Does any therapy really work for neurocardiogenic syncope?

Effectiveness of a treatment for neurocardiogenic syncope can be defined in terms of symptom response, quality-of-life, healthcare utilization, treatment side effects and cost-effectiveness. Most trials have focused on syncope recurrence or burden, without assessing quality-of-life formally. Drug and device interventions are characterized by a dearth of randomized controlled trials, with those few of robust design demonstrating little impact on recurrence of syncope. General advice includes hydration, trigger recognition and counter pressure maneuvers to attenuate episodes. Lifestyle recommendations have limited comparative effectiveness evidence, but are favored due to lack of side effects and low cost. The frequency of syncope improves in many patients regardless of the intervention, although ultimate recurrence of syncope remains high. In the minority of patients seeking treatment due to recurrence, midodrine has reasonable supporting evidence for effectiveness with some evidence for beta-blockers in older age patients. Emerging evidence favors pacing in patients with asystole during spontaneous (as opposed to provoked) syncope. Combining long-term implantable cardiac monitoring, tilt and adenosine triphosphate testing may yet accurately define the optimal minority who benefit from pacing. In the remaining majority, pharmacologic and device interventions should be used sparingly until clear benefits are established. Better understanding of patient fears, beliefs and behaviors may help develop cognitive therapies and improve quality-of-life alongside the focus on physical symptoms

Structural Insights into DNA Polymerase β Deterrents for Misincorporation Support an Induced-Fit Mechanism for Fidelity

AbstractDNA polymerases generally select the correct nucleotide from a pool of structurally similar molecules to preserve Watson-Crick base-pairing rules. We report the structure of DNA polymerase β with DNA mismatches situated in the polymerase active site. This was achieved by using nicked product DNA that traps the mispair (template-primer, A-C or T-C) in the nascent base pair binding pocket. The structure of each mispair complex indicates that the bases do not form hydrogen bonds with one another, but form a staggered arrangement where the bases of the mispair partially overlap. This prevents closure/opening of the N subdomain that is believed to be required for catalytic cycling. The partially open conformation of the N subdomain results in distinct hydrogen bonding networks that are unique for each mispair. These structures define diverse molecular aspects of misinsertion that are consistent with the induced-fit model for substrate specificity

Morphogenesis: Pharyngeal Arch Development in Ambystoma tigrinum

This study examines pharyngeal arch (PA) development in the eastern tiger salamander (Ambystoma tigrinum) during transformation. The PA is a series of six arches that give structure to the gills and is involved in feeding and moving water across the pharyngeal and branchial chambers. Proper remodeling of the PA during transformation is essential to ensure proper respiratory functioning and feeding in terrestrial salamanders. Salamander carcasses were obtained from salamanders that died before, during, or after transformation to a terrestrial state. The carcasses were cleared and stained with alcian blue (cartilage identification) and alizarin red (bone identification) to evaluate PA remodeling during transformation. The majority of salamanders exhibited abnormal PA remodeling. Based on current findings, we hypothesize that the abnormal ossification may be in part due to a changed morphogenesis process.https://openriver.winona.edu/urc2019/1115/thumbnail.jp

QuAnt: Quantum Annealing with Learnt Couplings

Modern quantum annealers can find high-quality solutions to combinatorialoptimisation objectives given as quadratic unconstrained binary optimisation(QUBO) problems. Unfortunately, obtaining suitable QUBO forms in computervision remains challenging and currently requires problem-specific analyticalderivations. Moreover, such explicit formulations impose tangible constraintson solution encodings. In stark contrast to prior work, this paper proposes tolearn QUBO forms from data through gradient backpropagation instead of derivingthem. As a result, the solution encodings can be chosen flexibly and compactly.Furthermore, our methodology is general and virtually independent of thespecifics of the target problem type. We demonstrate the advantages of learntQUBOs on the diverse problem types of graph matching, 2D point cloud alignmentand 3D rotation estimation. Our results are competitive with the previousquantum state of the art while requiring much fewer logical and physicalqubits, enabling our method to scale to larger problems. The code and the newdataset will be open-sourced.<br

Feasibility of self-structured current accessed bubble devices in spacecraft recording systems

