cssi/SciSciGPT-SciSciNet huggingface dataset:
Liposomal Amphotericin B, and Not Amphotericin B Deoxycholate, Improves Survival of Diabetic Mice Infected with Rhizopus oryzae

The efficacies of liposomal amphotericin B (LAmB) and amphotericin B deoxycholate (AmB) were compared in a diabetic murine model of hematogenously disseminated Rhizopus oryzae infection. At 7.5 mg/kg of body weight twice a day (b.i.d.), LAmB significantly improved overall survival compared to the rates of survival in both untreated control mice (P = 0.001) and mice treated with 0.5 mg of AmB per kg b.i.d. (P = 0.047). These data indicate that high-dose LAmB is more effective than AmB in treating murine disseminated zygomycosis.
Leucocyte culture and chromosome preparations from pig blood.

Blood was drawn into heparinized tubes from any large vein and allowed to settle 2–3 hr at 3–5 C. The cell sample consisting of 1 ml drawn from the buffy coat and 2 ml from the plasma was planted in the following medium: Medium 199 (Difco), 10 ml; penicillin G sodium, 1000 USP units; dihydrostreptomycin, 1 mg; and Bacto-PHA-M (Difco), 0.2 ml. Incubation, with twice daily shaking, was at 37 C for 68–70 hr; colchicine to give 4 μ ml was then added and incubation continued for 3–4 hr. The bulk of the medium was removed by centrifugation, the cells washed once in Hanks' salt solution, centrifuged, and all but 0.5 ml of the fluid decanted; 1.5 ml of distilled water at 37 C was added, the cell suspension incubated at 37 C 5–15 min, followed by centrifugation and fixation in methanolacetic acid 3:1 (3 changes) as usual. Spreads were made by applying 4–5 drops of cell suspension to ice-cold slides and burning off the fixative. Giemsa stain was used. The method has proved very satisfactory for determining chromoso...
EMBRACING THE COLLAGE: PASTORAL THEOLOGY IN AN ERA OF ‘POST-PHENOMENA’

One of the remarkable aspects of the current world situation is that our age is spoken of as one to be understood in terms of transcending or going beyond. We live in the 'after time,' the 'beyond' time the time following, contingent upon, critical of and reflective on realities which are no longer as clear and true as they were before. We live in post-modern, post-colonial post-Christian, post-human and perhaps also 'post-pastoral' times. For many people I have met here in the United States, the 'structure of feeling' (Harvey, 1992, p. 300) at this time is a diffuse sense of being 'unhinged.' Every taken for granted thing seems to have come unstuck Moving from Britain to the United States following the events of September 11 2001 has made this very poignant for me. My entry at this time in history has meant that the expected culture shocks of migration have been compounded by the trauma, pain and heart-searching as well as anger, vengefulness and outrage of a violated people. We all now live in the uncertainties and realities of post-September 11 time. To be sure, the global situation seems to be marked more than ever these days, among others, by: rapid transformation and uncertain flux in the social, economic, cultural, religious, political and personal spheres; crisis and chaos; violence and terror; endless cycles of revenge; personal martyrdom and communal murder; confusion, uncertainty, diffusion; plurality, multiplicity, fragmentation; provisionality of knowledge; fragility; vulnerability; and ephemerality. The prefix 'post-' has been used to point to conditions that have been variously understood and there is much debate and difference of opinion as to what they might refer to. Let me say at once that my usage of the prefix is not restricted merely to a way of talking about 'what comes after,' or of 'that which follows' (in a temporal sense) that which it qualifies. The term 'postmodern' does not simply refer to that which comes after or replaces modernity. Instead it is a way of speaking about the condition of being in critical vein or in questioning mode concerning it. Post-modernity as such, is the situation in which modernity is called to account, questioned and critically appraised. Where the assumptions and assertions of modernity are challenged and critiqued. Post-colonialism, similarly, is a critical re-appraisal of the colonial project and its effects, coupled with a creative engagement to transcend colonialism and re-configure the current reality.
Michelle Ann Stephens, Skin acts: race, psychoanalysis, and the black male performer

In Skin Acts, Michelle Ann Stephens provides a valuable contribution to the study of race and representation by offering a thorough account of the relationship between black skin and white gaze and...
A Limitation on the Patent Right to Exclude: An Introduction to International Exhaustion

This chapter provides an important clarification to the usual patent rights that were first explained in Chapter 1 (also available on SSRN). In particular, it explains that patent owners may sometimes lack the ability to exclude imports of patented drugs they previously sold in another country. Whether the patent owner lacks this ability depends on whether a nation rejects a legal doctrine called international exhaustion, to exclude what are referred to as parallel imports. This chapter explains the controversy concerning this doctrine, and how it impacts the commercial sale of drugs.
Training in Feminist Research Methodology: Doing Research on the Margins

Feminist research experiences could greatly enhance the training of clinical psychology graduate students. This article describes principles of feminist research methodology, such as attention to power imbalances, listening to women's voices and experiences, and reflectivity. Approaches to training include feminist classrooms, feminist research teams, required courses on feminist methodology, integrating feminist research throughout the curriculum, and postdoctoral training and continuing education programs. Among the challenges to incorporation of feminist research into clinical graduate training are the logical positivistic epistemology of many traditional programs, the lack of colleagues' support within many programs, and the hierarchical structure of educational institutions.
POLICING EPISTEMIC COMMUNITIES

