cssi/SciSciGPT-SciSciNet huggingface dataset:
Ludwig's angina complicated by fatal cervicofascial and mediastinal necrotizing fasciitis

A 54-year-old man, with a history of poorly controlled diabetes mellitus, presented to the emergency room with a three-day history of severe, progressive swelling of his neck associated with odynophagia. Oral cavity examination was remarkable for trismus with mouth opening limited to two fingers, edematous floor of the mouth, drooling and a carious second lower molar tooth. Physical exam was consistent with bilateral swelling of the neck, severe tenderness and symmetric induration in the submandibular area consistent with Ludwig's angina. On admission, leukocyte count was 7300/μL increasing to 26,000. Neck CT displayed gas in the fascial planes and musculature consistent with necrotizing fasciitis descending into the mediastinum and anterior chest (Fig. 1, Fig. 2). Blood cultures were negative and wound cultures were positive for an alpha-hemolytic streptococcus not further speciated and Actinomyces meyeri. Fig. 1 CT showing presence of gas in the anterior cervical space. Fig. 2 CT showing air dissecting into the anterior mediastinum. Broad-spectrum antimicrobials with Vancomycin and Imipenem/cilastatin were initiated; emergent surgical debridement and tracheostomy were performed (Fig. 3). During the hospital course he required multiple debridements and extraction of an infected second lower molar tooth. The clinical course was complicated by septic shock, acute respiratory distress syndrome and acute renal failure. Despite aggressive medical and surgical intervention, the patient expired from multisystem organ failure on day thirteen. Fig. 3 Extensive debridement with exposed sternomastoids and tracheostomy in situ. Ludwig's angina is an aggressive, potentially fulminant, deep neck infection often caused by dental infection/abscess from polymicrobial organisms [1]. It presents with fever, chills, mouth pain, drooling and dysphagia. Cervicofascial necrotizing fasciitis is rarely seen in patients with Ludwig's angina [2]. Clinical course and prognosis of patients with both conditions is determined by their immune status. Ludwig's angina superimposed by cervicofascial necrotizing fasciitis is a surgical emergency with a mortality rate of approximately >50%. The cornerstone of the treatment is securing the airway, providing efficient drainage, appropriate antimicrobials, and improving immunologic status [3]. Clinical presentation of Ludwig's angina can be subtle even in immunocompromised individuals with extensive underlying tissue destruction as seen in our case. It is important to maintain a high index of suspicion for necrotizing fasciitis in the setting of Ludwig's angina. Delay in the diagnosis and treatment is associated with a high mortality and morbidity [4].
Optimization of SCR Systems by Integration of Mixture Elements

Efficient SCR systems require an optimal reductant conditioning and a uniform NH3 distribution. This can only be achieved by the choice and the optimization of the appropriate mixing device. A novel, at Tenneco developed two-stage mixer provides a very good mixing performance at a comparatively low pressure loss. For a rapid and cost efficient system optimization, Tenneco uses the CFD simulation in combination with a high resolution measuring procedure for the determination of the local NH3 concentration.
A Qualitative Analysis of the Free Amino Acids in Insect Blood

The free amino acid content of the blood of insects is strikingly high in comparison with that of other animals. It varies from 40 mg.% in adults and young larvae to as high as 385. mg. % in some mature larvae and in pupae (3, 5, 7, 11, 12, 13, 16, 17, 22, 29). Comparable values for the blood of decapod Crustacea are from 1.6 to 8 mg. % (23) and for whole human blood 6 mg. % (14).
Reduced hyperthermia-induced cutaneous vasodilation and enhanced exercise-induced plasma water loss at simulated high altitude (3,200 m) in humans.

We examined whether less convective heat loss during exercise at high altitude than at sea level was partially caused by reduced cutaneous vasodilation due to enhanced plasma water loss into contra...
Pathway and Regulation of Lysine Biosynthesis in Brevibacterium lactofermentum

The pathway and regulation of lysine biosynthesis in Brevibacterium lactofermentum were investigated. The biosynthetic pathway of l-lysine in Brevibacterium was the same as that in Escherichia coli, since biosynthetic enzymes, which were aspartokinase [EC 2.7.2.4], dihydrodipicolinate (DDP)* synthetase, DDP reductase and N-acetyl-e-keto-α-aminopimelate (AKAP) synthetase, could be detected in B. lactofermentum.AKAP synthetase was measured with 1Δ-piperideine-2,6-dicarboxylate, which was prepared from l-diaminopimelate by l-amino acid oxidase, and either acetyl-CoA or succinyl-CoA could be served as an acyl donor for this reaction.Effect of amino acids on these enzymes was estimated. Aspartokinase was inhibited about 41, 45 and 82% by single or simultaneous addition of l-threonine and l-lysine at 1 mm, respectively, whereas the addition of other amino acids did not cause significant inhibitory effect.In contrast with DDP synthetase from E. coli, B. lactofermentum enzyme was not affected by l-lysine.DDP redu...
Introduction to The Silent World of Doctor and Patient.

