cssi/SciSciGPT-SciSciNet huggingface dataset:
Diabetes Autoantibodies Mediate Neural- and Endothelial Cell- Inhibitory Effects Via 5-Hydroxytryptamine- 2 Receptor Coupled to Phospholipase C/Inositol Triphosphate/Ca2+ Pathway.

Aims To identify the G-protein coupled receptor(s) on neuroblastoma and endothelial cells which mediate neural- and endothelial cell-inhibitory effects in plasma autoantibodies from a subset of older type 2 diabetes with neurologic and vascular co-morbidity. To determine the mechanism(s) of neurite retraction induced by diabetic pathologies' auto antibodies. Methods Protein-A eluates from plasma of 11 diabetic patients having nephropathy, moderate-severe obesity and/or complications in which increased inflammation plays a role (depression, Parkinson's disease, atrial fibrillation, obstructive sleep apnea) were tested for neurite retraction and decreased survival in N2A neuroblastoma cells, and decreased survival in pulmonary artery endothelial cells. Specific antagonists of G protein coupled receptors belonging to the G alpha q subfamily of hetero trimetric G proteins or the phospholipase C/inositol triphosphate/Ca2+ pathway were tested for modulatory effects on diabetic pathologies' autoantibody-induced N2A neurite retraction, or cell survival. Results Co-incubation with specific antagonists of the 5-hydroxytryptamine- 2A receptor significantly prevented acute N2A neurite retraction induced by 50-100 nM concentrations of diabetic pathologies' autoantibodies. Protection against neurite retraction (M100907> spiperone> ketanserin) closely paralleled the antagonists' potency order at the 5-HT2-AR. Neuroblastoma or endothelial cell death (after 24 hours incubation) with 50-100 nM autoantibodies was completely or nearly completely (91%) prevented by co-incubation with 200 nM M100907, a highly selective 5-HT2-AR antagonist. Alpha-1 adrenergic, angiotensin II, metabotropic glutamate 5, or endothelin A (100 nM-10µM) receptor antagonists did not substantially inhibit autoantibody-induced cell death. The intracellular calcium chelator (BAPTA-AM, 50 µM) and inhibitors of the inositol triphosphate (IP3) receptor (2-APB, 50µM), and phospholipase C-gamma (U73144, 1µM) each significantly protected against autoantibody-induced acute N2A neurite retraction. Conclusion These data suggest that neural- and endothelial- inhibitory effects in autoantibodies from older adult diabetes with nephropathy and obesity/inflammation-associated complications are mediated by agonist autoantibodies directed against the 5-hydroxytryptamine 2 receptor positively coupled to the phospholipase C/inositol triphosphate/ cytosolic Ca2+ release pathway.
Patterns of Palliative Care Pharmacist Interventions and Outcomes as Part of Inpatient Palliative Care Consult Service.

Abstract Introduction: Palliative care uses a team approach, including physicians, nurses, social workers, chaplains, and pharmacists. The pharmacist's role within palliative care teams is increasi...
Prenatal and Developmental Toxicology of Arsenicals

A variety of species, including the human, have been shown to be susceptible to the embryotoxic effects of inorganic arsenic. Malformations of the axial skeleton, neurocranium, viscerocranium, eyes, and genitourinary systems as well as prenatal death followed a bolus dose of trivalent or pentavalent inorganic arsenic. Trivalent arsenic was more teratogenic than pentavalent arsenic; in contrast, the methylated metabolites of arsenic possessed only limited teratogenic activity. Administration of inorganic arsenic to mammals results in concentration of arsenic within the placenta and small amounts are deposited within the embryo. Studies concerning the pathogenesis of arsenic-induced axial skeletal lesions revealed early failure of neural fold elevation and a subsequent, persistent failure of closure of the neural tube. Physical factors, drugs and heavy metals may modify the response to a teratogenic dose of inorganic arsenic. Medical problems associated with industrial or agricultural arsenicalism are most often typified by chronic exposure; future studies should emphasize those routes of administration and types of exposure that are characteristic of arsenic intoxication.
Structural an immmunological characterization of cell wall antigens in strains FA638 and CS7 of Neisseria gonorrhoeae

Peptidoglycan-associated proteins were recently identified in Neisseria gonorrhoeae strains FA638 and CS7 (Hill & Judd, 110th Meeting of ASM, March, 1986, Washington, DC). Antiserum was raised against purified cell wall preparations of the aboven strains. By the criterion of Western blotting there appeared to be several common protein antigens. Antibody to the CS7-cell wall immunoprecipitated a radiolabeled protein with an apparent molecular weight of 55 KDa in several strains tested (both PI A and PIB bearing strains). Fractionation using MG+ + —acetone appeared to precipitate the 55 kilodalton protein which was extremely cross-reactive when screened with anti- whole cell antibody. The 55 KDa protein appears in fractions which are also enriched for a 14.5 KDa protein. Antibody has been raised to the acetone precipitated 55 KDa protein derived from strain CS7 which is currently being used to further study the peptidoglycanassociated proteins of N. gonorrhoeae.
Free Trade and Free Immigration: Why Domestic Competitive Injury Should Never Influence Government Policy