I examine how particular social arrangements and incentive structures encourage the honest reporting of experimental results and minimize fraudulent scientific work. In particular I investigate how epistemic communities can achieve this goal by promoting members to police the community. Using some basic tools from game theory, I explore a simple model in which scientists both conduct research and have the option of investigating the findings of their peers. I find that this system of peer policing can in many cases ensure high levels of honesty.
Rab11 Interacting Proteins as Regulators of Parietal Cell Apical Recycling: Lessons from the Master

The gastric parietal cell in mammals is a highly differentiated cell with a specialized function: the secretion of HCl into the gastric lumen. To accomplish this highly regulated function, the parietal cell sequesters the H/K-ATPase responsible for pumping protons within a intracellular tubulovesicular membrane network (5). The tubulovesicular network lies deep to an elaborate infolding of the apical plasma membrane designated as the intracellular canaliculus. The intracellular canaliculus represents a target membrane surface for regulated fusion with tubulo vesicles (38). In response to either cAMP-dependent (histamine) or calcium-dependent (muscarinic cholinergic) agonists, tubulovesicle membrane fuse with the apical canalicular target membranes to deliver the H/K-ATPase to the luminal surface of activated parietal cells. Following the cessation of agonist stimulation, the H/K-ATPase is internalized and reassembled into the tubulovesicular system (12).
Central noradrenergic neurons: studies on the mechanism of the in vivo activation of tyrosine hydroxylase

Neuronal depolarization of peripheral and central catecholamine neurons causes an increase in catecholamine biosynthesis. This enhanced formation of transmitter in both peripheral and central catecholaminergic neurons results from an increase in the apparent activity of the enzyme which is rate-limiting in the formation of catecholamines, tyrosine hydroxylase. However, the precise mechanism whereby the activity of this enzyme is so dramatically increased from one minute to the next during periods of altered impulse flow remains unresolved (Roth et al., 1978; Salzman and Roth, 1979).
Ketamine-induced inhibition of glycogen synthase kinase-3 contributes to the augmentation of α-amino-3-hydroxy-5-methylisoxazole-4-propionic acid (AMPA) receptor signaling.

Objectives Sub-anesthetic doses of ketamine have been found to provide rapid antidepressant actions, indicating that the cellular signaling systems targeted by ketamine are potential sites for therapeutic intervention. Ketamine acts as an antagonist of N-methyl-D-aspartate (NMDA) receptors, and animal studies indicate that subsequent augmentation of signaling by α-amino-3-hydroxy-5-methylisoxazole-4-propionic acid (AMPA) receptors is critical for the antidepressant outcome. Methods In this study, we tested if the inhibitory effect of ketamine on glycogen synthase kinase-3 (GSK3) affected hippocampal cell-surface AMPA receptors using immunoblotting of membrane and synaptosomal extracts from wild-type and GSK3 knockin mice. Results Treatment with an antidepressant dose of ketamine increased the hippocampal membrane level of the AMPA glutamate receptor (GluA)1 subunit, but did not alter the localization of GluA2, GluA3, or GluA4. This effect of ketamine was abrogated in GSK3 knockin mice expressing mutant GSK3 that cannot be inhibited by ketamine, demonstrating that ketamine-induced inhibition of GSK3 is necessary for up-regulation of cell surface AMPA GluA1 subunits. AMPA receptor trafficking is regulated by post-synaptic density-95 (PSD-95), a substrate for GSK3. Ketamine treatment decreased the hippocampal membrane level of phosphorylated PSD-95 on Thr-19, the target of GSK3 that promotes AMPA receptor internalization. Conclusions These results demonstrate that ketamine-induced inhibition of GSK3 causes reduced phosphorylation of PSD-95, diminishing the internalization of AMPA GluA1 subunits to allow for augmented signaling through AMPA receptors following ketamine treatment.
Dynamics and yields for CHBrCl2 photodissociation from 215-265 nm.

We investigate the A-band photodissociation of CHBrCl2 at 215, 225, 235, 245, 255, and 265 nm. Following C–Br bond cleavage, resonance enhanced multiphoton ionization and time of flight mass spectrometry provide selective detection of the two product channels, from which we quantify the relative quantum yield of Br/Br* production. Velocity-map imaging of the photofragments allows us to determine the energy partitioning as a function of the photolysis energy for different exit channels. The anisotropy present in the imaging data suggests that absorption to the 3Q0+(A′) state is important throughout the entire region we study, though competition with other excited states is evident. The 3Q0+(A′) state forms an avoided crossing with the 1Q1(A′) state, and we find that the propensity for adiabatic passage through this crossing region dictates the Br yield at longer wavelengths. At shorter wavelengths, Br production from excited states not subject to the crossing is more evident. While we find that spin–orbit excitation comes largely at the expense of the CHCl2 internal energy, both channels still produce highly excited CHCl2 photofragments. Impulsive modeling and comparison with similar halomethane dissociations suggests that a high degree of rotational excitation is present, dictated by the torque inherent in Cs-symmetry dissociation and the angular dependence of the potential.
ECFCs from patients with PAH show a disturbed reaction to high fluid flow induced shear stress

