cssi/SciSciGPT-SciSciNet huggingface dataset:
The Impact of Bladder Neck Suspension on the Resting and Stress Urethral Pressure Profile: A Prospective Study Comparing Controls with Incontinent Patients Preoperatively and Postoperatively

Abstract For further understanding of the urodynamics of urinary stress incontinence 20 female patients with this condition were evaluated using resting and stress urethral pressure profiles before and after endoscopic suspension of the bladder neck. The results were compared to those in 13 normal volunteers who were evaluated similarly. In addition, the effect of posture on the urethral pressure profile was studied with the patients in the supine, standing and sitting positions. The results show that the mean maximum urethral closure pressure and functional profile length were significantly lower (p equals 0.005) in patients with stress urinary incontinence when compared to the normal volunteers. Posture did not significantly affect the maximum urethral closure pressure and functional profile length in either group (p greater than 0.1). Successful endoscopic suspension of the bladder neck did not significantly alter the maximum urethral closure pressure, while it significantly increased the functional profile length with the patient in the standing position only (p less than 0.05). The stress urethral pressure profile separated objectively the stress urinary incontinent patients and the continent volunteers. In continent women the transmitted abdominal pressure in the urethra during a cough or Valsalva’s maneuver was significantly higher than that in the bladder over most of the urethral length in all 3 positions. In the group with stress urinary incontinence the transmitted abdominal pressure in the urethra during the same maneuvers was less than that in the bladder. The data also showed that the stress urethral pressure profile curves in patients with stress urinary incontinence who were cured surgically reverted to the normal control pattern with higher abdominal pressure transmission in the urethra than in the bladder during a cough or Valsalva’s maneuver. The anatomical and physiological implications of these findings with their clinical application in the understanding of the mechanisms of continence in normal and stress incontinent women are discussed.
Glycemic control in patients with diabetes mellitus upon admission to a dental clinic: considerations for dental management.

OBJECTIVE The purpose of this study was to determine the level of glycemic control in dental patients with diabetes upon admission to a dental school clinic. METHODS AND MATERIALS One hundred patients (mean age: 57.7 years) of the Oral Diagnosis-Admissions Clinic at the University of Minnesota School of Dentistry, Minneapolis, Minnesota, with diabetes mellitus were chosen as subjects. Fasting blood glucose was measured using a portable blood glucose monitoring device as a part of their initial dental examination. RESULTS Twenty-eight of the 100 patients were found to be hyperglycemic (> or = 126 mg/dl; 174.8 +/- 40.8 mg/dl; mean +/- SEM); 2 patients were found to be hypoglycemic ( 250 mg/dl. CONCLUSIONS This is important information for dental practitioners because patients with diabetes may not be under good glycemic control, and dentists may have to take special precautions before, during, and after treatment. This paper reviews the pathogenesis of diabetes, the detection of patients with undiagnosed or poorly controlled diabetes, and the management of patients with diabetes during dental treatment.
Mating System, Introduction and Genetic Diversity of Bromus tectorum in North America, the Most Notorious Product of Evolution Within Bromus Section Genea

The genus Bromus (Poaceae) consists of approximately 150–160 species that occur in temperate regions worldwide. Members of section Genea in Bromus are native to Eurasia, and most are invasive in North America (NA). Most environmentally and economically important among these species is Bromus tectorum, which along with Bromus rubens and B. diandrus are some of the most destructive invasive grasses in the Western United States (USA). Members of section Genea form a polyploid series. Molecular data suggest a reticulate speciation pattern (a netlike pattern of diversification) for the polyploid members of Genea. Seed set, floral characteristics, sex allocation patterns, and genetic markers reveal that B. tectorum is predominately self-pollinating. Historical records and genetic data indicate that B. tectorum entered repeatedly into NA and that its current distribution can be attributed to multiple phenomena, including direct introduction from its native range and multidirectional range expansion. Across invasive populations of B. tectorum, overall genetic diversity (e.g., allelic richness and number of polymorphic loci) is lower compared to the diversity among native populations. Conversely, invasive populations of B. tectorum exhibit, on average, higher within-population genetic diversity than found in native populations, suggesting that multiple introductions have partially offset founder effects within invasive populations. Additionally, invasive populations appear to be genetic admixtures composed of two or more independently derived native genotypes. These admixtures have produced invasive populations with generally less genetic differentiation than native populations. The genetic consequences of multiple introductions have implications for the management of invasive populations of B. tectorum, especially in Western NA.
Bone Mineral Density Response from Teriparatide in Patients with Osteoporosis

Background A review of data from large clinical trials reported more than 90% of subjects significantly improved their bone mineral density (BMD) at the lumbar spine (LS) with teriparatide (TPTD) (bone 39:1268–1275, 1). However, our clinical experience suggests that many patients may be non-responders, raising questions as to the true efficacy of TPTD in improving BMD in osteoporotic patients.
Sentinel lymph node biopsy: An overview