There is little doubt that two of the hot button issues of our time involve, first, international trade of goods and services and, second, the movement of people from one country to another, sometimes for short periods but sometimes with the intention of acquiring either rights of citizenship or permanent occupation in their new destination country.1 The central choice in both areas is whether nations, in particular the United States, should adopt parallel regimes of free trade and free immigration. It has long been clear that the case for free immigration is harder to make out than the case for free trade.2 That difference cannot be chalked up solely to nativism or improper racial sentiment. Those forces are surely at work in some cases, but not in all. What can be shown, however, is that a comprehensive and unified approach to these two areas, and to the relationship between them, justifies that initial assessment, even if it does not justify many of the restrictions commonly found in dealing with immigration and naturalization. It is best to start with a brief description of the pros and cons of free trade before tackling the thornier issue of free immigration of individuals across borders.
Solving Mixed Equal Groups and Multiplicative Compare Problems

Learning outcome: Solving Mixed EG and MC word problems with the diagram equations Materials Needed: Diagrams EG and MC Diagram Equation Models Posters EG and MC Word Problem Story Grammar Posters DOTS Checklist Poster Overhead Modeling Modeling EG and MC Problem Solving 1–6 Student Worksheets Modeling EG and MC Problem Solving 1–6 Independent worksheet- mixed EG and MC problem solving 7–12 Reference Guide Reference Guide –EG and MC problem solving 1–12
Feedback Effects of Mammary Gland Tumors on the Host Pituitary Prolactin Cell

Prolactin (PRL) cells in pituitary glands of F-344 ♀rats bearing transplantable mammary gland adenocarcionmas (13762, 3230) were smaller, contained less intracellular hormone, and released less hormone in culture relative to non tumor-bearing littermates. In some instances removal of the tumor by surgery or chemotherapy (PAM) resulted in restoration of function in vitro. On the other hand, PRL cells from pituitaries of breast cancer patients were often hypertrophied. Since these patients had mastectomies prior to hypophysectomy, the data are consistent with the hypothesis that the tumor exerts negative feedback at the pituitary or hypothalamic level. In support of this hypothesis we have discovered a potent PIF in rat serum. In addition, an experimental protocol involving a) encapsulation of pituitary cells in Amicon hollow fibers, b) their implantation in ectopic sites and c) their subseugent in vitro culture yields data which suggest that the brain of the tumor bearing rat suppresses PRL release. It is suggested that decreased PRL cell function in animals bearing certain mammary tumors ultimately favors metastatic activity of the tumor cell.
Research on Risk Assessment and Strategy Dynamic Attack and Defense Game Based on Twin Model of Power Distribution Network

Based on the research and construction of smart grid at home and abroad, this paper puts forward the application of machine learning theory to smart grid. For the first time, this paper tries to integrate the traditional power grid strategy with the computer network to establish the distribution network fault solving strategy library, leading the grid to be intelligent. At the same time, another innovation of this paper is to put forward the conception of the twin model system. The method abstracts the power grid into the integration of the information-physical system through data exchange, and the grid state in each node corresponds to the twin matrix, which makes the grid modeled, digitized. According to this idea, the smart grid system can find the optimal strategy in the fault solving strategy library after the failure, and can realize the self - healing function of the distribution network. In this paper, we first simply introduce the algorithms of machine learning and information physics coupling system. Then we introduce the composition of twin model system and its basic principles. Finally, we elaborate the process of intelligent distribution network's offline construction and online operation.
Review of evidence for bosentan therapy for treatment of Eisenmenger syndrome.

BACKGROUND AND PURPOSE Eisenmenger syndrome (ES) is a rare condition caused by a right-to-left cyanotic shunt. To date, only heart-lung transplant has been shown to be curative. Bosentan is the only medication studied with a double-blind placebo-controlled randomized trial for management of this condition. The intent of this article is to explore the literature surrounding bosentan in ES and assess its efficacy. METHODS A literature review was conducted with no limitation on date. Titles were scanned for applicability, and abstracts of those articles found to be pertinent were reviewed. Those articles considered relevant based on the abstract were read in entirety. CONCLUSIONS Eisenmenger syndrome remains incurable except through heart-lung transplant. Although no specific medical treatment or algorithm exists, three pharmacological classes show promise in disease management: endothelin receptor antagonists, phosphodiesterase inhibitors, and prostacyclins. Combined therapy with these agents may improve cardiopulmonary function. Bosentan has not been proven as a monotherapy for ES and is not appropriate in all patients as side effects are commonly reported. IMPLICATIONS FOR PRACTICE Further study is required to assess efficacy of combination therapy and utilization as a bridge to transplant or surgical correction of the underlying defect.
Beamforming with Partial Knowledge of the Acoustic Scenario

