The prognostic value of cortical magnetic stimulation in acute middle cerebral artery infarction compared to other parameters

The prognostic value of magnetic evoked potentials (MEP), somatosensory evoked potentials (SSEP), age and radiological parameters was determined in 50 patients with acute middle cerebral artery infarction. We performed MEP and SSEP within 4 days and after 6 weeks and 3 months of the infarction and assessed clinical improvement by using the Barthel index (BI) and the Rankin scale. The localization and extent of the infarction was investigated by CT scanning or NMR. All parameters were correlated to clinical outcome and the prognostic significance of each parameter in addition to BI was determined. MEP, SSEP, and age were valuable prognostic parameters in predicting stroke outcome when used together with the BI. However, in stepwise regression analysis using all parameters simultaneously, only MEP and age significantly contributed to clinical outcome in addition to BI. Patients showed a better outcome when their MEP was normal or delayed, measured within 4 days of the infarction, compared to patients with absent MEP. Clinical outcome was better at a younger age

A Role of the Bile Salt Receptor FXR in Atherosclerosis

This study reviews current insights into the role of bile salts and bile salt receptors on the progression and regression of atherosclerosis. Bile salts have emerged as important modifiers of lipid and energy metabolism. At the molecular level, bile salts regulate lipid and energy homeostasis mainly via the bile salt receptors FXR and TGR5. Activation of FXR has been shown to improve plasma lipid profiles, whereas Fxr(-/-) mice have increased plasma triglyceride and very-low-density lipoprotein levels. Nevertheless, high-density lipoprotein cholesterol levels are increased in these mice, suggesting that FXR has both anti-and proatherosclerotic properties. Interestingly, there is increasing evidence for a role of FXR in "nonclassical" bile salt target tissues, eg, vasculature and macrophages. In these tissues, FXR has been shown to influence vascular tension and regulate the unloading of cholesterol from foam cells, respectively. Recent publications have provided insight into the antiinflammatory properties of FXR in atherosclerosis. Bile salt signaling via TGR5 might regulate energy homeostasis, which could serve as an attractive target to increase energy expenditure and weight loss. Interventions aiming to increase cholesterol turnover (eg, by bile salt sequestration) significantly improve plasma lipid profiles and diminish atherosclerosis in animal models. Bile salt metabolism and bile salt signaling pathways represent attractive therapeutic targets for the treatment of atherosclerosi

A Study of Requests by Two Native Speaker Groups: University of Hawai'i at Mānoa Graduate Students & the American Military Speech Community of Oahu

The fields of Linguistics and ESL frequently use English spoken by native speakers as the target language for ESL learners or for comparative studies with interlanguage. Is it possible to claim that one English native speaker group represents all native English speakers? This paper illustrates similarities and differences in the English of two American native speaker groups in Oahu and by the genders of both groups: the American military speech community and graduate students at the University of Hawaii at Manoa. I present the data of 20 men and 20 women from each native speaker group, with a total of 80 participants. A questionnaire collects native speaker perceptions of the appropriate level of directness of requests to be used in encounters with personnel of both genders who serve the public. The native speaker groups choose directness of requests equivalently, but the genders show some significant statistical differences in choices with women choosing more direct requests than men. Different situations and addressee genders also are factors in request directness choice. The findings indicate that it is important for researchers and teachers to pay attention to accuracy in representing native speaker language

Understanding The Antecedents And Consequences Of Sales And Use Tax Policy: Evidence From Three Studies

This dissertation consists of three separate but interrelated studies examining the antecedents and consequences of sales and use tax (SUT) policy. The first study investigates whether elements of the SUT system influence elements of economic development, and tests whether SUT rates and/or bases influence state-aggregated levels of capital expenditures and employment within the manufacturing sector from 1983-2006. Results indicate that elements of the tax base (i.e., SUT exemptions) affect these indicators of economic development, but the same relationship was not seen for SUT rates. The second study examines individual taxpayer compliance across different tax settings (i.e., the state use tax compared to the federal income tax) and tests whether differences in detection mechanisms, social norms, or ignorance explain these differences in compliance. Based on a final sample of 148 taxpayers, results show that social norms had an important influence on tax compliance differences across tax settings. The third study investigates the antecedents of states\u27 adoption of the Streamlined Sales & Use Tax Agreement (SSUTA) using both a cross-sectional empirical model and an in-depth qualitative case study of three states. Both the model and case study suggest that governmental interest groups, rather than businesses, play an important role in the adoption of inter-jurisdictional tax policy changes. Overall, the three studies within this dissertation all advance the SUT literature by using various theoretical perspectives and methodological approaches to demonstrate that governmental interest groups influence the adoption of SUT policy (antecedents), and that SUT provisions in turn influence business and individual decisions alike (consequences)

The Reproductive Biology of the Paddlefish, Polyodon Spathula (Walbaum), in Lake Cumberland, Kentucky