This Foreword is brought to you for free and open access by the Law Review & Student Publications at Digital Commons @ Western New EnglandUniversity School of Law. It has been accepted for inclusion in Western New England Law Review by an authorized administrator of DigitalCommons @ Western New England University School of Law. For more information, please contact pnewcombe@law.wne.edu.
A young man with an unusual cause of palpitations.

His heart rate is 260, with wide QRS complexes. Is his tachycardia ventricular or supraventricular?
The Renewal of Ecclesiastical Studies: Chenu, Tübingen, and Theological Method in Optatam Totius:

Marie-Dominique Chenu remains significant not only as a scholar of the ressourcement but more foundationally for his contribution to method in theology. Only by tracing the influence of Tubingen on Chenu can one appreciate the methodological revolution that it inspired in him, and that the Second Vatican Council decree on priestly formation, Optatam Totius, subsequently reflected.
Relapse prediction: A meteorology-inspired mobile model:

Predicting relapses to binge drinking in non-dependent drinkers may now be possible with smartphones. Smartphones have been shown to help individuals reduce their drinking and may help binge drinke...
Конституционная экономика: защита частной собственности: примеры того, как Конституция может защищать права собственности и способствовать долгосрочному процветанию (Constitutional Economics: Private Property Safeguard Cases of Constitutional Protection of Private Property, Which Support Long-Term Prosperity)

Russian Abstract: Можно ли заложить в Конституцию возможности для долгосрочного экономического роста? Конституции начинались как основные законы о власти ("инструмент правления"), как компромиссы между наиболее влиятельными и сильными группами, лидерами. Некоторые из конституций оказались эффективными средствами защиты личных прав. Однако личные права – права собственника – суть основа прав собственности. Надежные гарантии прав собственности в свою очередь – широко признаваемый рецепт создания наилучших условий для долгосрочного экономического роста. Конституционные ограничения безответственного поведения государства рассматриваются на примерах классическом – США и нескольких современных государств. При этом под конституционными нормами понимаются не только и не столько формально прописанные положения, но нормы, которые глубоко укоренены в культуре и изменить которые можно лишь с чрезвычайно высокими издержками.English Abstract: Could constitutional guaranties of property safeguards to boost and to sustain economic Growth in very Long Run? We are comparing classical case of the US Founding Fathers with a number of modern attempts (Hungary, Georgia, Ukraine, Russia) to manage economic problems of young Democracies by means of "constitutional regulation". "Constitution" is defined here as a set of values and norms (not necessary fixed), which have become deeply entrenched and accepted among the people so the changes in these norms are realized at maximum cost.
Endoplasmic Reticulum Stress Is a Target for Therapy in Paroxysmal Nocturnal Hemoglobinuria.

Abstract 160 Paroxysmal nocturnal hemoglobinuria (PNH) is characterized by hemolytic anemia, bone marrow failure and venous thromboembolism. The disease is caused by a somatic mutation of the X-linked gene PIG-A, encoding a key enzyme responsible for the biosynthesis of the glycosylphosphatidylinositol anchored proteins (GPI-APs). Unfolded GPI-APs are translated and degraded intracellularly in the endoplasmic reticulum (ER) via the proteasome machinery. We hypothesized that the accumulation of misfolded proteins in mutant PNH cells activates the unfolded protein response (UPR) signaling cascade, which physiologically maintains the quality of newly synthesized proteins. UPR could thus represent a new target for therapy in PNH. We first assessed the sensitivity of GPI-AP- deficient K562 cells to the proteasome inhibitor PS-341 (Velcade‘) by flow cytometry after staining for annexin V and propidium iodide (PI). After 24 hour exposure to PS-341, cytotoxicity was significantly higher in the K562 GPI-AP-deficient cell line compared to their wild type counterpart at all dose tested (0 to 200nM). At 50nM, the early stage apoptosis was 21±2% in the K562 GPI-AP-deficient cell line versus 9.3±2% for their wild type counterpart (p=0.013) while the late stage apoptosis was 38±2.3% versus 22±2.3% (p Disclosures: No relevant conflicts of interest to declare.
Rotors: How Do We Know When They Are Real?

See Article by Rodrigo et al A spiral wave is a common macroscopic behavior of excitable media observed in biological, chemical, and physical systems.1,2 In cardiac tissues, spiral wave reentry occurs when a wavefront of electric propagation encounters functionally inexcitable tissue and rotates around it in a vortex-like fashion.3 A rotor of a spiral wave is a rotation center from which a 2-dimensional spiral wave of excitation rotates outward. Phase mapping has been the de facto standard method to identify rotors and to track their trajectories in animal models of fibrillation.4 On phase maps, a rotor is defined as a phase singularity point around which the phase transitions through a complete cycle from −π to +π.3,5 Phase mapping can falsely detect phase singularities in the absence of rotors,6 and spiral waves can exist without phase singularities.7 Rotors and focal impulses have been proposed to be the underlying drivers of atrial fibrillation (AF) in human.3,8,9 This localized source hypothesis has resulted in the utilization of phase mapping in clinical practice, mainly in 2 settings: invasive focal impulse and rotor modulation (FIRM) and noninvasive electrocardiographic imaging (ECGI). FIRM uses phase mapping to locate stable rotors based on endocardial unipolar electrograms acquired by a 64-lead basket catheter.9 ECGI uses phase mapping to locate rotors based on unipolar electrograms acquired by ≈250 body surface electrocardiographic leads, which are back projected onto the epicardial surface, using a technique called inverse solution. FIRM and ECGI have …
Distribution of Ecologically-Invasive Plants Along Off-Road Vehicle Trails in the Chequamegon National Forest, Wisconsin