The self-structured, current aperture approach to magnetic bubble memory is described. Key results include: (1) demonstration that self-structured bubbles (a lattice of strongly interacting bubbles) will slip by one another in a storage loop at spacings of 2.5 bubble diameters, (2) the ability of self-structured bubbles to move past international fabrication defects (missing apertures) in the propagation conductors (defeat tolerance), and (3) moving bubbles at mobility limited speeds. Milled barriers in the epitaxial garnet are discussed for containment of the bubble lattice. Experimental work on input/output tracks, storage loops, gates, generators, and magneto-resistive detectors for a prototype device are discussed. Potential final device architectures are described with modeling of power consumption, data rates, and access times. Appendices compare the self-structured bubble memory from the device and system perspectives with other non-volatile memory technologies

Concentrations of Polychlorinated Biphenyls (PCB’s), Chlorinated Pesticides, and Heavy Metals and Other Elements in Tissues of Belugas, Delphinapterus leucas, from Cook Inlet

Tissues from Cook Inlet beluga whales, Delphinapterus leucas, that were collected as part of the Alaska Marine Mammal Tissue Archival Project were analyzed for polychlorinated biphenyls (PCB’s), chlorinated pesticides, and heavy metals and other elements. Concentrations of total PCB’s (ΣPCB’s), total DDT (ΣDDT), chlordane compounds, hexachlorobenzene (HCB), dieldrin, mirex, toxaphene, and hexachlorocyclohexane (HCH) measured in Cook Inlet beluga blubber were compared with those reported for belugas from two Arctic Alaska locations (Point Hope and Point Lay), Greenland, Arctic Canada, and the highly contaminated stock from the St. Lawrence estuary in eastern Canada. The Arctic and Cook Inlet belugas had much lower concentrations (ΣPCB’s and ΣDDT were an order of magnitude lower) than those found in animals from the St. Lawrence estuary. The Cook Inlet belugas had the lowest concentrations of all (ΣPCB’s aver-aged 1.49 ± 0.70 and 0.79 ± 0.56 mg/kg wet mass, and ΣDDT averaged 1.35 ± 0.73 and 0.59 ± 0.45 mg/kg in males and females, respectively). Concentrations in the blubber of the Cook Inlet males were significantly lower than those found in the males of the Arctic Alaska belugas (ΣPCB’s and ΣDDT were about half). The lower levels in the Cook Inlet animals might be due to differences in contaminant sources, food web differences, or different age distributions among the animals sampled. Cook Inlet males had higher mean and median concentrations than did females, a result attributable to the transfer of these compounds from mother to calf during pregnancy and during lactation. Liver concentrations of cadmium and mercury were lower in the Cook Inlet belugas (most cadmium values were <1 mg/kg and mercury values were 0.704–11.42 mg/kg wet mass), but copper levels were significantly higher in the Cook Inlet animals (3.97–123.8 mg/kg wet mass) than in Arctic Alaska animals and similar to those reported for belugas from Hudson Bay. Although total mercury levels were the lowest in the Cook Inlet population, methylmercury concentrations were similar among all three groups of the Alaska animals examined (0.34–2.11 mg/kg wet mass). As has been reported for the Point Hope and Point Lay belugas, hepatic concentrations of silver were r

Using Lightweight Activity Diagrams for Modeling and Generation of Web Information Systems

The development process of web information systems nowadays improved a lot regarding effectiveness and tool support, but still contains many redundant steps for similar tasks. In order to overcome this, we use a model-driven approach to specify a web information system in an agile way and generate a full- edged and runnable application from a set of models. The covered aspects of the system comprise data structure, page structure including view on data, page- and workflow within the system as well as overall application structure and user rights management. Appropriate tooling allows transforming these models to complete systems and thus gives us opportunity for a lightweight development process based on models. In this paper, we describe how we approach the page- and workflow aspect by using activity diagrams as part of the agile modeling approach MontiWIS. We give an overview of the defined syntax, describe the supported forms of action contents and finally explain how the behavior is realized in the generated application.Comment: 12 pages, 6 figure

Effects of fluoxetine on the oral environment of bulimics

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73809/1/j.1399-302X.1993.tb00545.x.pd