The original concept of sentinel lymph node biopsy (SLNB) is attributed to Cabanas, who described use of the technique for the treatment and staging of penile cancer. The concept of SLNB was revived 15 years later by Morton et al., in their work using lymphatic mapping with blue dye in patients with melanoma. Ultimately, Alex and Krag introduced use of the gamma probe with radioactive colloid injections, and Giuliano et al. applied SLNB with blue-dye-based lymphatic mapping to breast surgery, influencing the techniques we use today. Sentinel node biopsy is now considered the standard of care in managing the axilla in patients with clinically negative regional nodes.
Health beliefs as a key determinant of intent to use anabolic-androgenic steroids (AAS) among high-school football players: implications for prevention

AbstractThe use of anabolic-androgenic steroids (AAS) is problematic for youth because of negative effects such as reduced fertility, increased aggression and exposure to toxic chemicals. An effect...
Sequential Capture of O(3P) and HCN by Helium Nanodroplets: Infrared Spectroscopy and ab Initio Computations of the 3Σ O-HCN Complex.

Catalytic thermal cracking of O2 is employed to dope helium droplets with O(3P) atoms. Mass spectrometry of the doped droplet beam reveals an O2 dissociation efficiency larger than 60%; approximately 26% of the droplet ensemble is doped with single oxygen atoms. Sequential capture of O(3P) and HCN leads to the production of a hydrogen-bound O–HCN complex in a 3Σ electronic state, as determined via comparisons of experimental and theoretical rovibrational Stark spectroscopy. Ab initio computations of the three lowest lying intermolecular potential energy surfaces reveal two isomers, the hydrogen-bound (3Σ) O–HCN complex and a nitrogen-bound (3Π) HCN–O complex, lying 323 cm–1 higher in energy. The HCN–O to O–HCN interconversion barrier is predicted to be 42 cm–1. Consistent with this relatively small interconversion barrier, there is no experimental evidence for the production of the nitrogen-bound species upon sequential capture of O(3P) and HCN.
Image Reconstruction for Limited-Angle Electron Beam X-Ray Computed Tomography With Energy-Integrating Detectors for Multiphase Flows

We propose a new iterative X-ray computed tomography (CT) reconstruction algorithm for electron beam X-ray tomography of multiphase flows in metal pipes. This application uses limited-angle projections due to the fixed configuration, and semiconductor-type energy-integrating detectors. For the data-fitting objective function, the proposed method incorporates a nonlinear Gaussian model with object-dependent variance to approximate the compound Poisson distribution, and a dual material decomposition based on images of the volume fractions of metal (titanium) and liquid (water). The volume fraction-based material decomposition enables us to use a maximum sum constraint that helps address the ill-posed nature of the problem. Two different regularizers, $\ell _0$ norm and edge-preserving hyperbola regularizers, are applied differently on each volume fraction image based on the characteristics of objects in each image. A synthetic phantom simulation illustrates that the proposed algorithm enables the aforementioned CT system to achieve high quality images by minimizing artifacts induced by limited-angle data and beam hardening.
Leonardo da Vinci: Proofs as Art

This chapter discusses a question related to Leonardo da Vinci as an artist: can we view great proofs as great art? Four famous proofs in mathematics are compared for their context, ideas, core innovation, plan, and craft.
Extensive Suprapubic Vesicocutaneous Fistula Following Trauma

AbstractThere are few reports on extensive suprapubic vesicocutaneous fistulas. We report the problems encountered in the closure of these fistulas following lower abdominal trauma. Two patients are described in whom the trauma produced extensive loss of skin, fascia and muscle, leaving the bladder exposed and open. Despite several attempts at bladder closure the bladder repair always failed and the fistula remained open. It was necessary to cover the subsequent bladder closure with overlying muscle, fascia and skin to obtain a successful closure. The techniques of closure are explained.
Preliminary perspectives on DNA collection in anti-human trafficking efforts.

Forensic DNA methodologies have potential applications in the investigation of human trafficking cases. DNA and relationship testing may be useful for confirmation of biological relationship claims in immigration, identification of trafficked individuals who are missing persons, and family reunification of displaced individuals after mass disasters and conflicts. As these applications rely on the collection of DNA from non-criminals and potentially vulnerable individuals, questions arise as to how to address the ethical challenges of collection, security, and privacy of collected samples and DNA profiles. We administered a survey targeted to victims' advocates to gain preliminary understanding of perspectives regarding human trafficking definitions, DNA and sex workers, and perceived trust of authorities potentially involved in DNA collection. We asked respondents to consider the use of DNA for investigating adoption fraud, sex trafficking, and post-conflict child soldier cases. We found some key differences in perspectives on defining what qualifies as "trafficking." When we varied terminology between "sex worker" and "sex trafficking victim" we detected differences in perception on which authorities can be trusted. Respondents were supportive of the hypothetical models proposed to collect DNA. Most were favorable of DNA specimens being controlled by an authority outside of law enforcement. Participants voiced concerns focused on privacy, misuse of DNA samples and data, unintentional harms, data security, and infrastructure. These preliminary data indicate that while there is perceived value in programs to use DNA for investigating cases of human trafficking, these programs may need to consider levels of trust in authorities as their logistics are developed and implemented. Keywords: Human trafficking Language: en
The Case for Elective Lymphadenectomy