To describe the invasive flora of off-road vehicle (ORV) trails, I combined field surveys for 7 invasive plant species along 2 ORV trails and seed surveys via soil samples taken from the undercarriage of ORVs. Field surveys identified 4 of the 7 species (Centaurea biebersteinii, Phalaris arundinacea, Hieracium aurantiacum, and Lotus corniculata), and at least one invasive plant occurred along 88% of the 100 m trail segments surveyed. Alliaria petiolata Euphorbia esula, and Lythrum salicaria were not present, but are included in the analysis for comparative purposes. Some ORVs dispersed seeds. While none of the seeds were invasive species, they were the same size as the invasive plants in this study. Because many invasive species have seed traits that predispose them for vehicular dispersal, ORVs occasionally contribute to long-distance dispersal events.
CRT-200.02 Therapeutic Window of Clopidogrel and Ticagrelor in Patients with Critical Limb Ischemia

Critical limb ischemia (CLI) is associated with increased risk of amputations, cardiovascular events and mortality. Antiplatelet therapy is a crucial component of CLI treatment. High on-treatment platelet reactivity (HPR), defined by a platelet reactivity unit (PRU) score above 208 on the VerifyNow
The internet and state repression: A cross-national analysis of the limits of digital constraint

Although the internet is an indispensable part of everyday life as well as an essential medium of political discourse, governments may struggle to completely black out their repressive acti...
The Anashid of the Islamic State: Influence, History, Text, and Sound

This article examines the rise of the Islamic State (IS) through its anashid (a cappella), analyzing their lyrics and their musical attributes such as sonic elements, pitch, and harmony, among othe...
Massive MIMO — Beyond 4G and a basis for 5G

Massive Multiple-Input Multiple-Output (MIMO) is the most compelling wireless technology and a key component of fifth generation (5G) systems. This paper discusses the technology and its objectives in detail. The paper also discusses the complete design process of a 5G antenna system.
Information centric approach to analysing security threats and node behaviour in underwater senor networks

Underwater sensor networks (UWSN) have a broad range of applications requiring accurate and efficient data management. Due to the restricted energy of underwater modems and the harsh UWSN environment, we consider the possibility of mobile malicious nodes interjecting false packets into various networks. With the proper incite, a denial of service (DoS) attack can drastically affect an UWSN. In this work, we first analyse different types of DoS attacks in which UWSNs may be vulnerable. Next, we purpose an adapted algorithm to help detect and restrict potential malicious nodes. Finally, we analyse node behaviour using three different machine learning techniques to find statistical, adaptive, and predictive approaches to DoS restriction. Simulation results show a strong correlation between DoS defensive methods and decreased network traffic in typical attacker scenarios. Furthermore, we introduce more advanced scenarios to test our machine learning techniques in various topologies.
Maxwell's Equations in Two-Phase Systems II: Two-Equation Model

The method of volume averaging is used to derive the two-equation model for Maxwell's equations in a two-phase system. The analysis provides a set of macroscopic transport equations for the electric and magnetic fields that are completely coupled in terms of the closure problem. When the closure problem is quasi-steady, a formal solution is obtained and estimates are developed for the differences between the averaged fields in the individual phases. These estimates lead to constraints for the condition of local electrodynamic equilibrium.
Spinal cord injury and health locus of control beliefs

Individual beliefs about control over their health were assessed in 53 patients with spinal cord injury. Patients who believed they exercised control over their health were less depressed than patients who were fatalistic. A significant number of patients were found to be higher in their internal attributions of health control (N = 31) than those who believed in chance (N = 5) and those who believed medical personnel were in control of their health (N = 11). The results are integrated with a past study of depression following spinal cord injury and locus of control beliefs.
Full-wave electromagnetic simulation of millimeter-wave active devices and circuits

This paper discusses the most recent progress in developing effective physics-based models for devices operating at millimeter-wave frequencies. The model is based on coupling dynamic electromagnetic wave solutions with carrier transport models. The potentials of this modeling approach for both device simulation and the global simulation of millimeter-wave circuits are demonstrated. Results comparing the full-wave model developed with conventional electrostatic models are provided through the simulation of different microwave transistors. The ability of the model to detect traveling wave effects, such as phase mismatch between the input and output electrodes of a conventional transistor, and their effects on the device gain are also provided. Results from the simulation of an air-bridged gateMesfet, designed to reduce traveling wave effects in high frequency transistors and solve the problem associated with high gate resistance, are illustrated and discussed. Finally, results showing the ability of this technique to model the nonlinearity and the harmonic distortion are provided through the simulation of an amplifier circuit.
Civil Protection Orders and their Courtroom Context: the Impact of Gatekeepers on Legal Decisions

