Perceived Utility of Intracranial Pressure Monitoring in Traumatic Brain Injury: A Seattle International Brain Injury Consensus Conference Consensus-Based Analysis and Recommendations

Intracranial pressure; Brain injury; ConsensusPresión intracraneal; Lesión cerebral; ConsensoPressió intracranial; Lesió cerebral; ConsensBACKGROUND: Intracranial pressure (ICP) monitoring is widely practiced, but the indications are incompletely developed, and guidelines are poorly followed. OBJECTIVE: To study the monitoring practices of an established expert panel (the clinical working group from the Seattle International Brain Injury Consensus Conference effort) to examine the match between monitoring guidelines and their clinical decision-making and offer guidance for clinicians considering monitor insertion. METHODS: We polled the 42 Seattle International Brain Injury Consensus Conference panel members' ICP monitoring decisions for virtual patients, using matrices of presenting signs (Glasgow Coma Scale [GCS] total or GCS motor, pupillary examination, and computed tomography diagnosis). Monitor insertion decisions were yes, no, or unsure (traffic light approach). We analyzed their responses for weighting of the presenting signs in decision-making using univariate regression. RESULTS: Heatmaps constructed from the choices of 41 panel members revealed wider ICP monitor use than predicted by guidelines. Clinical examination (GCS) was by far the most important characteristic and differed from guidelines in being nonlinear. The modified Marshall computed tomography classification was second and pupils third. We constructed a heatmap and listed the main clinical determinants representing 80% ICP monitor insertion consensus for our recommendations. CONCLUSION: Candidacy for ICP monitoring exceeds published indicators for monitor insertion, suggesting the clinical perception that the value of ICP data is greater than simply detecting and monitoring severe intracranial hypertension. Monitor insertion heatmaps are offered as potential guidance for ICP monitor insertion and to stimulate research into what actually drives monitor insertion in unconstrained, real-world conditions

Irreducible Multiplets of Three-Quark Operators on the Lattice: Controlling Mixing under Renormalization

High luminosity accelerators have greatly increased the interest in semi-exclusive and exclusive reactions involving nucleons. The relevant theoretical information is contained in the nucleon wavefunction and can be parametrized by moments of the nucleon distribution amplitudes, which in turn are linked to matrix elements of three-quark operators. These can be calculated from first principles in lattice QCD. However, on the lattice the problems of operator mixing under renormalization are rather involved. In a systematic approach we investigate this issue in depth. Using the spinorial symmetry group of the hypercubic lattice we derive irreducibly transforming three-quark operators, which allow us to control the mixing pattern.Comment: 13 page

Electron-spin-resonance in the doped spin-Peierls compound Cu(1-x)Ni(x)GeO3

ESR-study of the Ni-doped spin-Peierls compound CuGeO3 has been performed in the frequency range 9-75 GHz. At low temperatures the g-factor is smaller than the value expected for Cu- and Ni-ions. This anomaly is explained by the formation of magnetic clusters around the Ni-ions within a nonmagnetic spin-Peierls matrix. The transition into the AFM-state detected earlier by neutron scattering for doped samples was studied by means of ESR. For x=0.032 a gap in the magnetic resonance spectrum is found below the Neel temperature and the spectrum is well described by the theory of antiferromagnetic resonance based on the molecular field approximation. For x=0.017 the spectrum below the Neel point remained gapless. The gapless spectrum of the antiferromagnetic state in weekly doped samples is attributed to the small value of the Neel order parameter and to the magnetically disordered spin-Peierls background.Comment: 16 pages, LATEX, 12 figures, submitted to Journal of Physics : Condensed Matte

The Body in Isolation: The Physical Health Impacts of Incarceration in Solitary Confinement

We examine how solitary confinement correlates with self-reported adverse physical health outcomes, and how such outcomes extend the understanding of the health disparities associated with incarceration. Using a mixed methods approach, we find that solitary confinement is associated not just with mental, but also with physical health problems. Given the disproportionate use of solitary among incarcerated people of color, these symptoms are most likely to affect those populations. Drawing from a random sample of prisoners (n = 106) in long-term solitary confinement in the Washington State Department of Corrections in 2017, we conducted semi-structured, in-depth interviews; Brief Psychiatric Rating Scale (BPRS) assessments; and systematic reviews of medical and disciplinary files for these subjects. We also conducted a paper survey of the entire long-term solitary confinement population (n = 225 respondents) and analyzed administrative data for the entire population of prisoners in the state in 2017 (n = 17,943). Results reflect qualitative content and descriptive statistical analysis. BPRS scores reflect clinically significant somatic concerns in 15% of sample. Objective specification of medical conditions is generally elusive, but that, itself, is a highly informative finding. Using subjective reports, we specify and analyze a range of physical symptoms experienced in solitary confinement: (1) skin irritations and weight fluctuation associated with the restrictive conditions of solitary confinement; (2) un-treated and mis-treated chronic conditions associated with the restrictive policies of solitary confinement; (3) musculoskeletal pain exacerbated by both restrictive conditions and policies. Administrative data analyses reveal disproportionate rates of racial/ethnic minorities in solitary confinement. This analysis raises the stakes for future studies to evaluate comparative prevalence of objective medical diagnoses and potential causal mechanisms for the physical symptoms specified here, and for understanding differential use of solitary confinement and its medically harmful sequelae