We address the problem of acoustic beamforming with a small number of microphones given only limited knowledge of the spatial scenario. We first identify a set of plausible target (desired source) scenarios and a set of interferer scenarios that have desirable suppression characteristics. We then design soft masks (postprocessors) for all target-interferer scenario pairs and select the composite scenario that maximizes the output variance over target scenarios and minimizes it over interferer scenarios. This corresponds to an approximate concatenation of soft masks. The result is a nonlinear beamformer with an adjustable beamwidth and an adjustable region where point interferers are strongly suppressed, even for two microphones. For the individual masks we use a new postprocessor formulation that is robust to scenario mismatch. The resulting system provides excellent performance with few microphones even when the acoustic scenario is ill-defined.
Property, Money, and Benevolence in The Mysteries of Udolpho

This essay suggests that Ann Radcliffe’s writings exhibit greater attention to economic concerns of money and property than has been acknowledged. An analysis of her often-overlooked travel narrati...
A Descriptive Study of Drug Use Among the Hearing Impaired in a Senior High School for the Hearing Impaired

Deafness as a handicap is difficult to understand or to identify visually because usually there are no physical deformities. Deafness usually is socially identified when the deaf person begins to communicate with a hearing or another deaf person.
What Is the Koopman Operator? A Simplified Treatment for Discrete-Time Systems

This paper provides an introduction to the discrete-time Koopman operator for nonexperts, including a treatment of the basic definitions and properties of the Koopman operator and a numerical method for approximating the Koopman spectrum. Furthermore, the paper stresses the role of compositional completeness for spaces of Koopman observables and gives conditions under which the $\mathrm{L}_{p}$ spaces are compositionally complete. Numerical examples are given to illustrate the basic concepts.
Big Data and the Future Law of Armed Conflict in Cyberspace

Some who should know argue, and I find plausible, that among these aspects of AI, accumulation and organization of data sets is the most significant. If this claim is right, then increasingly the most valuable property on the planet will be in cyberspace. As a conflict grows in intensity, adversaries will want to protect their property and degrade that of their opponents. The more important big data becomes, the more likely that adversaries will take actions affecting it. Almost inevitably some kind of international law will come into the picture, in the sense that relevant actors will frame claims about what they and others do in terms of international legal arguments. This chapter focuses on the question of jurisdiction or domain, rather than content: Under what circumstances will international lawyers in 2040 look to LOAC, including ius ad bellum, to regulate actions taken in cyberspace involving big data? This focus allows me to avoid considering what particular rules LOAC will apply. Rather, I consider whether LOAC, rather than some other body of international law or exclusively municipal law, might govern particular cyberspace activity.
Abstract P275: Growth Differentiation Factor (gdf)-15 and Metabolic Outcomes: The ARIC Study

Introduction: Mechanistic studies suggest an involvement of growth differentiation factor 15 (GDF-15) in metabolic dysregulation. However, the potential utility of GDF-15 as a marker of diabetes or...
Long-Term Academic Outcomes of Triological Society Research Career Development Award Recipients.

OBJECTIVES/HYPOTHESIS Each year, the Triological Society awards several Research Career Development Awards (CDAs) to support early-career otolaryngologists. The objective of this study was to evaluate academic outcomes of CDA recipients including National Institutes of Health (NIH) funding acquisition and h-index. A secondary objective was to appraise gender differences in outcomes among awardees. STUDY DESIGN Cross-sectional study. METHODS Recipients' practice setting, degree type, academic rank, and leadership titles were determined through review of academic and private practice profiles in October 2019. NIH funding was assessed using the NIH Research Portfolio Online Reporting Tool and the h-index was calculated using the Scopus database. RESULTS Between 2004 and 2019, 70 investigators received a CDA. Of the 65 awardees prior to 2019, 26 (40.0%) obtained NIH grants after the CDA. Having an MD/PhD or MD/master's was not associated with NIH funding attainment (P = .891) nor with higher funding total (P = .109). However, funding total was significantly higher for full professors compared to assistant professors (P = .022). The median h-index among awardees was 16 (interquartile range = 11-21) and differed significantly by academic rank (P < .001). Moreover, 23 CDAs (32.9%) were awarded to women. However, fewer female recipients obtain NIH funding after the CDA compared to men (10.5% vs. 52.2%, P = .002), and they had significantly lower h-indices than men (10 vs. 17, P < .001). CONCLUSIONS As a cohort, CDA awardees achieve higher academic success than academic otolaryngologists in general. However, female CDA recipients lag behind their male colleagues, highlighting the need for more research to uncover contributors to gender differences and ways to foster equity in research. LEVEL OF EVIDENCE NA Laryngoscope, 131:288-293, 2021.
Anterior Nucleus of Thalamus Gates Progression of Mesial Temporal Seizures by Modulating Thalamocortical Synchrony