Using observational data obtained from a sample of 303 protection order hearings in a large Southwestern city, the current study explores the impact of formal (i.e., presiding Hearing Master, legal counsel, courtroom-employed translator) and informal actors (i.e., victim advocate, family members, friends) on civil protection order (CPO) decisions. Several multivariate analyses were conducted to assess the net and context-specific effects of these legal and informal actors on the likelihood of receiving an order of protection and its length of time. When examining the effectiveness of courtroom actors in assisting domestic violence (DV)/ intimate partner violence (IPV) victims with their CPO cases, this study finds that whether or not a victim successfully obtains a protection order, and for how long, depends on a range of case attributes as well as who is actually present in the courtroom with the victim. As these findings suggest, gatekeepers matter depending on a range of case attributes. States should allocate additional resources and funding to non-profit agencies to continue to promote affordable/free legal services through legal aid and other similar legal entities as well as offer continued support for victim advocacy and self-help centers.
The Proton-Coupled Monocarboxylate Transporter Hermes Is Necessary for Autophagy during Cell Death.

Summary Nutrient availability influences the production and degradation of materials that are required for cell growth and survival. Autophagy is a nutrient-regulated process that is used to degrade cytoplasmic materials and has been associated with human diseases. Solute transporters influence nutrient availability and sensing, yet we know little about how transporters influence autophagy. Here, we screen for solute transporters that are required for autophagy-dependent cell death and identify CG11665/hermes. We show that hermes is required for both autophagy during steroid-triggered salivary gland cell death and TNF-induced non-apoptotic eye cell death. hermes encodes a proton-coupled monocarboxylate transporter that preferentially transports pyruvate over lactate. mTOR signaling is elevated in hermes mutant cells, and decreased mTOR function suppresses the hermes salivary gland cell death phenotype. Hermes is most similar to human SLC16A11, a protein that was recently implicated in type 2 diabetes, thus providing a link between pyruvate, mTOR, autophagy, and possibly metabolic disorders.
Bayesian Knowledge Base Distance-Based Tuning

In order to rigorously characterize the difference or similarity between two probabilistic knowledge bases, a distance/divergence metric must be established. This becomes increasingly important when conducting parameter learning or tuning of a knowledge base. When tuning a knowledge base, it is essential to characterize the global probabilistic belief change as the knowledge base is tuned to ensure the underlying probability distribution of the knowledge base is not drastically compromised. In this paper, we develop an entropy-based distance measure for a Bayesian Knowledge Base (BKB) derived from the Chan-Darwiche distance measure used in a variety of probabilistic belief network analyses. Through this distance measure it is possible to calculate the theoretical minimum distance required to correct a BKB when the system's answer contradicts that of an expert. Having a theoretical minimization limit on distance allows for a quick calculation to test the integrity of either the BKB or the expert's judgement, since a high minimum distance would suggest the necessary tuning is not consistent with the rest of the knowledge base. Further still, this distance measure can be used to prove that in some cases the standard single causal rule set BKB tuning procedure (discussed in our prior work) in fact minimizes the global BKB distance. The final portion of this paper presents a few practical examples which analyze the utility of the BKB distance measure along with evidence supporting the proposition that the Causal Rule Set tuning procedure minimizes the distance between the original and tuned knowledge base in many cases.
Music and Song in Persia (RLE Iran B) : The Art of Avaz

This book is the first full-length analysis of the theory and practice of Persian singing, demonstrating the centrality of Persian elements in the music of the Islamic Middle Ages, their relevance to both contemporary and traditional Iranian music and their interaction with classical Persian poetry and metrics.
Subanesthetic ketamine infusions for the management of pediatric pain in non-critical care settings: An observational analysis

BACKGROUND Guidelines issued by the American Society of Regional Anesthesia and Pain Medicine suggest that ketamine infusions for acute pain management are advantageous as a primary treatment or as an opioid adjunct. Despite significant data regarding its use in adult patients, there remains a paucity of information related to its quality and side effect profile in pediatrics and how it can be effectively used. We aimed to summarize our practice of utilizing ketamine for pediatric pain management in non-critical care settings. METHODS Patients aged 0-21 years receiving low-dose ketamine infusions (≤0.3 mg/kg/hour) in inpatient care units over five years were retrospectively analyzed. Demographics, specific quality metrics, and side effects were quantified. RESULTS About 172 patients received 270 subhypnotic ketamine infusions. The median duration of the infusions was 63.8 hours and 0.2 mg/kg/hour for the highest dose. The primary indication for ketamine was chronic pain exacerbation (83.3%). Despite similar opioid consumption, there was a significant reduction in mean verbal pain scores before (8.9 ± 1.9, P < .001) and after ketamine (6.5 ± 2.7, P < .001) use. Although there were 52 incidences of some side effect (neurologic excitability [10.4%]; over-sedation [7.4%]; rapid response team alerts [1.1%]), none resulted in termination of the infusion or escalations in care. CONCLUSION Ketamine can effectively be used as part of a multimodal analgesic regimen in pediatric patients in non-critical care settings. Our five-year experience using low-dose ketamine infusions highlights an acceptable side effect profile, with no attributable escalations in care or serious adverse events.
Long-Term Postoperative Complication of the Cabrol Procedure Presenting as Recurrent Anterior ST-Segment Elevation Myocardial Infarction.