The role of elective regional lymphadenectomy in the management of patients with clinically localized melanoma remains controversial. Several retrospective studies demonstrate that patients who had lymph node dissections for microscopic or occult nodal metastases exhibited improved survival as compared with patients who underwent lymphadenectomy for palpable nodal disease. Analysis of large melanoma databases have determined that patients with intermediate thickness melanoma are most likely to benefit from an elective lymphadenectomy because these patients have a relatively high risk for developing regional disease but a comparatively low risk for distant disease. Prospective randomized trials have not confirmed these findings but these studies were not designed to target the appropriate patient population. The most recent prospective randomized study, conducted by the Intergroup Melanoma Committee of the National Cancer Institute, was designed with the limitations of the previous trials in mind. Long-term follow-up of this large multicenter study will provide conclusive insights into the role of elective lymph node dissection. In the interim, it is warranted to include lymph node dissections as part of the primary treatment of a significant proportion of patients with stage I and stage II melanomas. This practice also will identify patients who are eligible for ongoing and future systemic adjuvant trials by providing accurate staging information.
Pentaquark Θ+(1540) production in γN→KK¯N reactions

Abstract Recent developments in the search of exotic pentaquark hadrons are briefly reviewed. We then focus on investigating how the exotic pentaquark Θ ( 1540 ) baryon production can be identified in the γ N → K K ¯ N reactions, focusing on the influence of the background (non- Θ production) mechanisms. By imposing the SU(3) symmetry and using various quark model predictions, we are able to fix the coupling constants for evaluating the kaon backgrounds, the K K ¯ production through the intermediate vector meson and tensor meson photoproduction, and the mechanisms involving intermediate Λ ( 1116 ) , Λ ( 1405 ) , Λ ( 1520 ) , Σ ( 1193 ) , Σ ( 1385 ) , and Δ ( 1232 ) states. The vector meson photoproduction part is calculated from a phenomenological model which describes well the experimental data at low energies. We point out that the neutral tensor meson production cannot be due to π 0 -exchange as done by Dzierba et al. [Phys. Rev. D 69 (2004) 051901] because of C parity. The neutral tensor meson production is estimated by considering the vector meson exchange and found to be too weak to generate any peak at the position near Θ ( 1540 ) . For Θ ( 1540 ) production, we assume that it is an isoscalar and hence can only be produced in γ n → K + K - n and γ p → K 0 K ¯ 0 p reactions, but not in γ p → K + K - p and γ n → K 0 K ¯ 0 n . The total cross section data of γ p → K + K - p is thus used to fix the form factors which regularize the background amplitudes so that the signal of Θ ( 1540 ) in γ n → K + K - n and γ p → K 0 K ¯ 0 p cross sections can be predicted. We find that the predicted K + K - and K + n invariant mass distributions of the γ n → K + K - n reaction can qualitatively reproduce the shapes of the JLab data. However, the predicted Θ ( 1540 ) peak cannot be identified unambiguously with the data. High statistics experiments are needed to resolve the problem. We also find that an even-parity Θ is more likely to be detected, while it will be difficult to identify an odd-parity Θ , even if it exists, from the background continuum, if its coupling constants are small as in the present quark model predictions.
Outcomes of Stereotactic Body Radiotherapy for Hepatocellular Carcinoma with Severe Cirrhosis and Ineligibility for Transplant.

Background/aim Our study reviewed the results of patients with hepatocellular carcinoma and Child-Pugh score 8-11 cirrhosis treated with stereotactic body radiotherapy when liver transplant was not an option. Patients and methods A retrospective review was performed on 15 patients with Child-Pugh class B and C cirrhosis treated with stereotactic body radiotherapy. The median total dose was 35 Gy in 4-5 fractions. None were listed for a liver transplant due to either being outside of the Milan criteria or to medical contraindications. Results The overall survival was 26.7% at 6 months, with a mean survival of 152 days. The mean survival with and without ascites was 3.3 months and 8.3 months, respectively. Conclusion For hepatocellular carcinoma with cirrhosis of Child-Pugh score 8 or more, prognosis after liver stereotactic body radiotherapy was suboptimal. While irradiation achieved local tumor control, progressive cirrhosis was a common cause of death. Patients without ascites at the time of radiotherapy had the best prognosis.
(117) Characterizing Fibrofog in Daily Life: Ambulatory Cognitive Functioning in Adults with Fibromyalgia and Matched Controls