Abstract The anterior nucleus of the thalamus (ANT) mediates cortical-subcortical interactions between the limbic system and is hypothesized to facilitate the early organization of temporal lobe seizures. We set out to investigate the dynamic changes in synchronization parameters between the seizure onset zone (SOZ) and ANT during seizure stages (pre-onset to post-termination) in seven patients (n=26 seizures) with drug-resistant nonlesional temporal lobe epilepsy. Using local field potentials recorded directly from the limbic system and the ANT during stereoelectroencephalography, we confirm that the onset of mesial temporal lobe seizure is associated with increased thalamocortical network excitability and phase-amplitude coupling. The increase in thalamocortical phase synchronization preceded seizure onset, thereby suggesting that the early organization of temporal lobe seizures involves the integration of the ANT within the epileptic network. Towards seizure termination, there is a significant decrease in thalamic excitability, thalamocortical synchronization, and decoupling, thereby suggesting a breakdown in thalamocortical connectivity. A higher disease burden is significantly correlated with increased synchronization between the ANT and epileptic networks. Collectively, the results elucidate mechanistic insights and provide the temporal architecture of thalamocortical interactions that can be targeted in the rational designing of closed-loop seizure abortive interventions. Highlights Anterior nucleus of thalamus is coactivated at the onset of temporal lobe seizures Increase thalamocortical synchronization and excitability is observed at seizure onset Seizure termination is characterized by a breakdown in thalamocortical connectivity Increased seizure burden affects thalamocortical synchronization
Case Study: Secessionists Motives in the American Civil War

This chapter offers an empirical examination of the American civil war, 1861–1865, looking at the secessionist’s side. The model developed in Chapter 2 is used to compare the benefits of retaining slave wealth (the rents) with the costs of the civil war fought to keep it (the dispute costs). Expected benefits are weighted by probabilities of victory and time preferences. It is shown that war costs might have been recovered in as little as six years. Also discussed is how the benefits of secession may quantitatively have been divided between the greed motive of retaining slave wealth and the grievance motive of states’ rights.
Education reform imaginaries: mapping -scapes of philanthropic influence

This paper unpacks the discursive work of global education philanthropies to shed light on how the work of educational actors inscribes and directs global forces, connections and imaginaries to spe...
Axonal transport and active zone proteins regulate volume transmitting dopaminergic synapse formation

Summary At a typical synapse, the precise juxtaposition between the active zone and postsynaptic receptors ensures local and precise neurotransmitter release and detection. Dopamine neurons release neurotransmitter more diffusely using volume-transmission, where precise pre- and post-synaptic alignment is lacking. It is unknown whether Dopaminergic presynaptic terminals have typical active zone structures and how they develop. Here we show that presynaptic terminals of the C. elegans dopaminergic neuron PDE contain bona fide AZ proteins, including SYD-2/Liprin-ʡ, ELKS-1, UNC-10/RIM and CLA-1/Piccolo. During development, synaptic vesicles (SVs) and active zone proteins (AZs) coalesce within minutes behind the advancing growth cone. Precise regulation of UNC-104/Kinesin-3-mediated SV transport through kinesin autoinhibition is required to pause transported SVs at synapses. SYD-1 and SYD-2 recruit and cluster the transiting SVs, while ELKS-1 aggregates through a distinct mechanism.
K- and W-Band Free-Space Characterizations of Highly Conductive Radar Absorbing Materials

This work presents a characterization technique of highly conductive material in the K- and $W$ -bands. The transmission line theory model is modified to adapt to the phase challenges observed in the measured S-parameters at high frequency. The S-parameters measurements are obtained using the nondestructive focused beam free-space system connected with the network analyzer and the millimeter-wave frequency extenders. The system provides measurements in a frequency range from 5.8 to 110 GHz, and it includes focused beam horn lens antennas to minimize sample edge reflection. The thru-reflect-line (TRL) calibration and the time-gated feature of the network analyzer are used. Good agreement between the measured and calculated S-parameters in the transmission mode is achieved using the extraction algorithm. The measured S-parameters are further used to obtain the electromagnetic shield effectiveness parameters and the percentage of power absorbed in the material. In addition, the return loss of the metal-backed material is calculated using the extracted permittivity to obtain the maximum absorption at the desired frequencies.
Schedule Control Over Following Instructions Comprised of Novel Combinations of Verbal Stimuli

To examine schedule control over following instructions comprised of novel combinations of verbal stimuli, three children, from 8 to 10 years old, received either continuous or intermittent reinforcement for a chain of buying and then following such instructions. Later, a series of training-extinction tests was conducted. During the training trials, the chain produced either continuous or intermittent reinforcement. During the extinction trials, buying produced instructions but following instructions never produced reinforcement. For one subject, a partial reinforcement extinction effect was detected for the chain. For two subjects, a stimulus correlated with extinction onset enhanced schedule control. Overall, the frequency of the chain covaried with the probability of reinforcement. The schedule effects detected and the methodology used extend the generality of an operant interpretation of instruction following to instructions comprised of novel combinations of verbal stimuli.
Intrinsic tame filling functions are equivalent to intrinsic diameter functions

Intrinsic tame filling functions are quasi-isometry invariants that are refinements of the intrinsic diameter function of a group. The main purpose of this paper is to show that every finite presen...
Advancing Diversity during a Pandemic: Using the PackBack platform as a tool

In a virtual environment finding creative ways to connect course material is essential to student success. PackBack is a platform that can bridge course material as students learn new knowledge. Pa...
Abstract P356: Relationship between Serum Cystatin C, Body Mass Index and All-Cause Mortality in Adults with Normal Renal Function