Systematic Transfer of Prokaryotic Sensors and Circuits to Mammalian Cells

Prokaryotic regulatory proteins respond to diverse signals and represent a rich resource for building synthetic sensors and circuits. The TetR family contains >10[superscript 5] members that use a simple mechanism to respond to stimuli and bind distinct DNA operators. We present a platform that enables the transfer of these regulators to mammalian cells, which is demonstrated using human embryonic kidney (HEK293) and Chinese hamster ovary (CHO) cells. The repressors are modified to include nuclear localization signals (NLS) and responsive promoters are built by incorporating multiple operators. Activators are also constructed by modifying the protein to include a VP16 domain. Together, this approach yields 15 new regulators that demonstrate 19- to 551-fold induction and retain both the low levels of crosstalk in DNA binding specificity observed between the parent regulators in Escherichia coli, as well as their dynamic range of activity. By taking advantage of the DAPG small molecule sensing mediated by the PhlF repressor, we introduce a new inducible system with 50-fold induction and a threshold of 0.9 μM DAPG, which is comparable to the classic Dox-induced TetR system. A set of NOT gates is constructed from the new repressors and their response function quantified. Finally, the Dox- and DAPG- inducible systems and two new activators are used to build a synthetic enhancer (fuzzy AND gate), requiring the coordination of 5 transcription factors organized into two layers. This work introduces a generic approach for the development of mammalian genetic sensors and circuits to populate a toolbox that can be applied to diverse applications from biomanufacturing to living therapeutics.United States. Defense Advanced Research Projects Agency (DARPA-BAA-11-23)National Institutes of Health (U.S.) (P50GM098792)Life Technologies, Inc. (Research Contract A114510)United States. Office of Naval Research. Multidisciplinary University Research Initiative (N00014-13-1-0074)National Institute of General Medical Sciences (U.S.) (Award R01 GM095765

Expression profiling of human glial precursors

<p>Abstract</p> <p>Background</p> <p>We have generated gene expression databases for human glial precursors, neuronal precursors, astrocyte precursors and neural stem cells and focused on comparing the profile of glial precursors with that of other populations.</p> <p>Results</p> <p>A total of 14 samples were analyzed. Each population, previously distinguished from each other by immunocytochemical analysis of cell surface markers, expressed genes related to their key differentiation pathways. For the glial precursor cell population, we identified 458 genes that were uniquely expressed. Expression of a subset of these individual genes was validated by RT-PCR. We also report genes encoding cell surface markers that may be useful for identification and purification of human glial precursor populations.</p> <p>Conclusion</p> <p>We provide gene expression profile for human glial precursors. Our data suggest several signaling pathways that are important for proliferation and differentiation of human glial precursors. Such information may be utilized to further purify glial precursor populations, optimize media formulation, or study the effects of glial differentiation.</p

Finite strain Landau theory of high pressure phase transformations

The properties of materials near structural phase transitions are often successfully described in the framework of Landau theory. While the focus is usually on phase transitions, which are induced by temperature changes approaching a critical temperature T-c, here we will discuss structural phase transformations driven by high hydrostatic pressure, as they are of major importance for understanding processes in the interior of the earth. Since at very high pressures the deformations of a material are generally very large, one needs to apply a fully nonlinear description taking physical as well as geometrical nonlinearities (finite strains) into account. In particular it is necessary to retune conventional Landau theory to describe such phase transitions. In Troster et al (2002 Phys. Rev. Lett. 88 55503) we constructed a Landau-type free energy based on an order parameter part, an order parameter-(finite) strain coupling and a nonlinear elastic term. This model provides an excellent and efficient framework for the systematic study of phase transformations for a wide range of materials up to ultrahigh pressures

Magnetic Resonance of the Intrinsic Defects of the Spin-Peierls Magnet CuGeO3

ESR of the pure monocrystals of CuGeO3 is studied in the frequency range 9-75 GHz and in the temperature interval 1.2-25 K. The splitting of the ESR line into several spectral components is observed below 5 K, in the temperature range where the magnetic susceptibility is suppressed by the spin-Peierls dimerization. The analysis of the magnetic resonance signals allows one to separate the signals of the S=1/2- and S=1 defects of the spin-Peierls phase. The value of g-factor of these signals is close to that of the Cu-ion. The additional line of the magnetic resonance is characterized by an anomalous value of the g-factor and by the threshold-like increase of the microwave susceptibility when the microwave power is increasing. The ESR signals are supposingly attributed to two types of the planar magnetic defects, arising at the boundaries of the domains of the spin-Peierls state with the different values of the phase of the dimerization.Comment: LATEX-text, 12 PS-figures, typos corrected, LATEX-style change

Statistics of low-energy levels of a one-dimensional weakly localized Frenkel exciton: A numerical study

Numerical study of the one-dimensional Frenkel Hamiltonian with on-site randomness is carried out. We focus on the statistics of the energy levels near the lower exciton band edge, i. e. those determining optical response. We found that the distribution of the energy spacing between the states that are well localized at the same segment is characterized by non-zero mean, i.e. these states undergo repulsion. This repulsion results in a local discrete energy structure of a localized Frenkel exciton. On the contrary, the energy spacing distribution for weakly overlapping local ground states (the states with no nodes within their localization segments) that are localized at different segments has zero mean and shows almost no repulsion. The typical width of the latter distribution is of the same order as the typical spacing in the local discrete energy structure, so that this local structure is hidden; it does not reveal itself neither in the density of states nor in the linear absorption spectra. However, this structure affects the two-exciton transitions involving the states of the same segment and can be observed by the pump-probe spectroscopy. We analyze also the disorder degree scaling of the first and second momenta of the distributions.Comment: 10 pages, 6 figure