In Pulmonary Arterial Hypertension (PAH) structural and functional abnormalities in the lung lead to an increased pulmonary vascular resistance and right heart failure. Dysfunction of the pressure-regulating endothelial cells (ECs) is thought to play an crucial role. Recently it was shown in our laboratory that lung biopsy derived microvascular ECs (MVECs) from PAH-patients are unable to align under 120h of high shear stress. As the availability of these cells is limited, a suitable alternative is needed. Our aim was to investigate ECFC as a substitute for MVECs regarding reaction to shear stress. ECFC are circulating ECs, easily obtainable from venous blood. ECFCs obtained form patients expressed EC markers CD31, VE-cadherin, VEGFR2, VWF, and were negative for α-SMA, CD14, CD45. For flow experiments, an unidirectional flow (25 dyn/cm 2 ) was applied to ECFC for 120 hours. Allignment was quantified with phase contrast microscopy. When >50% of cells aligned, this is called aligned. After 120 h 6 out of 6 control donors aligned, in the PAH group 4 out of 6 alligned. In addition we analyzed proliferation under flow. After 120 h, in the control group we count 37.25x10 cells/ cm 2 , in the PAH group 73,7x10/ cm 2 cells (multiple t-test, corrected by Holm Sidak method) p= 0.013551. In conclusion we show that out of ECFC from 8 PAH patients 4 donors are unable to align after 120h of high fluid flow induced shear stress. This is in line with with previous observations in PAH-MVECS. In addition we found that ECFC proliferate under flow. This makes it likely that ECFC play a role in disease progression, and strengthens the hypothesis for an intrinsic base for EC dysfunction in PAH.
Natural Killer Cells

Natural killer (NK) cells are a member of the innate lymphoid cell (ILC) family that provide host defense against tumors and pathogen-infected cells. They express a remarkably diverse repertoire of inhibitory and activating receptors on their cell surface, which regulates their immune responses. As their name implies, NK cells can kill transformed or infected cells by the release of perforin and granzymes or by using effector molecules of the tumor necrosis factor (TNF) family, such as TNF, TNF-related apoptosis inducing ligand (TRAIL), and Fas ligand, which induce apoptosis in the target cells. Additionally, upon activation NK cells rapidly produce chemokines and cytokines, including interferon (IFN)-γ, GM-CSF, and IL-10, that recruit and affect the function of hematopoietic and nonhematopoietic cells in the host.
First extinct representative of the rove beetle subtribe Acylophorina from Baltic amber, and its phylogenetic placement

The recently established subtribe Acylophorina comprises several morphologically diverse genera. They were revealed as a monophyletic group primarily by molecular-based phylogenetic analysis. The morphological disparity and significantly disjunct geographical distribution of Acylophorina suggest a higher diversity in the past that has been reduced by extinctions. Consequently, the fossil record preserving extinct transitional morphologies is a very important source of data to test for monophyly and improve overall phylogenetic understanding of this subtribe. Here, we describe the first undoubted representative of the subtribe as a new species, Acylophorus hoffeinsorum sp. nov., and confirm its placement within Acylophorina by phylogenetic analysis using Bayesian inference and maximum parsimony methods. We question the monophyly of Acylophorus Nordmann, 1837, the most speciose genus in the subtribe, and call for further phylogenetic investigation and taxonomic revision of this genus and the subtribe as a w...
Beard, George Miller

American neurologist George Miller Beard (1839–83) defined neurasthenia (Beard's disease) as a societal illness, which resulted from the “nervous exhaustion” produced by an increasingly urbanized society. Neurasthenia was later championed by other prominent physicians and became a common diagnosis into the early twentieth century. Beard promoted an organic paradigm for neurasthenia in which stimulating and restorative treatments were purported to replenish depleted neural energy stores, but no organic substrate was ever identified and the formulation was abandoned. Beard also described an exaggerated startle reflex in French-Canadian lumbermen, the so-called jumping Frenchmen of Maine, a report that was the impetus for description of Gilles de la Tourette's syndrome.
Feature selection in crowd creativity

Crowdsourcing is emerging as a wellspring of creative designs. This paper examines the mechanisms that support collective design. A sequential combination system is described: one crowd generates designs, and another crowd combines these designs. Previous experiments showed that the combined designs were judged more creative than the initial designs. The current work extends this previous research by examining the combination process of the designs more closely, looking at how features of the designs were selected and integrated into later designs. Participants preferred atypical features to typical ones for integration, and given a choice, selected practical but less atypical features over impractical but more atypical features. We conclude that crowds attend to both novelty and practicality of the features, and that the presence of atypical yet practical features contributes to the increased creativity of the combined designs.
Some Thoughts on Amino Acid Supplementation of Proteins in Relation to Improvement of Protein Nutriture

Supplementation of diets with free amino acids has not routinely been beneficial and poses a potential risk. Thus, mixing proteins to increase the quality of the dietary protein is attractive. The slope-ratio technique for evaluation of protein quality has serious drawbacks, because the growth response is not linear and animals appear to adapt to the diet and thus make more efficient use of diets low in protein or low in protein quality. Apparently, the relative value of proteins is not constant, but varies with the amino acid spectrum as well as intake. Thus, evaluation of proteins or protein mixtures should be determined under the conditions (e.g. maintenance or maximum gain) of their potential use. This approach could lead to the development of a protein replacement equivalents system similar to the starch equivalents system in the evaluation of the net energy of animal feeds.
Within- and Between-Site Variability in Moustached Tamarin (Saguinus mystax) Positional Behavior during Food Procurement