Most people with fibromyalgia (FM) report “fibrofog”, or cognitive dysfunction. To better characterize fibrofog in daily life, we conducted an ambulatory study of subjective and objective cognitive function in real-world settings in persons with FM and sex-, age-, and education-matched healthy controls (HC) to test whether: 1) people with FM demonstrate poorer cognitive function on ambulatory measures; 2) people with FM demonstrate a different diurnal pattern of cognitive function; and 3) subjective cognitive function corresponds more highly with objective cognitive measures in HC compared to FM. Participants (N=102; nFM=50; nHC=52) completed ecological momentary assessments of perceived cognitive function (perceived clarity and speed) on a numerical rating scale of 0-100 and cognitive tests of processing speed (Symbol Search) and working memory (Dot Matrix) via a smartphone app at 5 quasi-random times/day for 8 days. The FM group scored significantly lower than HC on measures of self-reported cognitive functioning, as well as on objective measures of processing speed and working memory. Results from multilevel models showed that both groups demonstrated similar diurnal patterns for objective measures of working memory, which was stable across the day, and objective processing speed, which was slowest at wake- and bed-times and fastest midday. For both groups, perceived cognitive dysfunction was highest upon waking and improved across the day; however, the HC group showed a significantly steeper rate of improvement. Perceived cognitive dysfunction corresponded only with processing speed, not working memory, and there were no group differences in these associations. Findings for ambulatory subjective and objective cognitive function in FM are generally consistent with findings from lab-based studies; the FM group demonstrated relatively worse cognitive functioning, but diurnal patterns and associations between objective/subjective functioning were similar to HC.
Resuming Anticoagulation following Upper Gastrointestinal Bleeding among Patients with Nonvalvular Atrial Fibrillation-A Microsimulation Analysis.

Background Among patients with nonvalvular atrial fibrillation (NVAF) who have sustained an upper gastrointestinal bleed (UGIB), the benefits and harms of oral anticoagulation change over time. Early resumption of anticoagulation increases recurrent bleeding, while delayed resumption exposes patients to a higher risk of ischemic stroke. We therefore set out to estimate the expected benefit of resuming anticoagulation as a function of time after UGIB among patients with NVAF. Methods We created a decision-analytic model estimating discounted quality-adjusted life-years when patients with NVAF resume anticoagulation on each day following UGIB. We simulated from a health system perspective over a lifelong time horizon. Results Peak utility for warfarin was achieved by resumption 41 days after hemostasis from the index UGIB. Resumption between days 32 and 51 produced greater than 99.9% of the peak utility. Peak utility for apixaban was achieved by resumption 32 days after the index UGIB. Resumption between days 21 and 47 produced greater than 99.9% of the peak utility. Of input parameters, results were most sensitive to underlying stroke risk. Specifically, across the range of CHA2DS2-Vasc scores, the optimal day of resumption varied by around 11 days for patients resuming warfarin and by around 15 days for patients resuming apixaban. Results were less sensitive to underlying risk of rebleeding. Conclusions For patients with NVAF following UGIB, warfarin is optimally restarted approximately six weeks following hemostasis, and apixaban is optimally restarted approximately one month following hemostasis. Modest changes to this timing based on probability of thromboembolic stroke are reasonable.
Carrot leaves improve color and xanthophyll content of egg yolk in laying hens but are not as effective as commercially available marigold fortificant

ABSTRACT Yellow and orange egg yolks are good sources of xanthophyll carotenoids, consumption of which is associated with health benefits, such as cancer prevention, eye health, and bone health. Industrial feed fortificants used to improve egg yolk color and carotenoid concentration typically are derived from marigold flowers. Green leafy vegetables are also concentrated sources of the xanthophylls lutein and zeaxanthin (L+Z), but they have not been rigorously evaluated in laying hen feeds as a yolk colorant. The addition of food manufacturing byproducts, including carrot leaves, to animal feed is a promoted method of improving animal nutrition. The ability of dehydrated carrot leaves to improve egg yolk color and L+Z concentration was evaluated by feeding laying hens (n = 40) white maize-based feeds fortified with 2 different dehydrated carrot leaves, marigold as a positive control, or no fortificant as a negative control for 28 D. After a 7-D washout period, the hens were separated into 4 groups, and eggs were collected every other day. Yolks were analyzed by using a portable colorimeter to define the color space and by ultra-performance liquid chromatography to determine the carotenoid profile. Carotenoid concentration rapidly declined from day 0 to 8, confirming adequate washout conditions. The white maize negative control (WM) day 28 lutein concentration (3.59 ± 0.51 nmol/g) was significantly less than orange-carrot leaf-treated (OCL) (5.34 ± 0.36 nmol/g) and red-carrot leaf-treated hens (RCL) (5.92 ± 1.00 nmol/g) in addition to the marigold-treated hens (MG). However, MG was significantly higher than both leaf-treated groups. From day 8 (3.93 ± 0.74 nmol/g) to 28 (9.32 ± 1.66 nmol/g), MG had the largest increase in lutein and was the only treatment to surpass day 0 initial concentrations (8.50 ± 1.64 nmol/g). A similar trend was observed for zeaxanthin and was reflected in the color space.
"It Was like a Partnership of the Two of Us Against the Cutting": Investigating the Counseling Experiences of Young Adult Women Who Self-Injure

Self-injury is an increasing phenomenon among young adult women. This qualitative study explored the counseling experiences of 10 young adult women with a history of self-injurious behavior. It examined the nature of the client-counselor relationship and how self-injury was treated. It also accessed the participants' thoughts and feelings about their experiences in counseling. Implications for training and treatment are set out, as are recommendations for research.
Developing a clinical and biological measures of aging core: Cancer and Aging Research Group infrastructure.