The Cabrol procedure is a classic method for the treatment of proximal aortic dissections and thoracic aneurysms involving the aortic root and valve. Pioneered in 1981, this procedure makes use of a composite graft replacement of the aorta, or a valve-sparing aortic replacement, with attachment of an interpositional graft for restoration of blood flow to the coronary arteries. Although initial short-term outcomes had good results, this procedure has now become obsolete because of longer term outcomes leading to occlusion and stenosis of the interposition graft. Despite modifications to the original Cabrol procedure, current management of surgical aortic root and valve replacement typically involves the modified Bentall procedure. Here, we discuss a case involving the classic Cabrol procedure performed in 1985 in which unique postoperative complications were seen. Late presentation of myocardial ischemia related to dysfunction of a Cabrol graft is exceedingly rare. Currently, the Cabrol procedure has been modified from its original version and is used for complex aortic root replacement procedures refractory to the modified Bentall reimplantation technique.1
3D and 4D printing of nanomaterials: Processing considerations for reliable printed nanocomposites

Abstract Nanoparticles added to polymers can enhance their specific performance with respect to stiffness, strength, ultimate properties, impact properties, permeation, fire retardancy, and other desirable properties. However, these enhancements are observed only if care is taken to choose appropriate nanoparticles and to adapt processing parameters. This chapter will review the physical parameters relevant to 3D and 4D printing of nanoparticle-loaded polymer structures. This review will highlight the influence of nanoparticles on viscosity, thermal properties, vitrification, crystallization, and light interaction. Examples of successful printing of nanomaterial structures will be provided. The future outlook for nanomaterial printing, and the needs for future research, will be summarized.
An Experimental Course: Animal Handling, Safety, and Well-Being

Students in the Department of Animal Science at Iowa State University are coming from increasingly diverse backgrounds, with little to no experience working with or handling various livestock species. In order to best accommodate these students, additional courses are being developed, one of which is Animal Science 190X: Animal Handling, Safety, and Well-Being. Through the course, students handle all major livestock species; sheep, swine, poultry, horses, beef cattle and dairy cattle, and are required to demonstrate handling knowledge and skills learned as part of a final assessment. This creates an opportunity for students lacking a livestock background to feel more confident and safer as they interact with livestock species both throughout their collegiate careers and as they enter into the animal agriculture industry.
ENHANCED RECOVERY AFTER THORACIC SURGERY

Enhanced recovery pathways (ERPs), used across multiple surgical subspecialties, is a multidisciplinary delivery of perioperative care designed to lessen the psychological stress of patients undergoing surgery. Thoracic ERP has been implemented but is not widespread, and variations exist between programs. Evidence of the benefit of thoracic ERP is emerging. This article presents common components of a thoracic surgery ERP and reviews contemporary outcomes.
40 Years of My Venture with CYTOMETRY.

Briefly depicted are the publications in CYTOMETRY that received the highest frequency of citations. Among them are seminal papers describing application of metachromatic fluorochrome acridine orange to differentially stain DNA versus RNA or to analyze susceptibility of DNA in situ to denaturation; both features being markers of different sections of the cell cycle including identification of noncycling quiescent cells. The papers reviewing detection of cyclins D1, E, A or B1, each in relation to cell cycle phase, were also among the highly cited ones. The highest citation rates received publications describing development of the TUNEL methodology to detect apoptotic DNA fragmentation, and more recently expression of ϒH2AX to reveal DNA damage. © 2020 International Society for Advancement of Cytometry.
Linkage of atypical protein kinase C to Alzheimer disease

Abstract Alzheimer disease (AD) is thought to be caused by build-up of neurotoxic plaques containing Aβ peptides cleaved from amyloid precursor protein by β-secretase, compounded by increases in phospho-tau-containing neuronal “tangles.” Late-onset AD is commonly associated with insulin-resistant states, and our findings suggest that hyperinsulinemia therein hyperactivates brain Akt and atypical protein kinase C (aPKC), and thusly activated aPKC (rather than Akt) leads to β-secretase activation and excessive production of Aβ peptides and phospho-tau. Interestingly, others have reported that aPKC activity is also increased in nondiabetic AD, apparently by noninsulin factors. Fortunately, control of hyperinsulinemia in mouse models of obesity/diabetes, and chemical blockade, or partial knockout, or expressional inhibition of brain aPKC can prevent the activation of β-secretase and excessive production of Aβ peptides and phospho-tau that are provoked by insulin and other agents. Chemical inhibitors of aPKC that pass the blood–brain barrier may have potential to treat AD.
Asymptomatic and Biochemically Silent Pheochromocytoma with Characteristic Findings on Imaging.