Despite evidence of marked seasonal changes in diet, day range, and patterns of habitat utilization in several primate species, little is currently known regarding intraspecific variability in locomotor behavior. In general, morphologists have tended to emphasize the constraints that anatomy places on positional behavior and have classified primate locomotion into a small set of broad categories such as leaping, suspension, and arboreal or terrestrial quadrupedalism. These categories have descriptive and functional value, but they typically have failed to include both the specific environmental context in which the behavior takes place (e.g., size, orientation, and rigidness of the support; location within the tree crown, etc.), or the relationship of positional behavior to the activity pattern of the animal (e.g., differences in patterns of posture and locomotion when exploiting particular food types). If one assumes that animals exploit substrates that allow them to move efficiently through the arboreal canopy, then there should be consistent associations between postural and locomotor behavior, support type, and activity pattern (Prost, 1965). How limited or how variable these associations are within a species is determined by physiological factors influencing body size and the energetic and mechanical costs of movement (Tuttle and Watts, 1985; Cant, 1987; Steudel, 1990, 1996; Doran, 1993); environmental factors affecting the structure of the arboreal canopy, and the spatial relationship of support types to each other and to the food resources exploited (Crompton, 1984; Garber, 1984, 1993a; Grand 1984; Pound, 1991; Cant, 1992; Bergeson, 1996); andsocial factors affecting individual spacing and differential access to resources of particular age, sex, or status classes (Hunt, 1992; Remis, 1995) (Figure 1).
Irrigation and fertilization effects on Nantucket Pine Tip Moth (Lepidoptera: Tortricidae) damage levels and pupal weight in an intensively-managed pine plantation

The widespread application of intensive forest management practices throughout the southeastern U.S. has increased loblolly pine, Pinus taeda L., yields and shortened conventional rotation lengths. Fluctuations in Nantucket pine tip moth, Rhyacionia frustrana (Comstock), population density and subsequent damage levels have been linked to variations in management intensity. We examined the effects of two practices, irrigation and fertilization, on R. frustrana damage levels and pupal weights in an intensively-managed P. taeda plantation in South Carolina. Trees received intensive weed control and one of the following treatments; irrigation only. fertilization only, irrigation + fertilization, or control. Mean whole-tree tip moth damage levels ranged from <1 to 48% during this study. Damage levels differed significantly among treatments in two tip moth generations in 2001, but not 2000. Pupal weight was significantly heavier in fertilization compared to the irrigation treatment in 2000, but no significant differences were observed in 2001. Tree diameter. height. and aboveground volume were significantly greater in the irrigation + fertilization than in the irrigation treatment after two growing seasons. Our data suggest that intensive management practices that include irrigation and fertilization do not consistently increase R. frustrana damage levels and pupal weights as is commonly believed. However, tip moth suppression efforts in areas adjacent to our study may have partially reduced the potential impacts of R. frustrana on this experiment.
Sterile spikelets assimilate carbon in sorghum and related grasses

Sorghum and its relatives in the grass tribe Andropogoneae bear their flowers in pairs of spikelets, in which one spikelet (seed-bearing, or SS) of the pair produces a seed and the other is sterile or male (staminate). This division of function does not occur in other major cereals such as wheat or rice. Additionally, one bract of the seed-bearing spikelet often produces a long extension, the awn, which is in the same position as but independently derived from that of wheat and rice. The function of the sterile spikelet is unknown and that of the awn has not been tested in Andropogoneae. We used radioactive and stable isotopes of carbon, as well as RNA-seq of metabolically important enzymes to show that the sterile spikelet assimilates carbon, which is translocated to the largely-heterotrophic SS, thus functioning as a nurse tissue. The awn shows no evidence of photosynthesis. These results apply to distantly related species of Andropogoneae. Thus, the sterile spikelet, but not the awn, could affect yield in the cultivated species and fitness in the wild ones.
Background Class Defense Against Adversarial Examples

Adversarial examples allow crafted attacks against deep neural network classification of images. We propose a defense of expanding the training set with a single, large, and diverse class of background images, striving to `fill' around the borders of the classification boundary. We find it aids detection of simple attacks on EMNIST, but not advanced attacks. We discuss several limitations of our examination.
Application of an Environmental Phage-Based Assay (Sample6 Detect HT/L) for the Detection of Listeria spp. in Ice Cream