Background: Cystatin C (Cys-C) is a sensitive biomarker of renal function and an independent predictor of all-cause mortality (ACM) in patients with chronic kidney and cardiovascular disease (CVD). Although higher levels of Cys-C are associated with increased body mass index (BMI), the interplay between serum Cys-C, BMI and ACM in adults with normal renal function is unknown. Methods: Utilizing data from the National Health and Nutrition Examination Survey (1999-2002), analysis was conducted on participants (≥18 years) with normal renal function [glomerular filtration rate (GFR) ≥90 ml/min)]. BMI (kg/m2) was categorized as Normal (BMI:18.5-24.9); Overweight (BMI:25-29.9); Obese (BMI >30), while Cys-C (mg/L) was categorized into weight based quartiles [Q1:<0.72(ref); Q2: ≥0.72-0.80; Q3: ≥0.80-0.89; Q4: ≥0.89]. Mortality information was obtained from the National Death Index using probabilistic matching. Cox proportional hazards models (and associated 95% CI’s) estimated the likelihood of ACM by Cys-C quartiles in each BMI category. Results: The mean(±) age and GFR of 2649 participants (51% females) was 50±20 years and 123±28 mL/min, while the median (IQR) of CRP and Cys-C was 0.19(0.07-0.44) mg/dL and 0.80(0.72-0.89) mg/L, respectively. Approximately, 33% of the cohort was normal, 34% overweight, and 33% were obese. After a mean(SD) follow up of 5.9(1.3) years, 213 deaths (all-cause) were observed. Cys-C levels increased with increasing BMI (p trend <0.05), however, significant difference was only seen in obese when compared with normal weight adults (p<0.05). Within each BMI category, increasing Cys-C was associated with increased risk of ACM (p trend <0.05), however, the hazard ratio were statistically significant only at elevated Cys-C levels (Q4 vs.Q1) in normal and overweight adults (both p values <0.05). Conclusions: Independent of traditional CVD risk factors, elevated Cys-C levels predicts risk of ACM in normal and overweight but not in obese adults who have normal renal function based on GFR. ![][1] [1]: /embed/graphic-1.gif
THE ESTUARY AS A FILTER FOR FINE-GRAINED SUSPENDED SEDIMENT

: Estuaries function as “filters” for the signals they receive from the land and the sea. The nontidal residual circulation, tidal mixing, and estuarine geometry determine the efficiency of this filter for suspended sediment. Tidal currents provide energy for mixing saltwater from the ocean with freshwater from the river. The resulting salinity distribution drives that part of the nontidal circulation caused by density differences, which in turn influences the salinity patterns and resulting density gradients. This feedback between salinity redistribution and gravitational circulation places a constraint (filter) on the range of variations in flow and salt concentration in the estuary. The nontidal circulation also controls the distribution and transportation of suspended sediment, and the deposition of fine particles within the estuary. The distributions of salt and fine suspended matter control the behavior of many non-conservative constituents such as nutrients, radionuclides and some metals, their modes of occurrence and transport, and their reservoirs of accumulation. The result of these processes is that the estuary modifies significantly the strength and the form of the signals it receives from land and sea. Alteration of an estuary's gravitational circulation pattern by changing its freshwater input or its geometry modifies its filtering efficiency. In general, as an estuary changes from being highly stratified toward being well-mixed, its filtering efficiency for land-derived constituents first increases to a maximum (in the partially-mixed region) and then decreases. A simple kinematic model is used to demonstrate the relationship between estuarine type (gravitational circulation pattern) and filtering efficiency for Chesapeake Bay, USA.
A Rapid and Sensitive Method to Measure Secretion of Sphingosine‐1‐Phosphate

The serum-borne, bioactive sphingolipid mediator, sphingosine-1-phosphate (S1P), regulates numerous important physiological and pathological processes, mainly acting through specific cell surface G-protein-coupled receptors. Although many mammalian cells can produce S1P, there is little information as to how it is secreted to reach its receptors. Progress in elucidating this mechanism has been hampered by the difficulty of measuring very low levels of S1P. This chapter describes a simple, rapid method to measure S1P export from cells. It also discusses the current knowledge of how S1P is exported out of cells and its physiological significance.
Orthotopic heart transplant: A therapeutic option for unresectable cardiac fibroma in infants

Primary cardiac tumors are rare lesions in childhood, with the two most common being rhabdomyoma and fibroma. We report two infants who successfully underwent orthotopic heart transplant for massive interventricular septal cardiac fibromas. For unresectable infantile cardiac fibroma, orthotopic heart transplant may be considered a therapeutic option.
Chicken genome: New tools and concepts

Last spring, the Second International Chicken Genome Workshop was held at the Stowers Institute for Medical Research, less than 2 months after the first draft of the chicken genome was publicly released in March, 2004. This major event was highly anticipated by the chicken community, because of the invaluable resources that would be newly provided. In addition, from an evolutionary standpoint, birds are the species most closely related to mammals, whose genome has been sequenced. The meeting gathered both agricultural and academic chicken communities and provided the opportunity to discuss the status of the chicken genome sequencing, the preliminary analysis of the chicken genome sequences freshly available, and the impact on avian genetic tools.
Prehospital recognition of severe sepsis: development and validation of a novel EMS screening tool