The reproductive biology of the paddlefish (Polyodon spathula) was studied on specimens collected from Lake Cumberland, Kentucky, from September 1983 to July 1984. A total of 500 specimens was studied. Reproductive activity was observed on 17 April 1984 in the Big South Fork of Lake Cumberland. Seasonal differences were observed in sex ratios with more males than females occurring in the winter and spring. Movements were observed throughout the year, but these were accentuated prior to reproduction in the spring. Lake Cumberland paddlefish became sexually mature by Age Group V in males and VIII in females. In the spring, gravid females were found only in upstream spawning areas while non-gravid females occurred throughout the rest of the lake. This supported the alternating year spawning hypothesis for females of this species; mature males were found in all lake locations sampled at this time. Gonad development in Lake Cumberland paddlefish started in September-October and continued progressively throughout the year until egg release. Gonad fat bodies responded inversely with gonad development, progressively decreasing in size as the gonads increased. The liver and throat fat bodies did not show this weight correlation but were concluded to be important in the energetics of the gonads. Coefficients of condition for Lake Cumberland paddlefish corresponded closely with gonad development. Condition values for Lake Cumberland paddlefish were greater than those reported in the literature. This supported the idea that the optimum habitat for paddlefish is in lakes rather than rivers. The estimated average annual fecundity for Lake Cumberland paddlefish was similar to that reported in other studies. No relationship was seen between number of eggs and fish size. All sexually mature males and some females exhibited prominent secondary sexual characteristics

Lincoln and Oregon

The Civil War is one of the most significant events in American history. President Abraham Lincoln’s term in office was dominated by the War, therefore the study of Lincoln has likewise been dominated by War developments. The War’s battles were overwhelmingly concentrated in the eastern United States, and hence the American west has largely been ignored by Lincoln scholars. This study attempts to uncover Lincoln’s policy toward Oregon, including War developments and his domestic policy, to partially fill the “western gap” in Lincoln scholarship. Oregon was admitted to the federal Union in 1859, and by Lincoln’s election in 1860 that state’s population remained relatively small. Shortly after Lincoln’s election the Civil war broke out, and Oregon’s remoteness from Washington, D.C. made its situation difficult for Lincoln because communication was slow without a telegraph and transportation was laggard without the transcontinental railroad. A majority of Oregonians remained loyal to the Union, however a vocal minority formed a chapter of the Knights of the Golden Circle in Oregon to hinder the War’s success. The Knights even allied with other individuals in an effort to separate Oregon and California from the Union and form an independent Pacific Coast Republic. Oregon consisted mainly of Democratic voters, and after the War began Oregon’s Democratic Governor John Whiteaker was hostile toward Lincoln’s vigorous prosecution of the war. The attack on Fort Sumter by the Confederates had a great impact upon the Oregonians. Most Oregonians viewed the Confederate attack as the act that initiated the War, and as a result Union sentiment in Oregon was strengthened. Lincoln acted quickly to secure Oregon for the Union by forming a regiment of cavalry to remain in Oregon to guard its frontier during the War. The cavalry performed its duties well until their term of enlistment expired and Lincoln authorized a regiment of cavalry to take its place. Although the majority of Oregonians supported Lincoln and the War, the troops were needed to suppress threatened uprisings by the Knights and Indians living in Oregon. Lincoln’s war policy toward Oregon was just one part of his overall policy. Along with forming troop regiments, initiating the construction of forts, and supplying Oregon with an iron-clad, Lincoln also had a domestic policy toward Oregon. Lincoln reformed the federal circuit court system in order to include Oregon and other states into the system. Lincoln also signed the Homestead Act, the Pacific Railroad Act, and an act to provide economic assistance for a Pacific telegraph, all of which were pieces of legislation that Oregonians had long coveted. In return Oregon shipped large quantities of its gold eastward to help finance the war effort. Lincoln’s policy toward Oregon was one of patience and prudence. Lincoln insured Oregonian support for the Union by supporting legislation that they had perennially demanded without antagonizing the Knights. He also acted decisively in his war policy toward Oregon that enabled that state to mobilize against both internal and external foes

Physical Therapy Intervention for a Patient with Bilateral Achilles Tendinopathy Following Periods of Immobilization: a Case Report

Background and Purpose. Achilles tendinopathy is a chronic disorder resulting from stressing the tendon beyond its physiological threshold. Eccentric calf strengthening is a common intervention used to treat and prevent Achilles tendinopathy; however, the standard eccentric exercise model assumes unilateral involvement. The purpose of this case report is to describe the physical therapy intervention used to treat a patient with bilateral Achilles tendinopathy following two six-week periods of immobilization. Case Description. The patient was a 30 year old National Guard male soldier with a history of bilateral Achilles tendinopathy. The patient had difficulty participating in high-impact activities, secondary to pain. Previous physical therapy treatment attempts had failed, and the orthopedic physician recommended immobilization coupled with physical therapy intervention before considering surgery. Physical therapy intervention emphasized concentric and eccentric strength training and neuromuscular re-education. When the immobilization phases were complete, exercise progressed to prepare the patient for his demanding duties as a National Guard soldier. Outcomes. The patient reported decrease in pain and increased function in daily living and sporting activity as demonstrated by the Victorian Institute of Sport Assessment- Achilles questionnaire (VISA-A) questionnaire. The patient’s VISA-A scores improved from 25/100 on the day of initial evaluation to a 76/100 after 18 weeks of physical therapy intervention and immobilization. The patient also demonstrated an improvement of 4 points on the Patient Specific Functional Scale, exceeding the minimal detectable change to demonstrate statistical improvement in running two miles. Discussion. The standard eccentric calf strengthening model is not applicable for a patient with bilateral Achilles tendinopathy or immobilization. Furthermore, current research challenges the effectiveness of eccentric exercise and recommends including sport-specific functional strengthening and endurance programs in conjunction with eccentric exercise, instead of focusing on eccentric exercise alone. More research is needed to establish an exercise protocol specifically for patients with bilateral Achilles tendinopathy