Background: Dairy products are common sources of Listeria outbreaks, and early detection of the pathogen is critical to prevent outbreaks of illnesses and financial losses for dairy producers. Objective: This study aimed to evaluate Sample6 Detect HT/L for effective detection of Listeria monocytogenes and L. innocua in ice cream. Methods: Performance of the Sample6 DETECT HT/L was compared with U.S. Food and Drug Administration (FDA) Bacteriological Analytical Manual (BAM) Chapter 10 method for detection of Listeria spp. in ice cream using an unpaired study design. Results: R2-enriched samples tested with Sample6 Detect HT/L performed as well as the reference method at all time points tested from 15 to 24 h. R2 is a proprietary blend for use with the test kit that helps with early detection. All the dPODC values (Sample6 Detect HT/L presumptive and confirmed results) equaled zero, indicating 100% concordance between the methods. Both Sample6 Detect HT/L and FDA BAM results showed low dPODC values, with confidence intervals indicating no significant differences between Sample6 Detect HT/L and reference method results. Conclusions: Sample6 Detect HT/L is suitable to detect Listeria spp. in ice cream, even with a 12 h enrichment. Sample6 Detect HT/L demonstrated equivalent detection of L. monocytogenes and L. innocua from R2-enriched samples as expected with 15 and 18 h enrichment when compared with the 24 h FDA BAM method for L. monocytogenes. Highlights: These results indicate that Sample6 Detect HT/L, primarily developed for environmental samples, can be used to detect Listeria spp. in ice cream with less incubation time, resulting in faster detection.
The message is the medium: immaterialism and McLuhan’s Poetic Excess

Against interpretations of Marshall McLuhan as philosophical materialist, I argue that Understanding Media and its tagline, the medium is the message, show McLuhan to be an immaterialist: a poetic,...
A ubiquitin-like domain is required for stabilizing the N-terminal ATPase module of human SMCHD1

Variants in the gene SMCHD1, which encodes an epigenetic repressor, have been linked to both congenital arhinia and a late-onset form of muscular dystrophy called facioscapulohumeral muscular dystrophy type 2 (FSHD2). This suggests that SMCHD1 has a diversity of functions in both developmental time and space. The C-terminal end of SMCHD1 contains an SMC-hinge domain which mediates homodimerization and chromatin association, whereas the molecular architecture of the N-terminal region, which harbors the GHKL-ATPase domain, is not well understood. We present the crystal structure of the human SMCHD1 N-terminal ATPase module bound to ATP as a functional dimer. The dimer is stabilized by a novel N-terminal ubiquitin-like fold and by a downstream transducer domain. While disease variants map to what appear to be critical interdomain/intermolecular interfaces, only the FSHD2-specific mutant constructs we tested consistently abolish ATPase activity and/or dimerization. These data suggest that the full functional profile of SMCHD1 has yet to be determined. Lars Pedersen, Kaoru Inoue et al. present the crystal structure of the N-terminal ATPase module of human SMCHD1 bound to ATP. They show that the dimer is stabilized by a ubiquitin-like fold at the N-terminal, as well as by a downstream transducer domain.
Glucagon-like peptide-1 receptor agonist, exendin-4, reduces reinstatement of heroin seeking behavior in rats

Abstract Background Studies have shown that ‘satiety’ agents such as exendin-4 (a glucagon-like peptide-1 analog) reduce responding for addictive drugs (e.g., cocaine, nicotine, alcohol). In this study we tested the effect of exendin-4 on cue-induced and drug-induced reinstatement of heroin seeking behavior in rats. Methods This study consisted of three phases: In Phase 1, 55 male Sprague-Dawley rats had 15 daily pairings of saccharin with heroin self-administration. In Phase 2, rats experienced a 16-day home cage abstinence period and daily treatment with vehicle or exendin-4. On day 17, an extinction/reinstatement test was performed to assess drug seeking. In Phase 3, rats experienced 9 days of extinction followed by a reinstatement only test. Finally, expression of mRNA for various receptors in the nucleus accumbens shell (NAcS) was measured using RTqPCR. Results In Phase 1, rats that avoided intake of the heroin-paired saccharin cue exhibited shorter latency to obtain the first infusion. In Phase 2, treatment with exendin-4 decreased cue-induced, but not drug-induced heroin seeking. In Phase 3, saccharin avoiders previously treated with exendin-4 increased acceptance of saccharin, and 1-hour pretreatment with Exendin-4 abolished drug-induced heroin seeking. Finally, exendin-4 treatment increased expression of mRNA for the Orexin 1 receptor (OX1) in the NAcS, but did not affect expression of dopamine D2 receptors, GLP-1 receptors, or leptin receptors in this same structure. Conclusion Exendin-4 reduced cue- and drug-induced heroin seeking and increased acceptance of the drug-associated saccharin cue. These changes in behavior were accompanied by an increase in the expression of the OX1 receptor in the NAcS.
Creative Pedagogy: Infusing the Ways Paradigm in a Foundational Course

The relationship between theory and intervention in counseling is complex, raising an interesting dilemma in counselor education. How do counselors in training learn to be grounded in a theoretical...
Transient amnesia following prehospital low-dose ketamine administration.

