Carotid approach to anterior circulation thromboembolectomy in an adult with failing fontan physiology: a case report

Background Anesthetic management of an adult with failing Fontan physiology is complicated given inherent anatomical and physiological alterations. Neurosurgical interventions including thromboembolectomy may be particularly challenging given importance of blood pressure control and cerebral perfusion. Case Presentation We describe a 29 year old patient born with double outlet right ventricle (DORV) with mitral valve atresia who after multi-staged surgeries earlier in life, presented with failing Fontan physiology. She was admitted to the hospital almost 29 years after her initial surgeries to undergo workup for a dual heart and liver transplant in the context of a failing Fontan with elevated end diastolic pressures, NYHA III heart failure symptoms, and liver cirrhosis from congestive hepatopathy. During the workup in the context of holding anticoagulation for invasive procedures, she developed a middle cerebral artery (MCA) stroke requiring a thromboembolectomy via left carotid artery approach. Discussion and Conclusions This case posed many challenges to the anesthesiologist including airway control, hemodynamic and cardiopulmonary monitoring, evaluation of perfusion, vascular access, and management of anticoagulation in an adult patient in heart and liver failure with Fontan physiology undergoing thromboembolectomy for MCA embolic stroke

Exile Vol. LVII

Spence, Caroline:To Lose a Brother 7Frances in Three Parts 8-11 Current, Abby: February\u27s Belly 12Selkie Woman 13-14 Callahan, Meghan: Whirl 15Halloween 25-26cool 27-29Faith 39-40Bookish (cover) Eden, Tristan: Runaway 16Sharkey\u27s Philadelphia 17 Heestand, Ashley: Tragedy, 1979 18-24 Persia, Danny: 20,000 Leagues Under the Sea 30-33Hymn to Satan 34-37 DiMartini, Amanda: untitled 38 Bullock, Karen: Gypsies 41-42 Swensson, Ellie: Phenomenology 43-44 Snow 45-47 Moran, Megan: untitled 48 untitled 58 Whites, Shawn: The Woman Across the Alley 49-57 Roozeboom, Nikki: Stain 59Distant 60-61 Ferguson, Brittani: That Dusty Italian Dugout 62-63 Gateway 64 Burdoff, Holly: Transitions 6

Effects of Nocturnal Light on (Clock) Gene Expression in Peripheral Organs: A Role for the Autonomic Innervation of the Liver

BACKGROUND:The biological clock, located in the hypothalamic suprachiasmatic nucleus (SCN), controls the daily rhythms in physiology and behavior. Early studies demonstrated that light exposure not only affects the phase of the SCN but also the functional activity of peripheral organs. More recently it was shown that the same light stimulus induces immediate changes in clock gene expression in the pineal and adrenal, suggesting a role of peripheral clocks in the organ-specific output. In the present study, we further investigated the immediate effect of nocturnal light exposure on clock genes and metabolism-related genes in different organs of the rat. In addition, we investigated the role of the autonomic nervous system as a possible output pathway of the SCN to modify the activity of the liver after light exposure. METHODOLOGY AND PRINCIPAL FINDINGS:First, we demonstrated that light, applied at different circadian times, affects clock gene expression in a different manner, depending on the time of day and the organ. However, the changes in clock gene expression did not correlate in a consistent manner with those of the output genes (i.e., genes involved in the functional output of an organ). Then, by selectively removing the autonomic innervation to the liver, we demonstrated that light affects liver gene expression not only via the hormonal pathway but also via the autonomic input. CONCLUSION:Nocturnal light immediately affects peripheral clock gene expression but without a clear correlation with organ-specific output genes, raising the question whether the peripheral clock plays a "decisive" role in the immediate (functional) response of an organ to nocturnal light exposure. Interestingly, the autonomic innervation of the liver is essential to transmit the light information from the SCN, indicating that the autonomic nervous system is an important gateway for the SCN to cause an immediate resetting of peripheral physiology after phase-shift inducing light exposures

Relativistically rotating dust

Dust configurations play an important role in astrophysics and are the simplest models for rotating bodies. The physical properties of the general--relativistic global solution for the rigidly rotating disk of dust, which has been found recently as the solution of a boundary value problem, are discussed.Comment: 18 pages, 11 figure

