Hypertension

Defining hypertension in pregnancy is challenging because blood pressure levels in pregnancy are dynamic, having a circadian rhythm and also changing with advancing gestational age. The accepted definition is a sustained systolic (sBP) of ≥140 mmHg or a sustained diastolic blood pressure (dBP) ≥90 mmHg, by office (or in-hospital) measurement. Measurement of blood pressure in pregnancy should follow standardised methods, as outside pregnancy. Blood pressure measurement may occur in three types of settings, which will dictate in part, which measurement device(s) will be used. The settings are (1) health care facility; and two types of settings outside the facility: (2) ‘ambulatory’ blood pressure measurement (ABPM); and (3) home blood pressure measurement (HBPM). Furthermore, blood pressure can be measured using auscultatory (mercury or aneroid devices) or automated methods. Factors to consider when selecting a blood pressure measurement device include validation, disease specificity, observer error and the need for regular recalibration. The accuracy of a device is repeatedly compared to two calibrated mercury sphygmomanometers (the gold standard), by trained observers, over a range of blood pressures and for women with different hypertensive disorders of pregnancy; only a few devices have been validated among women with pre-eclampsia. This chapter discusses the advantages and/or disadvantages of the various settings and devices. Low- and middle-income countries (LMICs) bear a disproportionate burden of maternal morbidity and mortality from the hypertensive disorders of pregnancy. While regular blood pressure monitoring can cost-effectively reduce this disparity, LMIC-health systems face unique challenges that reduce this capacity. Assessment of service gaps and programmatic responses to ensure access to blood pressure measurement are a priority, supported where appropriate by implementation research.Publisher PD

BAAAMM

BAAAMM was born in April 2016, when a group of six creative researcher-artists came together to investigate cultural identity through art making. Through searching, reaching, and wrestling, the group developed creative experiential processes by which to discover and communicate cultural identity through art and language. Over a few weeks, the creative researcher-artists generated a body of work expressing their unique cultural identities and felt responses to one another. This diverse collaborative wants to share their work to stimulate others to enter the realm of creativity, vulnerability, and receptivity to understand themselves better. BAAAMM is an exploratory cultural happening exhibiting individual and collective creative findings. BAAAMM is a collaborative endeavor to understand, communicate, and connect oneself to others. BAAAMM is a multicultural work of progress. This Jagazine (journal and magazine) chronicles the seven phases of BAAAMM\u27s research. It provides brief biographies of the creative researcher-artist and captures our extended findings, additional art and written work inspired by the investigation. This Jagazine is part of our original research project in partial fulfillment of the requirements for the degree Master of Art at Loyola Marymount University within the Department of Martial and Family Therapy. This jagazine will be presented at the American Art Therapy Association Annual Conference on November 9, 2017. Warning! This dynamic research is not for the faint of heart. It tests boundaries, schema, nerves, and feelings. Those who passionately search for opportunities to express themselves artistically and verbally, disagree, negotiate, be called out, humble, connected to others, and be heard may find that this cultural identity research framework stimulates growth and gratification

Evidence that APP gene copy number changes reflect recombinant vector contamination [preprint]

Mutations that occur in cells of the body, called somatic mutations, cause human diseases including cancer and some neurological disorders1. In a recent study published in Nature, Lee et al.2 (hereafter “the Lee study”) reported somatic copy number gains of the APP gene, a known risk locus of Alzheimer’s disease (AD), in the neurons of AD-patients and controls (69% vs 25% of neurons with at least one APP copy gain on average). The authors argue that the mechanism of these copy number gains was somatic integration of APP mRNA into the genome, creating what they called genomic cDNA (gencDNA). We reanalyzed the data from the Lee study, revealing evidence that APP gencDNA originates mainly from contamination by exogenous APP recombinant vectors, rather from true somatic retrotransposition of endogenous APP. Our reanalysis of two recent whole exome sequencing (WES) datasets—one by the authors of the Lee study3 and the other by Park et al.4—revealed that reads claimed to support APP gencDNA in AD samples resulted from contamination by PCR products and mRNA, respectively. Lastly, we present our own single-cell whole genome sequencing (scWGS) data that show no evidence for somatic APP retrotransposition in AD neurons or in neurons from normal individuals of various ages

Ariel - Volume 4 Number 3

Editors David A. Jacoby Eugenia Miller Tom Williams Associate Editors Paul Bialas Terry Burt Michael Leo Gail Tenikat Editor Emeritus and Business Manager Richard J. Bonnano Movie Editor Robert Breckenridge Staff Richard Blutstein Mary F. Buechler Steve Glinks Len Grasman Alice M. Johnson J.D. Kanofsky Tom Lehman Dave Mayer Bernie Odd