Pheochromocytomas are tumors that originate from the chromaffin tissue of the adrenal medulla and commonly produce catecholamines. The diagnosis is typically established by the measurement of catecholamines or their metabolites in urine or plasma, and tumors are localized with the use of radiographic and scintigraphic studies. Pheochromocytomas can occur in asymptomatic patients, and the preferred treatment is surgical removal of the tumor. We report a 48-year-old male with a left adrenal incidentaloma, which progressively increased in size from 1.1 cm to 2.6 cm over a 4-year period, as measured by an adrenal computed tomography (CT) scan. Throughout his entire course of treatment, he was asymptomatic with normal blood pressure readings. His biochemical screening was unremarkable for the first three years of tumor surveillance. Follow-up imaging, including CT and MRI, showed findings suspicious for pheochromocytoma, and the diagnosis was ultimately made with the combination of imaging and laboratory studies. He underwent laparoscopic resection of the adrenal mass with confirmation of pheochromocytoma on histology. This case illustrates how CT and MRI findings can alert providers to the presence of a pheochromocytoma, even in an asymptomatic, biochemically negative patient.
A Review of On-Field Investigations into the Biomechanics of Concussion in Football and Translation to Head Injury Mitigation Strategies

This review paper summarizes the scientific advancements in the field of concussion biomechanics in American football throughout the past five decades. The focus is on-field biomechanical data collection, and the translation of that data to injury metrics and helmet evaluation. On-field data has been collected with video analysis for laboratory reconstructions or wearable head impact sensors. Concussion biomechanics have been studied across all levels of play, from youth to professional, which has allowed for comparison of head impact exposure and injury tolerance between different age groups. In general, head impact exposure and injury tolerance increase with increasing age. Average values for concussive head impact kinematics are lower for youth players in both linear and rotational acceleration. Head impact data from concussive and non-concussive events have been used to develop injury metrics and risk functions for use in protective equipment evaluation. These risk functions have been used to evaluate helmet performance for each level of play, showing substantial differences in the ability of different helmet models to reduce concussion risk. New advances in head impact sensor technology allow for biomechanical measurements in helmeted and non-helmeted sports for a more complete understanding of concussion tolerance in different demographics. These sensors along with advances in finite element modeling will lead to a better understanding of the mechanisms of injury and human tolerance to head impact.
Tensions of trust in preservice teachers’ consideration of challenging mathematics tasks

Drawing on a larger, cross-institutional study that examines equitable elementary mathematics education, this article reports initial findings related to tensions that emerged for preservice teache...
H2 and carbon-heteroatom bond activation mediated by polarized heterobimetallic complexes

Abstract The field of heterobimetallic chemistry has rapidly expanded over the last decade. In addition to their interesting structural features, heterobimetallic structures have been found to facilitate a range of stoichiometric bond activations and catalytic processes. The accompanying review summarizes advances in this area since January of 2010. The review encompasses well-characterized heterobimetallic complexes, with a particular focus on mechanistic details surrounding their reactivity applications.
A Case of Adrenal Crisis-Induced Stress Cardiomyopathy.

We report a case of a 36-year-old male who presented to the emergency department with complaints of weakness. On presentation the patient was hypotensive, hyperkalemic, and hyponatremic. The patient experienced a sudden cardiac arrest in the computed tomography (CT) scanner moments after arrival. Electrocardiogram (EKG) demonstrated PR prolongation and widened QRS. Echocardiogram demonstrated a left ventricular ejection fraction of 26%-30% with evidence of severe hypokinesis of the mid antero-septal and inferior-septal segments of the left ventricle. CT of the chest, abdomen, and pelvis demonstrated hypoplastic/atrophic adrenal glands. Total cortisol level was undetectable by lab measurement. The patient was diagnosed with stress cardiomyopathy secondary to adrenal crisis. He was managed with hydrocortisone and eventually made a full clinical recovery and improvement in left ventricular ejection fraction. This article references the rarity of this phenomenon and its relevance to early clinical detection.
Does the Speech Cue Profile Affect Response to Amplitude Envelope Distortion

Purpose A broad area of interest to our group is to understand the consequences of the “cue profile” (a measure of how well a listener can utilize audible temporal and/or spectral cues for listenin...
Soft tissue response to silicones

Although the term’ silicone’ refers to a group of organic silicone compounds, the one most commonly used in medicine is composed of a polymer known as dimethypolysiloxane (DMPS). In silicone gel the polymer is cross-linked; the more cross-linking, the more solid is the gel. Liquid silicone consists of glucose-linked DMPS polymer chains. Silicones first became commercially available in 1943, with the first subdermal implantation of silicone occurring in the late 1940s [1–3]. Silicones have since been developed for a wide variety of medical applications, most notably in joint and breast prostheses.
Deconstructing sex differences in C-reactive protein trends over time.