The relevance and impact of human subject research on clinical practice depends on whether the study population reflects the age distribution and health characteristic profiles of the general population. Older adults with a cancer are disproportionately underrepresented in clinical trials and fewer data are available to assess the risks and benefits of cancer treatments, particularly adverse effects on functional outcomes and quality of life1. Furthermore, there is a lack of understanding of how the underlying biologic processes of aging affect tolerance of cancer treatment and survival outcomes. In 2010, the Cancer and Aging Research Group (CARG) outlined the following gaps in generating high quality research in older adults with cancer: 1) clinical measures most relevant to older adults are rarely incorporated into oncology clinical trials; 2) biological and physiological markers of aging are inconsistently included in oncology research; 3) a need for more studies of vulnerable older adults and/or those aged 75 years or older; and 4) limited research infrastructure to support collaborations between geriatrics and oncology.2 Almost a decade later, CARG has been awarded a five-year R21/R33 grant to develop a sustainable national research infrastructure to create and support significant and innovative projects at the interface of cancer and aging that address the four gaps that were initially identified. As a component of this infrastructure award, interactive Cores were developed to facilitate and support aging-related research in oncology. The purpose of this perspective is to summarize the mission and proposed function, process and procedures for Core 1: Clinical and Biological Measures of Aging; and to provide examples of how the Core will facilitate research in geriatric oncology.
SOLAR-GP: Sparse Online Locally Adaptive Regression Using Gaussian Processes for Bayesian Robot Model Learning and Control

Machine learning methods have been widely used in robot control to learn inverse mappings. These methods are used to capture the entire non-linearities and non-idealities of a system that make geometric or phenomenological modeling difficult. Most methods employ some form of off-line or batch learning where training may be performed prior to a task, or in an intermittent manner, respectively. These strategies are generally unsuitable for teleoperation, where commands and sensor data are received in sequential streams and models must be learned on-the-fly. We combine sparse, local, and streaming methods to form Sparse Online Locally Adaptive Regression using Gaussian Processes (SOLAR–GP), which trains streaming data on localized sparse Gaussian Process models and infers a weighted local function mapping of the robot sensor states to joint states. The resultant prediction of the teleoperation command is used for joint control. The algorithm was adapted to perform on arbitrary link manipulators including the Baxter robot, where modifications to the algorithm are made to run training and prediction in parallel so as to keep consistent, high-frequency control loop rates. This framework allows for a user-defined cap on complexity of generated local models while retaining information on older regions of the explored state-space.
Harnessing Machine Intelligence in Automatic Echocardiogram Analysis: Current Status, Limitations, and Future Directions

Echocardiography (echo) is a critical tool in diagnosing various cardiovascular diseases. Despite its diagnostic and prognostic value, interpretation and analysis of echo images are still widely performed manually by echocardiographers. A plethora of algorithms has been proposed to analyze medical ultrasound data using signal processing and machine learning techniques. These algorithms provided opportunities for developing automated echo analysis and interpretation systems. The automated approach can significantly assist in decreasing the variability and burden associated with manual image measurements. In this paper, we review the state-of-the-art automatic methods for analyzing echocardiography data. Particularly, we comprehensively and systematically review existing methods of four major tasks: echo quality assessment, view classification, boundary segmentation, and disease diagnosis. Our review covers three echo imaging modes, which are B-mode, M-mode, and Doppler. We also discuss the challenges and limitations of current methods and outline the most pressing directions for future research. In summary, this review presents the current status of automatic echo analysis and discusses the challenges that need to be addressed to obtain robust systems suitable for efficient use in clinical settings or point-of-care testing.
Assisting the Expert in “Expert” Systems

Expert Systems are at the cutting edge of Artificial Intelligence. A number of successes have been claimed in problem areas usually associated with human decision making.
Quasi-periodic oscillations: Resonant shear Alfv`en waves in neutron star magnetospheres

In this paper we propose a new model for quasi-periodic oscillations (QPOs) based on oscillating magnetohydrodynamic modes in neutron star magnetospheres. We argue that the interaction of the accretion disk with the magnetosphere can excite resonant shear Alfv`en waves in a region of enhanced density gradients, the region where accretion material flows along the magnetic field lines in the magnetosphere. We demonstrate that depending on the distance of this region from the star and the magnetic field strength, the frequency of the field line resonance can range from several Hz (weaker field, farther from star), to approximately kHz frequencies (stronger field, ~ 2-10 stellar radii from the star). We show that such oscillations are able to significantly modulate inflow of matter from the high density region toward the star's surface, and possibly produce the observed X-ray spectrum. In addition, we show that the observed 2:3 frequency ratio of QPOs is a natural result of our model.
Effect of weighing uncertainty on assay values by isotope dilution mass spectrometry

