Musculoskeletal Injuries (MSKI) are exceedingly common in the US Military, resulting in compromised military medical readiness and a substantial burden on both health care and financial resources. ...Severe combat-related MSKI sustained during nearly 2 decades of conflict in Iraq and Afghanistan have resulted in frequently devastating injuries that challenge acute care capabilities, require extensive rehabilitation, and often result in long-term disability. Non–combat-related MSKI, while often less severe, are far more common than combat-related MSKI and overall cause a substantially greater number of lost duty days and nondeployable Service Members. Given the strain placed on health care and financial resources by MSKI, further efforts must be directed towards prevention, treatment, and rehabilitative strategies in order to mitigate the burden of MSKI in the US Military.
We study the excited states of interacting fermions in one dimension with particle-hole symmetric disorder (equivalently, random-bond XXZ chains) using a combination of renormalization group methods ...and exact diagonalization. Absent interactions, the entire many-body spectrum exhibits infinite-randomness quantum critical behavior with highly degenerate excited states. We show that though interactions are an irrelevant perturbation in the ground state, they drastically affect the structure of excited states: Even arbitrarily weak interactions split the degeneracies in favor of thermalization (weak disorder) or spontaneously broken particle-hole symmetry, driving the system into a many-body localized spin glass phase (strong disorder). In both cases, the quantum critical properties of the noninteracting model are destroyed, either by thermal decoherence or spontaneous symmetry breaking. This system then has the interesting and counterintuitive property that edges of the many-body spectrum are less localized than the center of the spectrum. We argue that our results rule out the existence of certain excited state symmetry-protected topological orders.
We present an approach for preparing cryo-electron microscopy (cryo-EM) grids to study short-lived molecular states. Using piezoelectric dispensing, two independent streams of ~50-pl droplets of ...sample are deposited within 10 ms of each other onto the surface of a nanowire EM grid, and the mixing reaction stops when the grid is vitrified in liquid ethane ~100 ms later. We demonstrate this approach for four biological systems where short-lived states are of high interest.
Clinical practice guidelines.
To develop the first Canadian clinical practice guidelines for screening and diagnosis of neuropathic pain in people with spinal cord injury (SCI).
The guidelines are ...relevant for inpatient and outpatient SCI rehabilitation settings in Canada.
The CanPainSCI Working Group reviewed evidence to address clinical questions regarding screening and diagnosis of neuropathic pain after SCI. A consensus process was followed to achieve agreement on recommendations and clinical considerations.
Twelve recommendations, based on expert consensus, were developed for the screening and diagnosis of neuropathic pain after SCI. The recommendations address methods for assessment, documentation tools, team member accountability, frequency of screening and considerations for diagnostic investigation. Important clinical considerations accompany each recommendation.
The expert Working Group developed recommendations for the screening and diagnosis of neuropathic pain after SCI that should be used to inform practice.
3-D Imaging of Vehicles using Wide Aperture Radar Dungan, Kerry E; Potter, L C
IEEE transactions on aerospace and electronic systems,
2011-January, 2011-01-00, 20110101, Letnik:
47, Številka:
1
Journal Article
Recenzirano
An image processing procedure is presented to construct a three-dimensional representation of a vehicle from a set of two-dimensional circular synthetic aperture radar (SAR) images. Given a ...previously generated digital elevation map, a third dimension is inferred from layover and polarization. With high data rates and circular flight paths, SAR scenes may be large relative to the standoff distance. Consequently, variations in elevation angles (with respect to terrain) across the scene become crucial for identifying signatures. The proposed 3D processing inverts elevated point layover to provide partial invariance to elevation angle and produces an unordered set of scattering centers with attributes including an azimuth attribute to preserve anisotropy. The proposed processing is demonstrated on both measured and simulated data.
We searched for cell-surface-associated proteins overexpressed on B cell chronic lymphocytic leukemia (CLL) to use as therapeutic antibody targets. Antibodies binding the immunosuppressive molecule ...CD200 were identified by cell panning of an antibody phage display library derived from rabbits immunized with primary CLL cells. B cells from 87 CLL patients exhibited 1.6- to 5.4-fold cellsurface up-regulation of CD200 relative to normal B cells. An effect of increased CD200 expression by CLL cells on the immune system was evaluated in mixed lymphocyte reactions. Addition of primary CLL but not normal B cells to macrophages and T cells down-regulated the Th1 response, as seen by a 50-95% reduction in secreted IL-2 and IFN-γ. Antibodies to CD200 prevented downregulation of the Th1 response in most B cell CLL samples evaluated, indicating abrogation of the CD200/CD200R interaction can be sufficient to restore the Th1 response. A disease-progression-associated shift of the immune response from Th1 to Th2 has been observed in numerous cancers. Because this cytokine shift is also believed to promote the induction of regulatory T cells, reverting the immune response to Th1 through direct targeting of the cancer cells may provide therapeutic benefits in CLL by encouraging a cytotoxic T cell response.