Abstract Objective To derive and validate a predictive model and novel emergency medical services (EMS) screening tool for severe sepsis (SS). Design Retrospective cohort study. Setting A single EMS system and an urban, public hospital. Patients Sequential adult, nontrauma, nonarrest, at-risk, EMS-transported patients between January 1, 2011, and December 31, 2012 were included in the study. At-risk patients were defined as having all 3 of the following criteria present in the EMS setting: (1) heart rate greater than 90 beats/min, (2) respiratory rate greater than 20 beats/min, and (3) systolic blood pressure less than 110 mm Hg. Interventions None. Measurements and Main Results Among 66,439 EMS encounters, 555 met the criteria for analysis. Fourteen percent (n = 75) of patients had SS, of which 19% (n = 14) were identified by EMS clinical judgment. In-hospital mortality for patients with SS was 31% (n = 23). Six EMS characteristics were found to be predictors of SS: older age, transport from nursing home, Emergency Medical Dispatch (EMD) 9-1-1 chief concern category of "sick person," hot tactile temperature assessment, low systolic blood pressure, and low oxygen saturation. The final predictive model showed good discrimination in derivation and validation subgroups (areas under curves, 0.843 and 0.820, respectively). Sensitivity of the final model was 91% in the derivation group and 78% in the validation group. At a predefined threshold of 2 or more points, prehospital severe sepsis (PRESS) score sensitivity was 86%. Conclusions The PRESS score is a novel EMS screening tool for SS that demonstrates a sensitivity of 86% and a specificity of 47%. Additional validation is needed before this tool can be recommended for widespread clinical use.
Impurity transport studies in NSTX neutral beam heated H-mode plasmas

The first experimental assessment of low-Z impurity transport in a neutral beam heated, high-confinement H-mode plasma sustained in a low-field, low-aspect ratio spherical tokamak, was performed at the National Spherical Torus Experiment (NSTX). The injected impurities penetrate to the core on a hundred millisecond time scale, indicating a low core particle diffusivity (1 m2 s−1) in good agreement with the values predicted by neoclassical transport theory. In addition, a fixed q-profile magnetic field scan that showed reduced impurity penetration at high fields is also reported. This result suggests that anomalous ion particle transport associated with turbulent long-wavelength electrostatic instabilities must be largely suppressed in the NSTX core.
Stipitate hydnoid fungi of the temperate southeastern United States

An 11 year study was conducted to reevaluate the species of stipitate hydnums from the southern United States especially the Great Smoky Mountains and surrounding geography. The genera evaluated included Bankera herein reduced to synonym with Phellodon, Hydnellum, Sarcodon, and Phellodon. Basidiomata of many stipitate hydnum species from this region were abundant but nitrogen depositions during the last 20 years have impacted their occurrences. Therefore it became critical to do a definitive study of these fungi using current taxonomic tools. Many species within Hydnellum and Phellodon have a indeterminate type growth often dependant on environmental conditions making discrimination between closely related species difficult without supportive molecular sequence data. Once sequence data (ITS) was obtained a phylogenetic analyzes were conducted and the sequences were compared to those in GenBank with particular attention to European data. A total of 41 distinct taxa were determined and many of those were confirmed based on morphological data. A specific new combination from Bankera fuligineoalbum to Phellodon fuligineoalbus is made herein. Futhermore, Phellodon brunneoolivaceus is described as new based on morphological and sequence data.
Analysis of non-Fourier conduction waves from a reciprocating heat source

The temperature proe les that result when a point heat source is swept back and forth along a rod in which heat travels at e nite speed are examined. Green’ s functions are used to solve the hyperbolic heat equation for cases in which the source speed is half, equal to, and double, the natural thermal wave speed of the rod material. Rod temperatures are found to depend on the value of the thermal Mach number that characterizes each heating scenario. For subsonic heating, temperatures decrease smoothly ahead of the source, but drop off sharply in its wake. In supersonic heating, the temperature proe le e ips, moving the sharp drop in rod temperature to the source’ s leading edge. For transonic heating, the temperature proe les have sharp drops on both sides of the source, producing a local spike that grows with time. In all cases, the source generates three distinct wave fronts as it slides along the rod: a primary front moving with the source and two startup fronts traveling at the rod thermal wave speed. These fronts interact to produce local variations in rod temperatures that would not be predicted by Fourier’ s law.
Quantitative and qualitative characteristics of the school and home language environments of preschool-aged children with ASD.