Isotope dilution mass spectrometry using traceable standards as spikes coupled with isotope ratio measurements by thermal ionization or inductively coupled plasma mass spectrometer instruments is the preferred methodology for element content determinations and isotopic composition measurements in a variety of applications, especially those involving highly radioactive isotopes like the actinide elements. This assay measurement technique takes advantage of the sensitivity of modern mass spectrometry instrumentation to minimize the amount of material utilized for the measurement and enables the measurement sequence to be automated, with minimal intervention from analyst during the measurement process. LA-UR-20-28878.
Guillain-Barré Syndrome and Other Acute Polyneuropathies.

Guillain-Barre syndrome (GBS) is an acute autoimmune neuropathy that can cause motor, sensory, and autonomic symptoms. Although GBS primarily is a neuropathic disorder, multiple organ systems can be affected during the disease course, and older patients may be more vulnerable to systemic complications. Close clinical monitoring and early interventions using pharmacologic and nonpharmacological treatments may lead to an improved long-term outcome.
The Development of Se from Latin to Spanish and the Reflexive Object Cycle

The Romance clitic se/si in reflexive, passive, and related constructions has been analyzed as a functional head/verbal inflection (Cuervo MC, Datives at large. PhD dissertation, MIT, 2003; Folli R, Harley H, Linguistic Inquiry 38:197–238, 2007) or as a pronominal argument (Raposo E, Uriagereka J, Natural Language and Linguistic Theory 14:749–810, 1996; D’Alessandro R, Impersonal Si constructions. Mouton de Gruyter, Berlin, 2007), or as both depending on type (Kempchinsky P, Teasing apart the middle. In Andolin gogoan/Homenaje a Andolin Eguzkitza, eds. Itziar Laka and Beatriz Fernandez, 532–547. University of the Basque Country Press, 2006). I show that Latin and Old Spanish se was within a DP argument as indicated by diagnostics of coordination, modification, and movement/interpolation. This changes in Middle Spanish, where se merges within a DP and moves as a D head. This reanalysis is supported by loss of interpolation and the development of the doubling of the tonic reflexive pronoun by se. Modern Spanish se is an inflectional morpheme, the realization of a Voice head. Following van Gelderen E, The linguistic cycle: Language change and the language faculty. Oxford University Press, Oxford, 2011, I argue that se’s current status results from a subtype of the object agreement cycle which turns object pronouns into object agreement on the verb. The reflexive object cycle turns reflexive pronouns into valency marking inflection.
Dorsal Thompson: Approach to the Proximal Radial Shaft.

SUMMARY Treatment principles in the management of radial shaft fractures, congruent with all fracture care, are to restore anatomy and function of the limb. Radial shaft fractures are unique in that preserving the anatomic bow of the radius, which allows for its rotation around the ulna during pronation and supination, is essential for proper function. The 2 main approaches for exposure of the proximal or middle third radial diaphyseal fractures are the volar "Henry" and the dorsal "Thompson." This article highlights the benefits of the dorsal Thompson approach, describes the key points of the operative technique, which allow for protection of the posterior interosseous nerve, and provides an overview of the measurable outcomes when using this approach. In the accompanying video, the steps of operative exposure to the proximal radial shaft with careful avoidance of the posterior interosseous nerve are demonstrated.
Reduced occurrence of primary rod fracture after adult spinal deformity surgery with accessory supplemental rods: retrospective analysis of 114 patients with minimum 2-year follow-up