Nitrous oxide (N₂O) is a potent greenhouse gas that contributes to climate change and stratospheric ozone destruction. Anthropogenic nitrogen (N) loading to river networks is a potentially important ...source of N₂O via microbial denitrification that converts N to N₂O and dinitrogen (N₂). The fraction of denitrified N that escapes as N₂O rather than N₂ (i.e., the N₂O yield) is an important determinant of how much N₂O is produced by river networks, but little is known about the N₂O yield in flowing waters. Here, we present the results of whole-stream ¹⁵N-tracer additions conducted in 72 headwater streams draining multiple land-use types across the United States. We found that stream denitrification produces N₂O at rates that increase with stream water nitrate (NO₃⁻) concentrations, but that <1% of denitrified N is converted to N₂O. Unlike some previous studies, we found no relationship between the N₂O yield and stream water NO₃⁻. We suggest that increased stream NO₃⁻ loading stimulates denitrification and concomitant N₂O production, but does not increase the N₂O yield. In our study, most streams were sources of N₂O to the atmosphere and the highest emission rates were observed in streams draining urban basins. Using a global river network model, we estimate that microbial N transformations (e.g., denitrification and nitrification) convert at least 0.68 Tg·y⁻¹ of anthropogenic N inputs to N₂O in river networks, equivalent to 10% of the global anthropogenic N₂O emission rate. This estimate of stream and river N₂O emissions is three times greater than estimated by the Intergovernmental Panel on Climate Change.
Bone has recently emerged as a target organ for some Janus kinase (JAK) inhibitors in adult and/or juvenile animal toxicity studies. Oral administration of tofacitinib, a JAK inhibitor, was not ...associated with clinical or macroscopic effects on bone growth and development in a rat juvenile animal study (JAS) with tofacitinib dosing starting on postnatal day (PND) 21. However, given that previous JAS did not include a targeted evaluation of bone, inclusive of microscopic examination, an additional rat JAS was conducted to further assess this risk. In this subsequent JAS, administration of tofacitinib from PND 7–49 or from PND 21–49 did not result in any direct effects on bone, with no histologic effects on developing bone. The only bone effect in this JAS was nonadverse shorter femur length, which was not considered to be a direct effect of tofacitinib, but rather an indicator of growth delay, as this was associated with lower body weights. There were no effects on femur length or body weight after a 2-month recovery period. To further explore the relationship between body weight and femur length, historical control data were analyzed from control rats in other JAS. This analysis clearly demonstrated that shorter femur length can occur as an indirect effect that is highly associated with lower body weight, consistent with what was observed in the JAS with tofacitinib. These analyses provide a robust and valuable data set to support the interpretation of such data in JAS, and further support the lack of direct effects of tofacitinib on bone growth and development. As with the previously conducted juvenile studies with tofacitinib, the additional JAS did not identify any special JAS-based concerns for use in pediatric patients as young as 2 years of age.
•Tofacitinib had no adverse bone effects when given to rats on PND 7–49 or PND 21–49.•Historical data analysis shows lower femur length correlates with lower body weight.•Femur length data should be analyzed and presented relative to body weight.
Introduction
Radical antegrade modular pancreatosplenectomy (RAMPS) was developed to improve R0 resections and lymph node harvests versus distal pancreatectomy (DP) in pancreatic adenocarcinoma ...(PDAC); relative complication rates are understudied.
Methods
Patients undergoing distal pancreas resections from 2006 to 2020 were identified from our institutional NSQIP database, grouped by resection method, and evaluated for the following outcomes: postoperative pancreatic fistula (POPF), clinically relevant POPF (crPOPF), incisional surgical site infection (iSSI), organ space SSI (osSSI), and Clavien-Dindo grade ≥ 3 (CD ≥ 3) complications using logistic regression. Patients were matched 1:1 based on disease risk score.
Results
Two-hundred-thirty-six and 117 patients underwent DP and RAMPS, respectively. POPF, crPOPF, CD ≥ 3 complications, iSSI, and osSSIs occurred in 105 (30%), 43 (12%), 74 (21%), 34 (10%) and 52 (15%) patients, respectively. Disease risk score matching yielded 89 similar patients per group. On multivariable analysis, patients undergoing RAMPS were not significantly more likely to experience POPF (OR 0.69,
P
= 0.26), crPOPF (OR 0.41,
P
= 0.72), CD ≥ 3 complication (OR 0.78,
P
= 0.44), iSSI (OR 0.58,
P
= 0.27), or osSSI (OR 0.93,
P
= 0.86).
Of patients with PDAC (
n
= 108) mean nodal harvest were 14.8 (SD 11.30) and 19.4 (SD 7.19) nodes for patients undergoing DP and RAMPS, respectively (
P
= 0.01). Six patients (20%) undergoing DP had positive margins versus 12 (15%) undergoing RAMPS (
P
= 0.56). At a median follow-up of 17 months, there was no difference in locoregional recurrence-free survival (
P
= 0.32) or overall survival (
P
= 0.92) on Kaplan–Meier analysis
.
Conclusion
RAMPS does not result in increased complications compared to DP and routine use is encouraged in pancreatic malignancies.
We report on optical spectroscopy of 165 flat spectrum radio quasars (FSRQs) in the Fermi 1LAC sample, which have helped allow a nearly complete study of this population. Fermi FSRQs show significant ...evidence for non-thermal emission even in the optical; the degree depends on the gamma -ray hardness. They also have smaller virial estimates of hole mass than the optical quasar sample. This appears to be largely due to a preferred (axial) view of the gamma -ray FSRQ and non-isotropic (H/R ~ 0.4) distribution of broad-line velocities. Even after correction for this bias, the Fermi FSRQs show higher mean Eddington ratios than the optical population. A comparison of optical spectral properties with Owens Valley Radio Observatory radio flare activity shows no strong correlation.
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