Abstract The purpose of this research was to begin to characterize and compare the school and home language environments of 10 preschool-aged children with Autism Spectrum Disorders (ASD). Naturalistic language samples were collected from each child, utilizing Language ENvironment Analysis (LENA) digital voice recorder technology, at 3-month intervals over the course of one year. LENA software was used to identify 15-min segments of each sample that represented the highest number of adult words used during interactions with each child for all school and home language samples. Selected segments were transcribed and analyzed using Systematic Analysis of Language Transcripts (SALT). LENA data was utilized to evaluate quantitative characteristics of the school and home language environments and SALT data was utilized to evaluate quantitative and qualitative characteristics of language environment. Results revealed many similarities in home and school language environments including the degree of semantic richness, and complexity of adult language, types of utterances, and pragmatic functions of utterances used by adults during interactions with child participants. Study implications and recommendations for future research are discussed. Learning outcomes : The reader will be able to, (1) describe how two language sampling technologies can be utilized together to collect and analyze language samples, (2) describe characteristics of the school and home language environments of young children with ASD, and (3) identify environmental factors that may lead to more positive expressive language outcomes of young children with ASD.
Dynamical mean-field theory of temperature- and field-dependent band shifts in magnetically coupled semimetals: Application to Eu B 6

A model for semimetals such as $\mathrm{Eu}{\mathrm{B}}_{6}$, in which band overlaps are controlled by magnetic order, is solved in the weak-coupling limit of the dynamical mean-field approximation. In this limit, the approximation becomes identical to a previously proposed Hartree theory. First-order phase boundaries are computed by evaluating the free energies of different states. The phase diagram is determined. A specific and physically reasonable choice of parameters is found to approximately reproduce the available data on $\mathrm{Eu}{\mathrm{B}}_{6}$. For this material, predictions are made for the location of a metamagnetic transition and its associated end point and a change in the order of the magnetic transition.
Late Adjunction and Minimalist Phrase Structure

An algorithm of phrase structure building is proposed within the bare phrase structure framework. The algorithm is rooted in the idea that applications of Merge–the operation that combines syntactic objects–should not change the set of basic relations (in particular, c-command) in the existing structure, what Chomsky (2000) terms “Least Tampering.” Under the proposed algorithm, this idea translates into a requirement that Merger must take place at the root of the tree/phrase marker when possible. As a result, the algorithm forces (base-generated or moved) structural adjuncts to be Merged postcyclically. Three empirical consequences of the proposed algorithm are discussed: (1) constructions involving raising across the experiencer (e.g., John seems to Mary to be smart) are shown not to be problematic for the Minimal Link Condition (cf. Chomsky 1995b); (2) a novel account of Adjunct Island effects (Huang 1982) is proposed; and (3) a principled analysis of approximative inversion in Russian is offered.
WHAT IS ADIABATICITY? SUGGESTIONS FROM A FLUCTUATING LINEAR POTENTIAL

Abstract We consider a Brownian particle in a well with a dichotomously fluctuating barrier. We show that, for a linear slope, the time to deterministically slide down the barrier is also the relaxation time for the escape rate after the barrier changes shape.
Psychologic and Biologic Factors Associated with Fatigue in Patients with Persistent Radiculopathy

Fatigue is a common symptom associated with neuropathic pain (NP) and can have negative consequences on psychosocial functioning, physical endurance, and quality of life. Recent evidence indicates that immune activation modulated through the increased release of proinflammatory cytokines can predict fatigue in some patient populations. Although earlier studies have shown that immune activation is a pathophysiologic feature of NP, there have been no studies to examine the relationship between immune activation and fatigue in persons with NP. Therefore, the purpose of this exploratory study was to: 1) determine the relationships among fatigue, pain, psychosocial factors, and selected biologic markers of immune activation (interleukin [IL] 6 and soluble IL-6 receptor [sIL-6R]) in participants with persistent radiculopathy; and 2) determine the differences in these variables based on fatigue severity. Participants (n = 80) were classified according to their level of fatigue as low (27.5%), moderate (32.5%), or high (40%), and significant differences were found between fatigue categories (p = .001). Multivariate analyses of variance revealed that individuals with moderate to high levels of fatigue differed from those with the lowest levels of fatigue in psychologic distress, depressive symptoms, IL-6, and sIL-6R, whereas the differences between moderate and high levels of fatigue were significant for psychologic distress and sIL-6R only. The findings suggest that immune activation affects fatigue severity and possibly other behavioral responses, offering important information when providing care to patients with persistent radiculopathy. The integration of biobehavioral nursing interventions in pain management may have a greater impact on quality of life than treatment focused only on pain.
Inconstant Companions: Archaeology and North American Indian Oral Traditions

As an historian of the American West, I find myself in the unusual position of writing a review of a book, written by an archaeologist, for an audience of oral historians. But Ronald J. Mason's ele...
Parenteral nutrition by peripheral vein in the management of gynecologic oncology patients.