OBJECTIVES Heightened inflammatory state, as measured by circulating C-reactive protein (CRP) levels, can promote inflammation-mediated disease risk. It is important to account for population fluctuation and sex variation in serum CRP concentrations on overall time trends. METHODS Using the National Health and Nutrition Examination Survey data, we specify linear and algebraic decomposition models separately by sex to identify the drivers of the changing trends in the distribution of CRP values in the population. RESULTS We found a nonsignificant overall increase in CRP, but a significant decrease among women and increase among men, over a 10-year period. We then used linear and algebraic decomposition techniques to identify the sources of change in CRP over time, separately for women and men. CRP increased among men mainly because lifestyle/health characteristics worsened over time, and because the size of socioeconomic/demographic groups with higher CRP increased and the size of groups with lower CRP decreased. The downward shift in CRP among women occurred because the typical woman across all cohorts had lower CRP levels. CONCLUSIONS We identified two fundamentally different processes of change driving the decline and rise in CRP values among women and men, respectively.
Helping Abused and Traumatized Children: Integrating Directive and Nondirective Approaches, By E. Gil

Working clinically with children who have endured abuse and trauma can be both theoretically challenging and emotionally intense. Drawing from more than 3 decades of experience working with such ch...
Insider Trading and Earnings Reporting: Evidence of Managerial Optimism or Opportunism?

This study examines managerial ethics with regard to earnings reporting and insider trading. Managers of firms with optimistic forecasts or firms with higher Street earnings versus GAAP earnings are considered candidates to be misleading investors. Two hypotheses are examined: 1) that these managers are indeed misleading investors and taking advantage of their deception by selling shares of their firms' stock at inflated prices (the managerial opportunism hypothesis) and 2) that these managers are not misleading investors, but merely believe the optimism surrounding their firms (the managerial optimism hypothesis). The tests find that managers who are candidates for misleading investors to opportunistically sell shares are actually behaving ethically. They buy relatively more shares than other managers, providing support for the managerial optimism hypothesis.
The metabolically healthy but obese phenotype in African Americans.

J Clin Hypertens (Greenwich). Obesity has become one of the leading public health concerns in the United States and worldwide. While obesity is associated with the metabolic syndrome, some obese individuals do not possess the constellation of the metabolic abnormalities and are referred to as metabolically healthy but obese (MHO) persons. Limited data exist on the prevalence and characteristics of the MHO in African Americans. The authors studied 126 obese African Americans and defined the MHO phenotype as an individual with a body mass index ≥30 kg/m2, high-density lipoprotein cholesterol ≥40 mg/dL, absence of type 2 diabetes mellitus, and absence of arterial hypertension. The correlates of the MHO phenotype with anthropometrical and metabolic indices were examined, as well as the effect of age on these correlates. Results showed that 36 (28.5%) of the individuals were identified with the MHO phenotype. Waist circumference (WC) and waist-to-hip ratio (WHR) were significantly lower (P<.05) in MHO than in non-MHO patients. While there were significant lower levels of low-density lipoprotein and triglycerides in MHO among patients younger than 40 years, the significance was lost among patients 40 years or older. This study indicates that increased WC and WHR may be early premetabolic syndrome markers in obese individuals and should warrant aggressive risk factor reduction therapy to prevent future development of related cardiovascular conditions.
The ribonucleases J1 and J2 are essential for growth and have independent roles in mRNA decay in Streptococcus pyogenes

The paralogous ribonucleases J1 and J2, recently identified in Bacillus subtilis, have both endoribonucleolytic and 5'-to-3' exoribonucleolytic activities and participate in degradation and regulatory processing of mRNA. RNases J1 and J2 have partially overlapping target specificities, but only RNase J1 is essential for B. subtilis growth. Because mRNA decay is important in regulation of virulence factors of Streptococcus pyogenes (the group A streptococcus, GAS), we investigated the role of these newly described RNases in GAS. We found that conditional mutants for both RNases J1 and J2 require induction for growth, so we conclude that, unlike the case in B. subtilis, both of these RNases are essential for GAS growth, and therefore their functions are not redundant. We compared decay of representatives of the two classes of messages we had previously identified: Class I, which decay rapidly in exponential and stationary phase of growth (hasA and gyrA), and Class II, which are stable in stationary phase and exhibit a biphasic decay curve in exponential phase (sagA and sda). We report that RNases J1 and J2 affect the rate of decay of Class I messages and the length of the first phase in decay of Class II messages.
Sharing a diagnosis of HPV-related head and neck cancer: the emotions, the confusion, and what patients want to know.