The solvation and dissociation of 4-benzylaniline hydrochloride in chlorobenzene

A reaction scheme is proposed to account for the liberation of 4-benzylaniline from 4-benzylaniline hydrochloride, using chlorobenzene as a solvent at a temperature of 373 K. Two operational regimes are explored: “closed” reaction conditions correspond to the retention of evolved hydrogen chloride gas within the reaction medium, whereas an “open” system permits gaseous hydrogen chloride to be released from the reaction medium. The solution phase chemistry is analyzed by 1H NMR spectroscopy. Complete liberation of solvated 4-benzylaniline from solid 4-benzylaniline hydrochloride is possible under “open” conditions, with the entropically favored conversion of solvated hydrogen chloride to the gaseous phase thought to be the thermodynamic driver that effectively controls a series of interconnecting equilibria. A kinetic model is proposed to account for the observations of the open system

HST NIR Snapshot Survey of 3CR Radio Source Counterparts II: An Atlas and Inventory of the Host Galaxies, Mergers and Companions

We present the second part of an H-band (1.6 microns) atlas of z<0.3 3CR radio galaxies, using the Hubble Space Telescope Near Infrared Camera and Multi-Object Spectrometer (HST NICMOS2). We present new imaging for 21 recently acquired sources, and host galaxy modeling for the full sample of 101 (including 11 archival) -- an 87% completion rate. Two different modeling techniques are applied, following those adopted by the galaxy morphology and the quasar host galaxy communities. Results are compared, and found to be in excellent agreement, although the former breaks down in the case of strongly nucleated sources. Companion sources are tabulated, and the presence of mergers, tidal features, dust disks and jets are catalogued. The tables form a catalogue for those interested in the structural and morphological dust-free host galaxy properties of the 3CR sample, and for comparison with morphological studies of quiescent galaxies and quasar host galaxies. Host galaxy masses are estimated, and found to typically lie at around 2*10^11 solar masses. In general, the population is found to be consistent with the local population of quiescent elliptical galaxies, but with a longer tail to low Sersic index, mainly consisting of low-redshift (z<0.1) and low-radio-power (FR I) sources. A few unusually disky FR II host galaxies are picked out for further discussion. Nearby external sources are identified in the majority of our images, many of which we argue are likely to be companion galaxies or merger remnants. The reduced NICMOS data are now publicly available from our website (http://archive.stsci.edu/prepds/3cr/)Comment: ApJS, 177, 148: Final version; includes revised figures 1, 15b, and section 7.5 (and other minor changes from editing process. 65 pages, inc. 17 figure

Model-based evaluation of the long-term cost-effectiveness of systematic case-finding for COPD in primary care

Introduction'One-off' systematic case-finding for COPD using a respiratory screening questionnaire is more effective and cost-effective than routine care at identifying new cases. However, it is not known whether early diagnosis and treatment is beneficial in the longer term. We estimated the long-term cost-effectiveness of a regular case-finding programme in primary care.MethodsA Markov decision analytic model was developed to compare the cost-effectiveness of a 3-yearly systematic case-finding programme targeted to ever smokers aged ≥50 years with the current routine diagnostic process in UK primary care. Patient-level data on case-finding pathways was obtained from a large randomised controlled trial. Information on the natural history of COPD and treatment effects was obtained from a linked COPD cohort, UK primary care database and published literature. The discounted lifetime cost per quality-adjusted life-year (QALY) gained was calculated from a health service perspective.ResultsThe incremental cost-effectiveness ratio of systematic case-finding versus current care was £16 596 per additional QALY gained, with a 78% probability of cost-effectiveness at a £20 000 per QALY willingness-to-pay threshold. The base case result was robust to multiple one-way sensitivity analyses. The main drivers were response rate to the initial screening questionnaire and attendance rate for the confirmatory spirometry test.DiscussionRegular systematic case-finding for COPD using a screening questionnaire in primary care is likely to be cost-effective in the long-term despite uncertainties in treatment effectiveness. Further knowledge of the natural history of case-found patients and the effectiveness of their management will improve confidence to implement such an approach

Neural Networks for Modeling Neural Spiking in S1 Cortex

Somatosensation is composed of two distinct modalities: touch, arising from sensors in the skin, and proprioception, resulting primarily from sensors in the muscles, combined with these same cutaneous sensors. In contrast to the wealth of information about touch, we know quite less about the nature of the signals giving rise to proprioception at the cortical level. Likewise, while there is considerable interest in developing encoding models of touch-related neurons for application to brain machine interfaces, much less emphasis has been placed on an analogous proprioceptive interface. Here we investigate the use of Artificial Neural Networks (ANNs) to model the relationship between the firing rates of single neurons in area 2, a largely proprioceptive region of somatosensory cortex (S1) and several types of kinematic variables related to arm movement. To gain a better understanding of how these kinematic variables interact to create the proprioceptive responses recorded in our datasets, we train ANNs under different conditions, each involving a different set of input and output variables. We explore the kinematic variables that provide the best network performance, and find that the addition of information about joint angles and/or muscle lengths significantly improves the prediction of neural firing rates. Our results thus provide new insight regarding the complex representations of the limb motion in S1: that the firing rates of neurons in area 2 may be more closely related to the activity of peripheral sensors than it is to extrinsic hand position. In addition, we conduct numerical experiments to determine the sensitivity of ANN models to various choices of training design and hyper-parameters. Our results provide a baseline and new tools for future research that utilizes machine learning to better describe and understand the activity of neurons in S1