Traumatic Injuries Among Multiple Sclerosis Patients

Background Because of the high degree of disability in multiple sclerosis (MS) patients, minimizing injury occurrence is essential for preserving quality of life. Objectives By documenting the incidence of particular injuries, establishing relative risks of particular injuries in different subsets of MS patients and analyzing when the injuries occurred following diagnosis, we aim to provide information to encourage injury prevention recommendations and to provide preliminary data for further clinical research. Methods This study utilized a questionnaire consisting of 40 fill-in-the-blank or multiple choice questions. It was administered to previously diagnosed MS patients at office visits, infusion center visits, hospital stays, MS clinic visits and MS support groups. Results The years following definite MS diagnosis with the highest injury rates (injuries/people years lived) were 25 years or more (.0594 injuries/year, 95% CI [0.0771 - 0.0449]). In addition, people below the age of 40 have nearly a doubled risk of injury compared to people above the age of 40 (p= .033). Primary progressive MS patients had the greatest past incidence of fractures, 55.6% (5/9) (p=0.033). Patients reported that only 17.4% (19/109) of injuries occurred during exercise. Conclusions Overall, risk factors for injury include male gender, living longer with MS, being younger and having the diagnosis of primary progressive MS. Patient education, along with specific treatments and regimented physical activity, can lead to a more robust and injury free lifestyle in this patient population

Counting to Four: The History and Future of Wisconsin\u27s Fractured Supreme Court

Over the past decade, the Wisconsin Supreme Court has issued “fractured” opinions—decisions without majority support for any one legal rationale supporting the outcome—at an alarming clip. These opinions have confounded legal analysts, attorneys, and government officials due to their lack of majority reasoning, but also due to their length and the court’s particular procedures for assigning, drafting, and labelling opinions. This has become especially problematic where the court has issued fractured opinions in areas core to the basic functioning of state and local government, leaving the state without clear precedential guidance on what the law is. Yet, virtually no one has analyzed the deeper issues animating this predicament: how fractured opinions in Wisconsin have been handled in the past, what norms surround those choices, and why this problem has become so pronounced. This Article details the history of fractured opinions at the Wisconsin Supreme Court, from the state’s founding to the present, with a particular focus on the past twenty years and the development of the court’s current crisis. With this history in mind, along with (i) foundational principles of state judicial practice and (ii) the shortcomings of the United States Supreme Court’s approach to fractured opinions in Marks v. United States, 430 U.S. 188 (1977), a series of potential reforms are proposed. In particular, this Article suggests that the Wisconsin Supreme Court clearly define and explain what this Articl

Indigenous People and the New England Town Meeting: Stockbridge, Massachusetts, 1730-1775

In the 1730s, Mahicans along the Housatonic River settled the mission town of Stockbridge, Massachusetts. They participated in town meetings and elected “traditional” leaders to typical New England offices. Even after a growing population of English settlers began dominating town offices, the Indians remained a strong presence in meetings, which was conducted in the Mahican as well as English language, and all voting done viva voce. In 1763, a major battle when an English faction tried to take control by introducing secret balloting; the Indians complained and mostly won their case. Stockbridge thus provides a case study comparing Indian and colonial New England decision-making, and highlighting the evolution of the town meeting during the 18th century

Experimental depletion of CD8+ cells in acutely SIVagm-Infected African Green Monkeys results in increased viral replication

<p>Abstract</p> <p>Background</p> <p><it>In vivo </it>CD8⁺cell depletions in pathogenic SIV infections identified a key role for cellular immunity in controlling viral load (VL) and disease progression. However, similar studies gave discordant results in chronically-infected SMs, leading some authors to propose that in natural hosts, SIV replication is independent of cellular immunity. To assess the role of cellular immune responses in the control of SIV replication in natural hosts, we investigated the impact of CD8⁺cell depletion during acute SIV infection in AGMs.</p> <p>Results</p> <p>Nine AGMs were infected with SIVagm.sab and were followed up to day 225 p.i. Four were intravenously infused with the cM-T807 antibody on days 0 (50 mg/kg), 6, and 13 (10 mg/kg, respectively) post infection (p.i.). CD8⁺cells were depleted for up to 28 days p.i. in peripheral blood and LNs in all treated AGMs. Partial CD8⁺T cell depletion occurred in the intestine. SIVagm VLs peaked at similar levels in both groups (10⁷-10⁸RNA copies/ml). However, while VLs were controlled in undepleted AGMs, reaching set-point levels (10⁴-10⁵RNA copies/ml) by day 28 p.i., high VLs (>10⁶RNA copies/ml) were maintained by day 21 p.i. in CD8-depleted AGMs. By day 42 p.i., VLs were comparable between the two groups. The levels of immune activation and proliferation remained elevated up to day 72 p.i. in CD8-depleted AGMs and returned to preinfection levels in controls by day 28 p.i. None of the CD8-depleted animals progressed to AIDS.</p> <p>Conclusion</p> <p>CD8⁺cells are responsible for a partial control of postacute viral replication in SIVagm.sab-infected AGMs. In contrast to macaques, the SIVagm-infected AGMs are able to control viral replication after recovery of the CD8⁺T cells and avoid disease progression.</p