Complex-type N-glycan recognition by potent broadly neutralizing HIV antibodies

Broadly neutralizing HIV antibodies (bNAbs) can recognize carbohydrate-dependent epitopes on gp120. In contrast to previously characterized glycan-dependent bNAbs that recognize high-mannose N-glycans, PGT121 binds complex-type N-glycans in glycan microarrays. We isolated the B-cell clone encoding PGT121, which segregates into PGT121-like and 10-1074–like groups distinguished by sequence, binding affinity, carbohydrate recognition, and neutralizing activity. Group 10-1074 exhibits remarkable potency and breadth but no detectable binding to protein-free glycans. Crystal structures of unliganded PGT121, 10-1074, and their likely germ-line precursor reveal that differential carbohydrate recognition maps to a cleft between complementarity determining region (CDR)H2 and CDRH3. This cleft was occupied by a complex-type N-glycan in a “liganded” PGT121 structure. Swapping glycan contact residues between PGT121 and 10-1074 confirmed their importance for neutralization. Although PGT121 binds complex-type N-glycans, PGT121 recognized high-mannose-only HIV envelopes in isolation and on virions. As HIV envelopes exhibit varying proportions of high-mannose- and complex-type N-glycans, these results suggest promiscuous carbohydrate interactions, an advantageous adaptation ensuring neutralization of all viruses within a given strain

Interpersonal interactions, job demands and work‐related outcomes in pharmacy

Objectives  The objective of this study was to examine the interaction between job demands of pharmacists and resources in the form of interpersonal interactions and its association with work‐related outcomes such as organizational and professional commitment, job burnout, professional identity and job satisfaction. The job demands‐resources (JD‐R) model served as the theoretical framework. Methods  Subjects for the study were drawn from the Pharmacy Manpower Project Database ( n  = 1874). A 14‐page mail‐in survey measured hospital pharmacists' responses on the frequency of occurrence of various job‐related scenarios as well as work‐related outcomes. The study design was a 2 × 2 factorial design. Responses were collected on a Likert scale. Descriptive statistics, reliability analyses and correlational and multiple regression analyses were conducted using SPSS version 17 (SPSS, Chicago, IL, USA). Key findings  The 566 pharmacists (30% response rate) who responded to the survey indicated that high‐demand/pleasant encounters and low‐demand/pleasant encounters occurred more frequently in the workplace. The strongest correlations were found between high‐demand/unpleasant encounters and frequency and intensity of emotional exhaustion. Multiple regression analyses indicated that when controlling for demographic factors high‐demand/unpleasant encounters were negatively related to affective organizational commitment and positively related to frequency and intensity of emotional exhaustion. Low‐demand/pleasant encounters were positively related to frequency and intensity of personal accomplishment. Low‐demand/unpleasant encounters were significantly and negatively related to professional commitment, job satisfaction and frequency and intensity of emotional exhaustion, while high‐demand/pleasant encounters were also related to frequency and intensity of emotional exhaustion Conclusion  Support was found for the JD‐R model and the proposed interaction effects. Study results suggest that adequate attention must be paid to the interplay between demands on the job and interactions with healthcare professionals to improve the quality of the pharmacist's work life. Future research should examine other types of job demands and resources.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/90610/1/j.2042-7174.2011.00165.x.pd

University of Oregon Department of Art MFA Thesis Exhibition Catalog

28 pagesEvery spring our graduating MFA candidates’ work emerges and activates the Art Department and the College of Design with an ethos of possibility and insight. Their creative research of new knowledge, or the rearrangement of old knowledge, brings with it the sense that a new day is rising. The 2021 MFA Thesis Exhibition culminates three years of independent research and experimentation by a cohort of eight artists whose various practices engage a broad range of inquiry, from expressions of the personal and diaristic to the examination and fictionalization of language, politics, and technology. While the world teetered this last year—fraught over the COVID-19 pandemic, racial injustice, and political chaos these candidates focused on their practices as the world blurred. They’ve shaped new strategies to teach on-line, built new curriculum to communicate remotely, and cloistered in their studios articulating their practices all the while navigating crisis shared with the nation. As the pandemic ebbs I hope the MFA Graduates of 2021 move forward with a sense of not only a new day rising but a new world emerging