Abstract Low doses of ketamine have been shown to be safe and effective for pain relief. Adverse effects are generally mild and transient. A 69-year-old woman suffered a witnessed ground-level fall without report of head injury, loss of consciousness, or intoxication. She was in severe pain despite 10 mg of intravenous morphine and paramedics provided intravenous ketamine 16 mg (0.19 mg/kg). Upon arrival to the ED, she was alert and oriented. An X-ray demonstrated an acute comminuted nondisplaced right humeral head and neck fracture. Her pain improved after an additional 4 mg of morphine and placement of a sling. Prior to discharge, the patient developed confusion, difficulty finding words, amnesia to the event, and anterograde amnesia evidenced by repetitive questioning. A head CT and a CT angiogram of the patient's head and neck demonstrated no acute abnormalities and an EEG demonstrated no epileptiform activity. The patient was admitted for observation and her mental status gradually improved overnight. She was discharged the following morning. Low dose ketamine is an important therapeutic option. Delayed or prolonged neuropsychiatric effects may be possible following combined ketamine and opioid analgesia. Clinicians utilizing low dose ketamine should be aware of this potential complication as it could result in the need for additional diagnostic testing and prolonged length of stay.
Liver Transplantation for Intrahepatic Cholangiocarcinoma: A Meta-analysis and Meta-regression of Survival Rates.

Background Intrahepatic cholangiocarcinoma (iCCA) is a contraindication to liver transplantation in most centers worldwide. Therefore, only a few such cases have been performed in each individual center, and the need for a systematic review and meta-analysis to cumulatively pool these results is apparent. Methods A systematic literature review was conducted using the MEDLINE and Cochrane Library databases according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement (end-of-search date: May 29, 2020). Meta-analyses of proportions were conducted to pool the overall survival (OS), recurrence-free survival (RFS), and overall recurrence rates using the random-effects model. Meta-regression was used to examine cirrhosis and incidental diagnosis as confounders on OS and RFS. Results Eighteen studies comprising 355 patients and a registry study of 385 patients were included. The pooled 1-, 3-, and 5-y OS rates were 75% (95% CI, 64%-84%), 56% (95% CI, 46%-67%), and 42% (95% CI, 29%-55%), respectively. The pooled 1-, 3-, and 5-y RFS rates were 70% (95% CI, 63%-75%), 49% (95% CI, 41%-57%), and 38% (95% CI, 27%-50%), respectively. Cirrhosis was positively associated with RFS, while incidental diagnosis was not. Neither cirrhosis nor incidental diagnosis was associated with OS. The pooled overall recurrence rate was 43% (95% CI, 33%-53%) over a mean follow-up of 40.6 ± 37.7 mo. Patients with very early (single ≤2 cm) iCCA exhibited superior pooled 5-y RFS (67%; 95% CI, 47%-86%) versus advanced iCCA (34%; 95% CI, 23%-46%). Conclusions Cirrhotics with very early iCCA or carefully selected patients with advanced iCCA after neoadjuvant therapy may benefit from liver transplantation under research protocols.
“Evaporating Mediterranean: The Fate of Migrants in a Shrinking Sea Commons”

Escaping privation and violence now prompt thousands of migrants and refugees to attempt to cross the Mediterranean Sea waters from North Africa to the relative safety and prosperity of southern Europe. Beyond the deadly peril of their journeys, they face the sophisticated coercive and ideological bureaucratic apparatuses deployed to discourage their movement. The tension between the constraints of international and supranational law together buttressed by humanitarian moral intuition on the one hand and virulent xenophobia and racism on the other have resulted in the externalization of border control across the Mediterranean Sea and immediate Eastern Atlantic. The practical result is to extend the effective territorial sovereignty of Italy and Spain, and with it the territorial sovereignty of the European Union. The Mediterranean Sea is drying up as a territorial commons, a fate likely to befall other bodies of water like the South China Sea and Arctic Sea.
Management of Obesity During Pregnancy and Periconception: Case-Based Learning for OB/GYN Clerkships.

Introduction Medical students lack knowledge about the effects of bariatric surgery on pregnancy and medical management of obesity as it relates to reproductive health. Additionally, there is bias ...
Competitive Advantage of Geosmithia morbida in Low-Moisture Wood May Explain Historical Outbreaks of Thousand Cankers Disease and Predict the Future Fate of Juglans nigra Within Its Native Range

Bark beetles vector symbiotic fungi and the success of these mutualisms may be limited by competition from other microbes. The outcome of fungal competition is strongly influenced by the physical and chemical conditions of the wood they inhabit. These conditions are in turn subject to climatic variation. In particular, wood moisture content influences fungal competition, and therefore could help determine environmental suitability for thousand cankers disease (TCD) caused by Geosmithia morbida and its vector Pityophthorus juglandis. We conducted competition experiments in J. nigra wood that was naturally or artificially colonized by G. morbida and other fungi over a range of wood moisture content expected across prevailing U.S. climatic conditions. G. morbida outcompeted antagonistic fungi Clonostachys and Trichoderma spp. at < 5% equilibrium moisture content. Aspergillus spp. outcompeted G. morbida at low moisture in wood from Indiana. We fit a logistic regression model to results of the competition experiments to predict survival of G. morbida across the U.S. Expected survival of G. morbida was highest in historical TCD epicenters and accounted for the low incidence and severity of TCD in the eastern U.S. Our results also predict that under future climate scenarios, the area impacted by TCD will expand into the native range of J. nigra. Given its role in emergent forest health threats, climate change should be a key consideration in the assessment of risks to hardwood resources.
Comparison of Pericranial Autograft and AlloDerm for Duraplasty in Patients With Type I Chiari Malformation: Retrospective Cohort Analysis.