OBJECTIVE Rod fracture (RF) after adult spinal deformity (ASD) surgery is reported in approximately 6.8%-33% of patients and is associated with loss of deformity correction and higher reoperation rates. The authors' objective was to determine the effect of accessory supplemental rod (ASR) placement on postoperative occurrence of primary RF after ASD surgery. METHODS This retrospective analysis examined patients who underwent ASD surgery between 2014 and 2017 by the senior authors. Inclusion criteria were age > 18 years, ≥ 5 instrumented levels including sacropelvic fixation, and diagnosis of ASD, which was defined as the presence of pelvic tilt ≥ 25°, sagittal vertical axis ≥ 5 cm, thoracic kyphosis ≥ 60°, coronal Cobb angle ≥ 20°, or pelvic incidence to lumbar lordosis mismatch ≥ 10°. The primary focus was patients with a minimum 2-year follow-up. RESULTS Of 148 patients who otherwise met the inclusion criteria, 114 (77.0%) achieved minimum 2-year follow-up and were included (68.4% were women, mean age 67.9 years, average body mass index 30.4 kg/m2). Sixty-two (54.4%) patients were treated with traditional dual-rod construct (DRC), and 52 (45.6%) were treated with ASR. Overall, the mean number of levels fused was 11.7, 79.8% of patients underwent Smith-Petersen osteotomy (SPO), 19.3% underwent pedicle subtraction osteotomy (PSO), and 66.7% underwent transforaminal lumbar interbody fusion (TLIF). Significantly more patients in the DRC cohort underwent SPO (88.7% of the DRC cohort vs 69.2% of the ASR cohort, p = 0.010) and TLIF (77.4% of the DRC cohort vs 53.8% of the ASR cohort, p = 0.0001). Patients treated with ASR had greater baseline sagittal malalignment (12.0 vs 8.6 cm, p = 0.014) than patients treated with DRC, and more patients in the ASR cohort underwent PSO (40.3% vs 1.6%, p < 0.0001). Among the 114 patients who completed follow-up, postoperative occurrence of RF was reported in 16 (14.0%) patients, with mean ± SD time to RF of 27.5 ± 11.8 months. There was significantly greater occurrence of RF among patients who underwent DRC compared with those who underwent ASR (21.0% vs 5.8%, p = 0.012) at comparable mean follow-up (38.4 vs 34.9 months, p = 0.072). Multivariate analysis demonstrated that ASR had a significant protective effect against RF (OR 0.231, 95% CI 0.051-0.770, p = 0.029). CONCLUSIONS This study demonstrated a statistically significant decrease in the occurrence of RF among ASD patients treated with ASR, despite greater baseline deformity and higher rate of PSO. These findings suggest that ASR placement may provide benefit to patients who undergo ASD surgery.
Atrial-paced, exercise-similar heart rate envelope induces myocardial protection from ischaemic injury.

Aims The study investigates the role and mechanisms of clinically translatable exercise heart rate (HR) envelope effects, without dyssynchrony, on myocardial ischaemia tolerance compared to standard preconditioning methods. Since the magnitude and duration of exercise HR acceleration are tightly correlated with beneficial cardiac outcomes, it is hypothesized that a paced exercise-similar HR envelope, delivered in a maximally physiologic way that avoids the toxic effects of chamber dyssynchrony, may be more than simply a readout, but rather also a significant trigger of myocardial conditioning and stress resistance. Methods and results For 8 days over 2 weeks, sedated mice were atrial-paced once daily via an oesophageal electrode to deliver an exercise-similar HR pattern with preserved atrioventricular and interventricular synchrony. Effects on cardiac calcium handling, protein expression/modification, and tolerance to ischaemia-reperfusion (IR) injury were assessed and compared to those in sham-paced mice and to the effects of exercise and ischaemic preconditioning (IPC). The paced cohort displayed improved myocardial IR injury tolerance vs. sham controls with an effect size similar to that afforded by treadmill exercise or IPC. Hearts from paced mice displayed changes in Ca2+ handling, coupled with changes in phosphorylation of calcium/calmodulin protein kinase II, phospholamban and ryanodine receptor channel, and transcriptional remodelling associated with a cardioprotective paradigm. Conclusions The HR pattern of exercise, delivered by atrial pacing that preserves intracardiac synchrony, induces cardiac conditioning and enhances ischaemic stress resistance. This identifies the HR pattern as a signal for conditioning and suggests the potential to repurpose atrial pacing for cardioprotection.
Functional Analysis of the Human Complement Receptor 2 (CR2/CD21) Promoter: Characterization of Basal Transcriptional Mechanisms

Human complement receptor (CR) type 2 (CR2/CD21) is a 145-kDa membrane protein encoded within the regulators of complement activation gene cluster localized on human chromosome 1q32. Understanding the mechanisms that regulate CR2 expression is important because CR2 is expressed during specific stages of B cell development, and several lines of evidence suggest a role for altered CR2 function or expression in a number of autoimmune diseases. Additionally, even modest changes in CR2 expression are likely to affect relative B cell responses. In this study we have delineated the transcriptional requirements of the human CR2 gene. We have studied the human CR2 proximal promoter and identified sites important for controlling the level of transcription in CR2-expressing cells. We have determined that four functionally relevant sites lie within very close proximity to the transcriptional initiation site. These sites bind the transcription factors USF1, an AP-2-like transcription factor, and Sp1.
Coordinated training and transmission for improved interference cancellation in a cellular network

Interference cancellation or joint detection in cellular systems can be used to improve the quality, capacity, or coverage. Gains may be limited, however, due to the lack of coordination between base stations. This resulting asynchronicity increases channel estimation error and degrades the performance of receivers which mitigate interference. We propose a cellular architecture, using sectored base station antennas, that employs successive time delays to reduce the asynchronicity of interfering transmissions. Training sequence assignments are coordinated among cells to ensure that both signal and interferer are trained. We derive the largest allowable offset correction for both uplink and downlink transmissions according to certain criteria. Examples using ideal cellular layouts are presented along with discussion of application to nonideal terrains.
Genetic analysis of Escherichia coli integration host factor interactions with its bacteriophage lambda H' recognition site.