Abstract Twenty-five patients with gynecologic cancer were treated with 34 courses of parenteral nutrition by peripheral vein (PNPV) using 10% dextrose and 5% casein hydrolysate. Indications for therapy included preoperative and postoperative support, radiation enteritis, bowel fistulas or obstruction, and support of patients during chemotherapy and radiation therapy. Weight gain was experienced by 21 of 25 patients during therapy, there was good wound healing in patients undergoing operation, and no patients had interruption of chemotherapy or radiation therapy while on PNPV. The data suggest that many patients who might benefit from protein sparing therapy and caloric supplementation can be treated with PNPV. The advantages of PNPV over total parenteral nutrition by central venous catheter include reduced risk of complications, expense, and complexity of monitoring and delivery. A systematic outline for the management of patients by PNPV is presented.
Conservation of Cell Order in Desiccated Mesophyll of Selaginella lepidophylla ([Hook and Grev.] Spring)

Abstract Understanding of the basis of desiccation tolerance in mature plant tissues that survive extreme dehydration requires knowledge of the degree of cellular order in the dry state. Generally, aqueous fixatives have been used in ultrastructural studies of such material, and these are known to be inadequate in the preservation of dry material. Cryopreservation provides a more assured level of fixation fidelity than aqueous fixatives, particularly with dry material. Using freeze substitution and electron microscopy, we examined the ultrastructure of dry mesophyll cells of Selaginella lepidophylla ([Hook and Grev.] Spring). In this material the cells were condensed and had highly folded walls. The plasmalemma was bounded on both sides by layers of granular material, and the membrane was in close and continuous apposition to the walls. The conformation and position of organelles and their structure appeared to be influenced by being compacted within the shrunken cells, but the ultrastructural integrity of all organelles and cellular membranes, including mitochondria, chloroplasts and vacuoles, was maintained in the dry state. These cells had numerous small vacuoles clustered in aggregates, and the tonoplast membranes appeared to be coated on the internal side by a fine granular layer. The vacuoles contained osmiophilic material of varying degrees of condensation and had embedment holes suggesting the presence of salt crystals within the vacuoles. The general conclusions from these studies are that a critical level of cell order is maintained in the dry state in these desiccation-tolerant plants, and a high degree of effective packing and shape fitting of cellular constituents with the compaction forces of dehydration underlies this conservation of cell order.
Biogenic silica deposition in Lake Malawi, East Africa over the past 150,000years

Abstract We report a 150,000 year record of the abundance of biogenic silica (BSi) in drill cores from the northern and central basins of Lake Malawi. The periods of highest diatom burial at both sites occurred around 65–69 and 51–60 thousand years ago (ka) after the termination of prolonged, intense drought in the region. These peaks are believed to reflect elevated delivery of dissolved silica to the lake due to acceleration of chemical weathering in the drainage basin. The droughts that preceded these BSi depositional episodes occurred at precessional frequency, corresponding to times of minimum austral spring (or summer?) insolation in the region prior to 60 ka. Subsequent arid spells have not been as severe due to the reduced amplitude of precessional forcing as a result of the superimposed effect of eccentricity. However, biogenic silica records do not show significant sensitivity to precessional forcing. The BSi burial flux in the north basin displays strong millennial-scale variability since 50 ka, with peak values occurring during cold times in the Northern Hemisphere, as reflected in the Greenland ice core records. We observe no relationship between BSi and deposition of volcanic tephras in this system. The central basin core also displays millennial-scale variability in BSi abundance during the past 50 ky, of comparable magnitude to that in the north basin, but without systematic correlation to the north basin BSi or Greenland ice core records. In general, we conclude that BSi profiles from the north and (probably) south basins are more readily interpreted in terms of regional climate dynamics than are BSi profiles from more central locations in long, narrow tropical rift lakes. Diatom burial rates are suspected to be too influenced by silica limitations imposed by diatom production and burial in the upwelling systems at either end of these low-latitude lacustrine systems.
The sense of effort and two models of single-joint motor control

Two sets of experiments were carried out. In the first set, human subjects were asked to make the same effort with the elbow flexors at different joint angles under isometric conditions. In some experiments, the subjects were standing with the arm in a vertical (parasagittal) plane; in others, they were seated with the arm in a horizontal (transverse) plane. When muscular torque at a given effort level (ordinate) was plotted as a function of elbow joint angle (abscissa), the resulting isoeffort torque-angle profiles tended to be flat or negatively sloping over a range from 45 degrees to 135 degrees, and they were often nonmonotonic. Increases in effort up to near-maximal levels caused the isoeffort torque-angle profiles to shift upward with little alteration in shape. In the second set of experiments, seated subjects with the arm horizontal resisted baseline torques produced by a motor that acted to extend the elbow joint. Unexpected increases and decreases in torque were superimposed on the baseline torque. The subjects either were instructed to intervene and return the elbow to the initial (90 degree) position, or were told, "Do not intervene voluntarily; let the motor move your arm." Effort was reported both under baseline conditions and after the changes in torque. It was found that changes in effort were a function of the changes in torque opposed by the elbow flexors, and were similar whether the subject had repositioned the arm or allowed it to be moved by the motor. In the latter case, the arm came to rest after displacements that were a function of the size and direction of the torque change. For individual subjects, the largest angular displacements ranged from +/- 10 degrees to +/- 20 degrees for changes in torque of +/- 10 N.m. There was no evidence for any angular dependence of the effort judgements at a given torque over this angular range. Depending on whether effort is primarily an efferent perception proportional to voluntary motor activity or also has a significant afferent (involuntary) component, different models of motor control are supported by these data.