BACKGROUND Pericranial autograft is a popular option for duraplasty during Chiari decompression with several theoretical advantages, but comparisons to other materials have yielded mixed results. OBJECTIVE To compare outcomes between pericranial autograft and AlloDerm (BioHorizons). METHODS Consecutive suboccipital craniectomies for patients with type I Chiari malformation (CM-I) over an 8-yr period at a single institution were identified. Exclusion criteria included revision surgeries and suboccipital decompressions without duraplasty. Outcomes included incisional cerebrospinal fluid (CSF) leakage, length of stay (LOS), wound complication, aseptic meningitis, syrinx improvement, and symptomatic improvement. RESULTS A total of 101 patients (70 females and 31 males) with a median (interquartile range) age of 17 yr (11-32) met the inclusion criteria. There were 51 (50%) patients who underwent duraplasty with pericranial autograft, and the remainder underwent duraplasty with AlloDerm. There were 9 (9%) patients who experienced a postoperative CSF leak. After adjusting for confounding factors, obesity (odds ratio [OR]: 4.69, 95% CI: 1.03-25.6) and use of AlloDerm (OR: 10.54, 95% CI: 1.7-206.12) were associated with CSF leak. Wound complication occurred in 8 (8%) patients but was not associated with graft type (P = .8). Graft type was not associated with LOS, syrinx improvement, or symptom improvement. Reoperations occurred in 10 patients with 4 in the autograft group and 6 in the AlloDerm group (P = .71). CONCLUSION In patients with CM-I, expansile duraplasty with AlloDerm was associated with greater odds of CSF leakage than pericranial autograft. Obesity was also associated with increased odds of CSF leakage.
Stern flows at full-scale Reynolds numbers

A numerical method for the solution of the Reynolds-averaged Navier-Stokes equations for three-dimensional flow of an incompressible fluid, used previously for calculations at model-scale Reynolds numbers, has been applied to the flow over the stern of an axi-symmetric body and a representative ship over a range of Reynolds numbers up to five billion. High Reynolds number experiments on axi-symmetric bodies strongly support the use of wall functions in the turbulence model. Comparisons with traditional ship wake scaling laws suggest that such laws do not properly describe the scale effects on the flow in the propeller plane.
Speech, Language, Cerebral Dominance and the Aphasias

In the preceding sections, we have alluded to various areas in the dominant hemisphere concerned with speech and language. The reader may well have been confused by the introduction of such terms as aphasia, apraxia, agnosia and dyslexia. It is well to warn the student beginning the study of language function that prior to the development of modern neuroimaging this had been an area of much confusion, with much disagreement and multiple hypotheses. This discussion will be limited to the more practical problems of anatomical localization.
Unusual intercarotid anastomosis associated with anterior communicating artery aneurysm. Case report.

✓ The case is presented of a 34-year-old man with subarachnoid hemorrhage from rupture of an anterior communicating artery aneurysm. The magnetic resonance imaging and angiographic findings are reported. Angiography showed the aneurysm plus an unusual anastomosis between the intracavernous portions of both internal carotid arteries. The anastomosis crossed posterior to the base of the dorsum sellae and was associated with absence of the right internal carotid artery and the A1 segment of the right anterior cerebral artery. This is the 11th case of such an unusual intercarotid anastomosis reported in the literature.
Candida albicans hypha formation and virulence.

Current research shows that major changes in gene expression accompany morphogenesis and suggest that fungal attributes necessary for proliferation and survival in the host are present in both yeast and hyphal growth forms. Manipulation of host-fungus interactions in animal models has provided insight into the role of hypha formation in virulence. The use of genetic manipulation has led to the discovery that transcription factors and signal transduction pathways are critical for the proper regulation of morphogenic conversions in Candida albicans. Mutant strains of C. albicans that are defective in hypha production in host tissue have reduced virulence in murine models of systemic candidiasis. A caveat associated with the use of morphogenic mutants in attempts to understand the role of hypha formation in virulence is that the roles of apical and budding modes of growth cannot be separated from morphology-specific gene expression. Studies of mutants displaying defects in hypha-specific gene expression but not in hypha production support the principle that the role of hyphae in virulence is more closely related to the changes in gene expression profiles that accompany hyphal growth than to hyphal growth itself. In addition to HWP1, PLD1, and other potential virulence factors, genes that could potentially regulate virulence factor gene expression during hypha production, such as those encoding transcription factors, signal transduction components, and proteins that function in secretion, as well as others, were identified.
Equivalences of Rewrite Programs

In this paper, we formulate syntactic, operational, and semantic equivalence concepts for rewrite programs in various formalisms, and study their properties and inter-relations.
Defense Mechanisms in Riffle Beetles (Coleoptera: Dryopoidea)

Adults or larvae or both of 11 dryopoid species were fed to 10 species of polyphagous fish and one turtle to determine the acceptability of beetles as prey. Aposematic adult Elmidae spp. were almost always rejected. Larval Elmidae spp., and adult or larval Dryopidae spp., Lutrochidae spp., and Psephenidae spp., do not have aposematic coloration; these test species were nearly always accepted. Further experiments showed that defense in Elmidae appears to be chemical and concentrated on or within the elytra. Defense in other dryopoids may be more closely related to concealment.
Higher BMI is associated with reduced brain volume in heart failure