Abstract The bacteriophage P22-based challenge phage system was used to study the binding of integration host factor (IHF) to its H' recognition site in the attP region of bacteriophage lambda. We constructed challenge phages that carried H' inserts in both orientations within the P22 Pant promoter, which is required for antirepressor synthesis. We found that IHF repressed expression of Pant from either challenge phage when expressed from an inducible Ptac promoter on a plasmid vector. Mutants containing changes in the H' inserts that decrease or eliminate IHF binding were isolated by selecting challenge phages that could synthesize antirepressor in the presence of IHF. Sequence analysis of 31 mutants showed that most changes were base pair substitutions within the H' insert. Approximately one-half of the mutants contained substitutions that changed base pairs that are part of the IHF consensus binding site; mutants were isolated that contained substitutions at six of the nine base pairs of the consensus site. Other mutants contained changes at base pairs between the two subdeterminants of the H' site, at positions that are not specified in the consensus sequence, and in the dA + dT-rich region that flanks the consensus region of the site. Taken together, these results show that single-base-pair changes at positions outside of the proposed consensus bases can weaken or drastically disrupt IHF binding to the mutated site.
Strategic Aspects of Communication

Rarely do human behavioral scientists and scholars study language, music, and other forms of communication as strategies—a means to some end. Some even deny that communication is the primary function of these phenomena. Here we draw upon selections of our earlier work to briefly define the strategy concept and sketch how decision theory, developed to explain the behavior of rational actors, is applied to evolved agents. Communication can then be interpreted as a strategy that advances the “fitness interests” of such agents. When this perspective is applied to agents with conflicts of interest, deception emerges as an important aspect of communication. We briefly review costly signaling, one solution to the problem of honest communication among agents with conflicts of interest. We also explore the subversion of cooperative signals by parasites and by plants defending themselves against herbivores, and we touch on biases in human gossip. Experiments with artificial embodied and communicating agents confirm that when there are conflicts of interest among agents, deception readily evolves. Finally, we consider signaling among super-organisms and the possible implications for understanding human music and language.
Oral caffeine maintenance potentiates the reinforcing and stimulant subjective effects of intravenous nicotine in cigarette smokers.

Abstract Rationale. Epidemiological, clinical and pre-clinical observations suggest that caffeine can potentiate the reinforcing and discriminative effects of nicotine. Objective. The present study examined whether chronic exposure to moderate doses of caffeine affects the reinforcing and subjective effects of intravenously administered nicotine. Methods. The effects of oral caffeine maintenance on the subjective and physiological effects of intravenously administered nicotine and caffeine were examined using double-blind methods in nine volunteers with current use of tobacco, caffeine, and cocaine. Each subject was exposed to two chronic drug phases (200 mg/70 kg oral caffeine t.i.d. and placebo t.i.d.), each of at least 12 days duration. Within each drug phase, the subject received intravenous injections of placebo, nicotine (1.0 and 2.0 mg/70 kg), and caffeine (200 and 400 mg/70 kg) in mixed order. Physiological and subjective data were collected before and repeatedly after drug or placebo injection. Results. Both intravenous nicotine and caffeine produced significant increases in ratings of drug effect, stimulated, rush, and bad effect, with only nicotine significantly increasing ratings of liking and good effect. Caffeine maintenance significantly increased ratings of drug effect and stimulated after the high dose of nicotine, and significantly decreased ratings of bad effect after the low dose of nicotine. Caffeine maintenance also significantly increased the identification of the low dose of nicotine as a stimulant. A drug versus money measure of reinforcement showed that subjects were willing to pay money to receive nicotine injections, but willing to forfeit money to avoid caffeine injections. Furthermore, subjects were willing to pay significantly more money to receive the high dose of nicotine in the caffeine maintenance phase than in the abstinence phase. Both intravenous nicotine and caffeine increased diastolic blood pressure and decreased skin temperature, and nicotine also increased heart rate. These physiological effects of intravenous nicotine and caffeine as well as the subjective effects of intravenous caffeine were not influenced by caffeine maintenance. Conclusions. The results extend recent clinical and preclinical findings by showing that oral caffeine maintenance can potentiate the reinforcing and stimulant subjective effects of nicotine.
Runtime support for execution of fine grain parallel code on coarse grain multiprocessors

The goal of this research is to provide systems support that allows fine grain, data parallel code to execute efficiently on much coarser grain multiprocessors. The task of writing parallel applications is simplified by allowing the programmer to assume a number of processors convenient to the algorithm being implemented. This paper describes and evaluates a runtime approach that efficiently manages thousands of "virtual" processors per actual processor. Tight integration and specialization of scheduling, communication, and context switching is used to significantly reduce the overhead of running fine grain parallel code. A Paragon prototype of this runtime approach is evaluated by comparing implementations of two numerical problems. The overhead due to scheduling, communication, and context switching is analyzed. The implementation and analysis show that fine grain code can be efficiently executed in a coarse grain multiprocessor using a runtime approach. >