS remained below the normal group even at 2 years following OHT (-21.3 ± 1.76). CONCLUSION In children following OHT, despite the absence of rejection, strain values are significantly impaired in the initial months, improve progressively over the first 2 years but remain abnormal compared with healthy controls.
Evaluating the use of Beer's law for estimating light interception in canopy architectures with varying heterogeneity and anisotropy

Abstract Light interception in plant canopies is most commonly estimated using a simple one-dimensional turbid medium model (i.e., Beer's law). Inherent in this class of models are assumptions that vegetation is uniformly distributed in space (homogeneous) and in many cases that vegetation orientation is uniformly distributed (isotropic). It is known that these assumptions are violated in a wide range of canopies, as real canopies commonly have heterogeneity at multiple scales and almost always have highly anisotropic leaf angle distributions. However, it is not quantitatively known under what conditions these assumptions become problematic given the difficulty of robustly evaluating model results for a range of canopy architectures. In this study, assumptions of vegetation homogeneity and isotropy were evaluated under clear sky conditions for a range of virtually-generated crop canopies with the aid of a detailed three-dimensional, leaf-resolving radiation model. Results showed that Beer's law consistently over predicted light interception for all canopy configurations. For canopies where the plant spacing was comparable to the plant height, Beer's law performed poorly, and over predicted daily intercepted sunlight by up to ∼115%. For vegetation with a highly anisotropic leaf inclination distribution but a relatively isotropic leaf azimuth distribution, the assumption of canopy isotropy (i.e., G = 0.5) resulted in relatively small errors. However, if leaf elevation and azimuth were both highly anisotropic, the assumption of canopy isotropy could introduce significant errors depending on the orientation of the azimuthal anisotropy with respect to the sun's path.
Changing Climate Drives Divergent and Nonlinear Shifts in Flowering Phenology across Elevations

Climate change is known to affect regional weather patterns and phenology; however, we lack understanding of how climate drives phenological change across local spatial gradients. This spatial variation is critical for determining whether subpopulations and metacommunities are changing in unison or diverging in phenology. Divergent responses could reduce synchrony both within species (disrupting gene flow among subpopulations) and among species (disrupting interspecific interactions in communities). We also lack understanding of phenological change in environments where life history events are frequently aseasonal, such as the tropical, arid, and semi-arid ecosystems that cover vast areas. Using a 33-year-long dataset spanning a 1,267-m semi-arid elevational gradient in the southwestern United States, we test whether flowering phenology diverged among subpopulations within species and among five communities comprising 590 species. Applying circular statistics to test for changes in year-round flowering, we show flowering has become earlier for all communities except at the highest elevations. However, flowering times shifted at different rates across elevations likely because of elevation-specific changes in temperature and precipitation, indicating diverging phenologies of neighboring communities. Subpopulations of individual species also diverged at mid-elevation but converged in phenology at high elevation. These changes in flowering phenology among communities and subpopulations are undetectable when data are pooled across the gradient. Furthermore, we show that nonlinear changes in flowering times over the 33-year record are obscured by traditional calculations of long-term trends. These findings reveal greater spatiotemporal complexity in phenological responses than previously recognized and indicate climate is driving phenological reshuffling across local spatial gradients.
Achieving Quality BMT Outcomes through Multidisciplinary Collaboration and Engagement

Introduction Interprofessional Practice Model (IPM) embodies autonomy, accountability, and authority for clinicians to advocate for those they serve. Interprofessional Shared Governance (ISG) is a monthly meeting structure consisting of Point of Care Interprofessional Councils (PoC-IC), Housewide Tenets, and leadership forums. ISG supports interprofessional shared decision-making, facilitation of bi-directional communication, and collaboration between POC-IC and housewide councils. ISG influences each housewide council and PoC-IC to develop patient and family empirical outcomes that align with the strategic plan while developing leaders. Methods The Bone Marrow Transplant (BMT) unit formed an interdisciplinary PoC-IC that includes a Mentor, Operational Excellence Leaders, Chair, 6 core nursing members, and multiple interprofessional team members (Patient Care Assistant, Health Unit Coordinator, PT/OT, Nurse Practitioner, Child Life Specialist, Care Manager, Social Worker, Pharmacist, and Dietician). Members collaborate to form goals that align with the housewide direction. Mentor collaborates with the team to establish a shared decision-making process for elections and member representation. Six PoC-IC core members are responsible for attending assigned housewide tenet council meeting and reporting information back to other PoC-IC members. Results Unit dashboard, which includes defined goals and percentages and harm infection rates, are presented at the monthly BMT PoC-IC meeting. Each goal is reviewed and interventions are discussed in collaboration with the team using a unified approach. PoC-IC members contact stakeholders within each goal to define interventions for improvement. Meeting minutes, updated interventions, and status of goals and infection rates are relayed to the BMT team. Members of the PoC-IC connect with bedside team members for assistance and collaboration. BMT POC-IC has defined the following goals: 1. Sepsis Algorithm compliance (antibiotics ordered and infused within the first hour of documented fever); 2. Patient Family Experience (90% compliance with greeting families as they enter/exit the unit, physician and nursing communication to patients and families, and addressing patient's pain); 3. Safety (documentation of chlorhexidine (CHG) bathing, environmental wipe down compliance, and catheter line associated bloodstream infection (CLABSI) rate reduction). Conclusions Since the Shared Governance restructuring, the BMT PoC-IC has raised and maintained Patient and Family Experience scores greater than 90% and continues to meet the goal of 100% Sepsis Algorithm compliance. PoC-IC members continue to collaborate with bedside team members to incorporate housewide interventions to improve CHG bathing, environmental cleanliness, and CLABSI rate reduction which is currently 1.76 BSI per 1,000 catheter line days.
Chapter 21 – Electronic Tags

Publisher Summary The acquisition of thorough information on fish behaviors that shape distributions, movements, and habitat use substantially improves the value and interpretation of genetic and population data for stock management. Telemetry is an excellent, high-resolution technique to obtain behavioral information in many situations. For marine fishery species, two key aspects of telemetry systems have traditionally limited the utility of this research technique: very poor radio signal transmission in salt water, and the limited detection range (1–3km in water) of ultrasonic telemetry for open-water studies. However, the recent technological advances have circumvented these impediments for large fish, and new fishery-relevant information on well-known species is now being reported. Traditional radio and ultrasonic telemetry has had broad utility for species migrating into freshwaters or making regular movements within enclosed coastal habitats. Performance capabilities and limitations are well known, selecting equipment and procedures are typically straightforward, and proper study designs no longer need to be characterized as trial and error. Potential investigators and fishery agencies can proceed confidently with telemetry if reasonable efforts are made to review the basic information presented in the chapter, communicate with investigators experienced with similar species and habitats, and explore equipment design options with well-established suppliers. Overall, marine aquatic telemetry should be viewed as a potentially useful research technique with rapidly growing capability to understand distributions and migrations, and to reveal complexities of very specific behaviors.