BACKGROUND Oropharyngeal cancers are increasingly associated with human papillomavirus (HPV). Little is known about the experience of patients receiving this diagnosis.
Mental Models of Research: Generating Authentic Questions

In this paper, we question how we might disrupt positivist research paradigms that preclude students from engaging and experiencing ownership in the research process. We question what we, as professors, could do to facilitate the transition from traditional research reporting to a disposition of inquiry that allows for ambiguity and discovery in the research process. Evidence presented was gathered over the course of a two-year qualitative research project completed in a capstone education course. Like most capstone courses, we required a summative research paper, but student work suggested they had minimal interest or enthusiasm for the project. However, by redirecting our students' research interest from traditional research reporting to the generation of authentic research questions drawn from their student teaching experience, a solution emerged. The students' questions provided the basis for the ensuing qualitative inquiry project that afforded them a new and authentic type of inquiry. This paper des...
Coulomb reacceleration as a clock for nuclear reactions

Reacceleration effects in the Coulomb breakup of nuclei are modeled with the two-dimensional time-dependent Schroedinger equation, extending a previous one-dimensional study. The present model better describes the individual contributions of longitudinal and transverse forces to the breakup and reacceleration. Reacceleration effects are found to preserve a strong memory of the pre-breakup phase of the reaction, as was concluded with the one-dimensional model.
Evaluation of logistic and economic impacts of hybrid vehicle propulsion/microgrid concepts: Demonstration of LOCSS applied to HE HMMWV in future unit of action

Computer models have been developed and used to predict the performance of vehicles equipped with advanced fuel and power train technologies such as hybrid electric or fuel cells. However, simulations that describe the interaction of the vehicle with the rest of the vehicle fleet and infrastructure are just emerging. This paper documents the results of an experiment to demonstrate the utility of these types of simulations. The experiment examined the business case of fielding hybrid electric, high-mobility multipurpose wheeled vehicles (HE HMMWVs) in a future Army organization. The hypothesis was that fielding HE vehicles would significantly reduce fuel consumption due to the economy offered by the HE technology and reducing the number of generators as a result of using the vehicles to generate electrical power. The Logistical and Combat Systems Simulation (LOCSS) was used to estimate differences in fuel consumption and associated equipment during a 72-hour operation with and without HE HMMWVs. There was a 25 percent reduction in fuel consumption over the systems examined. However, due to the relatively low density of the HE vehicles in the organization, the total difference in fuel consumption was not operationally significant; and the savings in fuel costs did not overcome the additional procurement costs over a twenty-year life cycle.
Significant Mitral Regurgitation is Protective Against Left Atrial Spontaneous Echo Contrast and Thrombus as Assessed by Transesophageal Echocardiography

This retrospective study examines whether a relationship exists between the severity of mitral regurgitation (MR) and the presence of left atrial spontaneous echo contrast and/or thrombus (SEC/THR) as assessed by transesophageal echocardiography in 427 consecutive patients. Clinical data were evaluated in 316 of these patients. Nine percent of patients with MR ≤2 + versus p p
The turnover of lysosomal glycosylasparaginase in rat liver

Abstract Rat liver glycosylasparaginase ( N 4 -(β-N- acetyl- d -glucosaminyl)- l -asparagine amidohydrolase (EC 3.5.1.26) was irreversibly inhibited in vitro by the asparagine analogue 5-diazo-4-oxo- l -norvaline (DONV). Following the abolition of this lysosomal hydrolase by DONV in rats, the enzyme activity in liver recovered exponentially. Assuming a zero order rate of protein synthesis, the half-life of the glycosylasparaginase in rat liver was measured to be 2 days.
The Application of Learning Theory to Serial Murder or “You Too Can Learn to be a Serial Killer”

Popular ideas concerning serial murder see these killings as an act committed by a deranged or irrational individual. This article contends that this is not the case, but that the killer is behaving in a manner which makes sense and is logical to the killer and is a response to some perceived wrong. The process through which this reponse occurs is detailed. The conclusion suggests that if serial murder is indeed a learned response then this response can be “unlearned” and the serial murderer can be restored to again function within society.
Logic of knowledge and belief in the design of an integrity kernel for an office information system (abstract)

An integrity specification language (ISL) based upon a form of interval temporal logic is defined and the framework for a logic of knowledge and beliefs about data integrity is developed. The intended purpose of ISL is for the design of integrity kernels in an office information system in which the dynamic evaluation of data integrity based upon partial knowledge and informed judgement relative to update request by clients, is required. ISL itself is described in an earlier paper and summarized in this paper. Beliefs in ISL are specified with a form of interval temporal logic and provide an extension of the Moser technique for formulating beliefs. The Clark and Wilson model designed to prevent fraudulent and erroneous data modification is subsumed. An integrity Characteristic Tuple (ICT) incorporates the notions of correctness, completeness, quality, timeliness and confidence is associated with each Constrained Data Item (CDI). An integrity system which includes extensions of the concept and function of the server architecture as defined in the Multimedia Office Server (MULTOS) project, is given. An integrity kernel is defined which incorporates an algorithm for the detection of faults in presumptions about data integrity based upon knowledge and beliefs. A simplified integrity kernel is specified formally and a corresponding sample server-client session is provided.
Some new upper bounds on the generation of prime numbers

Given an integer N, what is the computational complexity of finding all the primes less than N? A modified sieve of Eratosthenes using doubly linked lists yields an algorithm of OA(N) arithmetic complexity. This upper bound is shown to be equivalent to the theoretical lower bound for sieve methods without preprocessing. Use of preprocessing techniques involving space-time and additive-multiplicative tradeoffs reduces this upper bound to OA(N/log logN) and the bit complexity to OB(N logN log log logN). A storage requirement is described using OB(N logN/log logN) bits as well.