Heart failure (HF) patients are at risk for structural brain changes due to cerebral hypoperfusion. Past work shows obesity is linked with reduced cerebral blood flow and associated with brain atrophy in healthy individuals, although its effects on the brain in HF are unclear. This study examined the association among body mass index (BMI), cerebral perfusion, and brain volume in HF patients. Eighty HF patients underwent transcranial Doppler sonography to quantify cerebral blood flow velocity of the middle cerebral artery (CBF-V of the MCA) and brain magnetic resonance imaging (MRI) to quantify total brain, total and subcortical gray matter, white matter volume, and white matter hyperintensities. Body mass index (BMI) operationalized weight status. Nearly 45% of HF patients exhibited a BMI consistent with obesity. Regression analyses adjusting for medical variables, demographic characteristics, and CBF-V of the MCA, showed increased BMI was associated with reduced white matter volume (p < .05). BMI also interacted with cerebral perfusion to impact total gray matter volume, but this pattern did not emerge for any other MRI indices (p < 0.05). Our findings suggest increased BMI negatively affects brain volume in HF, and higher BMI interacts with cerebral perfusion to impact gray matter volume. The mechanisms for these findings remain unclear and likely involve multiple physiological processes. Prospective studies are needed to elucidate the exact pattern and rates of brain changes in obese HF persons.
The synthesis and characterization of telluranthrene

Abstract The reaction between o -phenylenemercury and finely powdered tellurium metal at temperatures not exceeding 250°C yields a pale yellow crystalline solid. Characterization of this solid by elemental analysis, determination of the molecular mass, mass spectral analysis, and 13 C and 125 Te NMR spectral analysis indicates that it is the hitherto uncharacterized telluranthrene.
The preparation and characterization of M2(OEPh3)2(NMe2)4,where M = Mo and W and E = C and Si. The x-ray crystal structures of gauche-W2(OCPh3)2(NMe2)4, anti-Mo2(OCPh3)2(NMe2)4 and anti-W2(OSiPh3)2(NMe2)4

Abstract Reaction of M 2 (NMe 2 ) 6 (M = Mo, W) with triphenylmethanol in hexane/ether produces M 2 (OCPh 3 ) 2 (NMe 2 ) 4 ( I ) as yellow crystals in high yield (92–97%). M 2 (OCPh 3 ) 2 (NMe 2 ) 4 are air-sensitive, soluble in aromatic solvents and decompose around 160°C. The 1 H NMR of I is temperature dependent and shows a mixture of anti and gauche rotamers. The X-ray crystal structures of I reveal exclusively the gauche isomer for tungsten and the anti isomer for molybdenum. The reactions between M 2 (NMe 2 ) 6 and triphenylsilanol (2 equiv.) yield M 2 (OSiPh 3 ) 2 (NMe 2 ) 4 compounds (M = Mo, W) ( II ) as orange crystals. In the presence of ρ6 equiv. of Ph 3 SiOH the M 2 (NMe 2 ) 6 compounds react further to give yellow crystalline compounds, M 2 (OSiPh 3 ) 4 (NMe 2 ) 2 . In.compound II , where M = W, the W 2 O 2 N 4 skeleton adopted the anti conformation with WW = 2.2954(6) A, W O = 1.925(4) A, WN = 1.935(8) A, WWO = 108.1(1)°, WWN = 102(1)°. The addition of Ph 3 SiOH (6 equiv.) to W 2 (OBu t ) 6 yielded the related compound W 2 (OBu t ) 2 (OSiPh 3 ) 4 .
Further comments on metalfluorechromic indicators

Abstract The mechanism previously proposed for the behaviour of metalfluorechromic indicators is further discussed, and criticisms of Korbl and Svoboda are answered.
Adoption of Lower-fat Food Choices by Americans

Abstract Nutrition messages targeting consumption of lower-fat food choices (i.e., use of skim milk, lean meats and/or fat-modified products) have been disseminated to consumers using the population approach. The current level of adoption of these food choices, and the demographics of adopters, are unknown. This study uses the 1989–90, 1990–91, and 1991–92 Continuing Survey of Food Intake by Individuals and the Statistical Analysis Software (SAS) package to address these issues and test the applicability of Roger's Diffusion of Innovations theory to lower-fat food choices. There was a significant relationship between year and milk use (p
Postmastectomy radiotherapy in patients with breast cancer.

1 EBCTCG (Early Breast Cancer Trialists’ Collaborative Group). Eff ect of radiotherapy after mastectomy and axillary surgery on 10-year recurrence and 20-year breast cancer mortality: meta-analysis of individual patient data for 8135 women in 22 randomised trials. Lancet 2014; 383: 2127–35. 2 Peto R, Davies C, Godwin J, et al. Comparisons between different polychemotherapy regimens for early breast cancer: meta-analyses of long-term outcome among 100 000 women in 123 randomised trials. Lancet 2012; 379: 432–44. 3 Jatoi I, Anderson WF, Jeong JH, Redmond CK. Breast cancer adjuvant therapy: time to consider its time-dependent eff ects. J Clin Oncol 2011; 29: 2301–04. 4 Hellman S. Karnofsky Memorial Lecture. Natural history of small breast cancers. J Clin Oncol 1994; 12: 2229–34. 5 Jatoi I. Breast cancer: a systemic or local disease? Am J Clin Oncol 1997; 20: 536–39.