Occultation Spectrophotometry of Extrasolar Planets with SOFIA

The NASA/DLR Stratospheric Observatory for Infrared Astronomy (SOFIA), a 2.5- meter infrared telescope on board a Boeing 747-SP, will conduct 0.3 - 1,600 micrometer photometric, spectroscopic, and imaging observations from altitudes as high as 45,000 ft., where the average atmospheric transmission is greater than 80 percent. SOFIA's first light cameras and spectrometers, as well as future generations of instruments, will make important contributions to the characterization of the physical properties of exoplanets. Our analysis shows that optical and near-infrared photometric and spectrophotometric follow-up observations during planetary transits and eclipses will be feasible with SOFIA's instrumentation, in particular the HIPOFLITECAM optical/NIR instruments. The airborne-based platform has unique advantages in comparison to ground- and space-based observatories in this field of research which we will outline here. Furthermore we will present two exemplary science cases, that will be conducted in SOFIA's cycle 1

S I N F L O W

ABSTRACT This paper is a discussion of a manufacturing technique that reduces dependency on in-plane resin flow, allowing greatly reduced injection times, increased injected resin volume per port (reducing the number of ports required), and allows relatively higher fiber volume content. This method uses a two-stage injection process. The first stage injects resin into a vacuum evacuated &quot;pool&quot; outside of the plane of the fabric. Pressure is then applied outside of a flexible film, forcing resin into the fabric in the thickness direction. Since resin is not required to flow in the plane of the fabric, relatively high volumetric flow rates are possible during the injection stage. The hydrostatic pressure on the flexible film results in part-to-part and spatially consistent high volume content. This process has also shown to be less sensitive to fabric and manufacturing inconsistencies than traditional twosided mold RTM, and has been used to successfully manufacture parts using difficult-to-RTM materials such as bonded fabrics. Drawbacks of this process include increased mold and process complexities, poor surface finish on one side of the part, and increased complexity of process tuning

Evaluating Performance of Composite Materials for MHK Applications

ABSTRACT Montana State University (MSU) has a compilation of material systems, environmental chambers, and mechanical testing equipment to determine composite materials performance and failure characteristics. Mechanical characterization of composite systems will provide direct quantification of the materials under consideration for Marine Hydro Kinetic (MHK) designs that were initially developed for the wind turbine industry. The work presented herein represents the testing protocol development and initial results to support investigations on the effect of sea water absorption on material strength. A testing protocol for environmental effects has been developed for the resin infused in-house fabricated laminates. Unidirectional ([0] and [90]) test samples of 2-mm and 6-mm thickness were be submerged for 1000 hours in synthetic sea water at 40°C with the weight recorded at time intervals over the entire period. After 1000 hours of conditioning, coupons were placed in the synthetic sea water at 20°C until testing. Static compressive and tensile strength properties at temperatures of 5°C, 20°C and 40°C were collected. These initial results show trends of reduced tensile and compressive strength with increasing moisture and temperature in the 0° (longitudinal) direction. In the 90° (transverse) direction, compression strength decreases but tensile strength is little affected as temperature and moisture increase. Elastic modulus (E) is little affected in the longitudinal direction but decreases in the transverse direction

Predictors of Improved Pain, Quality of Life, and Physical Function after Surgical Treatment of Lumbar Spinal Stenosis

Introduction: Degenerative lumbar stenosis is common in adults and is frequently managed by surgical intervention after non-operative measures fail to relieve pain. Limited evidence-based information regarding optimal selection of patients for surgery exists. Current reform in healthcare policy has sparked significant interest in comparative effectiveness research with the goal of optimizing treatment strategies for common conditions such as degenerative lumbar stenosis. The purpose of this study is to quantify the effectiveness of surgical treatment of lumbar stenosis and to identify patient predictors of greatest improvement using patient reported measures of pain, physical function and quality of life. Methods: A retrospective study evaluated 229 adult patients who underwent decompression with or without posterior lumbar fusion for treatment of lumbar stenosis over a two year time period. Patient reported outcomes were measured using the SF36 health survey. 146 patients had 6 month follow-up and 106 patients had one year follow-up. Variations in scores of the SF36 pain, mental component summary (MCS), and physical component summary (PCS) subscales were analyzed by multivariate linear regression analysis. Results: At 6-12 months post-surgery, patients reported an improvement of 8 points in average pain (32.3 to 40.4), physical function (28.6 to 36.9), and PCS (29.0 to 36.9) subscales of the SF36. There was a 6 point average improvement in MCS scores (41.8 to 48.10). Greater post-operative pain was significantly associated with smoking (p In regards to improvements in quality of life, older age (p Conclusion: In general, surgical treatment for lumbar stenosis improves patient pain, quality of life, and physical function as indicated by substantial improvement in all subscales of the SF36 health survey. Predictive factors associated with poor pain relief after surgery include smoking, diabetes, the presence of instrumentation, and re-operation within a 12 month time period. Higher MCS scores are seen in older patients and those with an increase in physical function post-operatively. Predictive factors for poor MCS scores include revision surgery and mental health diagnosis. No specific predictors of PCS score were identified, most likely due to the complicated nature of the patient population with lumbar spinal stenosis. Further work is necessary to determine the ideal surgical candidate