Profiles of autism characteristics in thirteen genetic syndromes : a machine learning approach

Background: Phenotypic studies have identified distinct patterns of autistic characteristics in genetic syndromes associated with intellectual disability (ID), leading to diagnostic uncertainty and compromised access to autism-related support. Previous research has tended to include small samples and diverse measures, which limits the generalisability of findings. In this study, we generated detailed profiles of autistic characteristics in a large sample of > 1500 individuals with rare genetic syndromes. Methods: Profiles of autistic characteristics based on the Social Communication Questionnaire (SCQ) scores were generated for thirteen genetic syndrome groups (Angelman n = 154, Cri du Chat n = 75, Cornelia de Lange n = 199, fragile X n = 297, Prader–Willi n = 278, Lowe n = 89, Smith–Magenis n = 54, Down n = 135, Sotos n = 40, Rubinstein–Taybi n = 102, 1p36 deletion n = 41, tuberous sclerosis complex n = 83 and Phelan–McDermid n = 35 syndromes). It was hypothesised that each syndrome group would evidence a degree of specificity in autistic characteristics. To test this hypothesis, a classification algorithm via support vector machine (SVM) learning was applied to scores from over 1500 individuals diagnosed with one of the thirteen genetic syndromes and autistic individuals who did not have a known genetic syndrome (ASD; n = 254). Self-help skills were included as an additional predictor. Results: Genetic syndromes were associated with different but overlapping autism-related profiles, indicated by the substantial accuracy of the entire, multiclass SVM model (55% correctly classified individuals). Syndrome groups such as Angelman, fragile X, Prader–Willi, Rubinstein–Taybi and Cornelia de Lange showed greater phenotypic specificity than groups such as Cri du Chat, Lowe, Smith–Magenis, tuberous sclerosis complex, Sotos and Phelan-McDermid. The inclusion of the ASD reference group and self-help skills did not change the model accuracy. Limitations: The key limitations of our study include a cross-sectional design, reliance on a screening tool which focuses primarily on social communication skills and imbalanced sample size across syndrome groups. Conclusions: These findings replicate and extend previous work, demonstrating syndrome-specific profiles of autistic characteristics in people with genetic syndromes compared to autistic individuals without a genetic syndrome. This work calls for greater precision of assessment of autistic characteristics in individuals with genetic syndromes associated with ID

A Search for Technosignatures Around 31 Sun-like Stars with the Green Bank Telescope at 1.15-1.73 GHz

We conducted a search for technosignatures in April of 2018 and 2019 with the L-band receiver (1.15-1.73 GHz) of the 100 m diameter Green Bank Telescope. These observations focused on regions surrounding 31 Sun-like stars near the plane of the Galaxy. We present the results of our search for narrowband signals in this data set as well as improvements to our data processing pipeline. Specifically, we applied an improved candidate signal detection procedure that relies on the topographic prominence of the signal power, which nearly doubles the signal detection count of some previously analyzed data sets. We also improved the direction-of-origin filters that remove most radio frequency interference (RFI) to ensure that they uniquely link signals observed in separate scans. We performed a preliminary signal injection and recovery analysis to test the performance of our pipeline. We found that our pipeline recovers 93% of the injected signals over the usable frequency range of the receiver and 98% if we exclude regions with dense RFI. In this analysis, 99.73% of the recovered signals were correctly classified as technosignature candidates. Our improved data processing pipeline classified over 99.84% of the ~26 million signals detected in our data as RFI. Of the remaining candidates, 4539 were detected outside of known RFI frequency regions. The remaining candidates were visually inspected and verified to be of anthropogenic nature. Our search compares favorably to other recent searches in terms of end-to-end sensitivity, frequency drift rate coverage, and signal detection count per unit bandwidth per unit integration time.Comment: 20 pages, 8 figures, in press at the Astronomical Journal (submitted on Sept. 9, 2020; reviews received Nov. 6; re-submitted Nov. 6; accepted Nov. 17