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Although proning is beneficial to acute respiratory distress syndrome, impressions vary about its efficacy. Some providers believe that paralysis is required to facilitate proning. We studied impact of paralysis on prone-induced gas exchange improvements and provider attitudes regarding paralytics.DesignObservational.SettingUniversity of California San Diego.PatientsIntubated COVID acute respiratory distress syndrome patients.InterventionsNone.Measurements and main results1) Changes in Pao2:Fio2 and Spo2:Fio2 ratios before and after proning with and without paralytics, 2) adverse events during proning with and without paralytics, and 3) nurse and physician attitudes about efficacy/safety of proning with and without paralytics. Gas-exchange improvement with proning was similar with and without paralytics (with no serious adverse events). Survey results showed similar attitudes between nurses and physicians about proning efficacy but differing attitudes about the need for paralytics with proning.ConclusionsFindings support use of proning and may help in design of randomized trials to assess paralytics in acute respiratory distress syndrome management.

Although proning is beneficial to acute respiratory distress syndrome, impressions vary about its efficacy. Some providers believe that paralysis is required to facilitate proning. We studied impact of paralysis on prone-induced gas exchange improvements and provider attitudes regarding paralytics.DesignObservational.SettingUniversity of California San Diego.PatientsIntubated COVID acute respiratory distress syndrome patients.InterventionsNone.Measurements and main results1) Changes in Pao2:Fio2 and Spo2:Fio2 ratios before and after proning with and without paralytics, 2) adverse events during proning with and without paralytics, and 3) nurse and physician attitudes about efficacy/safety of proning with and without paralytics. Gas-exchange improvement with proning was similar with and without paralytics (with no serious adverse events). Survey results showed similar attitudes between nurses and physicians about proning efficacy but differing attitudes about the need for paralytics with proning.ConclusionsFindings support use of proning and may help in design of randomized trials to assess paralytics in acute respiratory distress syndrome management.

ObjectivesTo assess the presence of right-to-left shunting (RLS) in patients with obstructive sleep apnea (OSA), and compare clinical characteristics and parameters of the sleep studies of patients with and without RLS.BackgroundThe most common cause of RLS is due to intermittent flow through a patent foramen ovale (PFO). PFO occurs more frequently in patients with OSA and may be involved in the exacerbation of OSA.MethodsPatients with an abnormal polysomnogram seen at UCLA-Santa Monica Sleep Medicine Clinic were enrolled. A diagnosis of RLS was made using a transcranial Doppler (TCD) bubble study. Gender and age-matched controls were drawn from patients referred for cardiac catheterization who underwent a TCD. The frequency of RLS in OSA patients and the controls was evaluated. Clinical characteristics and polysomnogram parameters were compared between OSA patients with and without a RLS.ResultsA total of 100 OSA patients and 200 controls participated in the study. The prevalence of RLS was higher in patients with OSA compared to the control group (42% versus 19%; p < 0.0001). Patients with OSA and a RLS had a lower apnea-hypopnea index (AHI), less obstructive apnea, and fewer hypopnea episodes than patients with OSA without a RLS. The baseline and nadir SpO2 were similar in both groups and did not correlate with the level of RLS assessed by TCD. The degree of desaturation for a given respiratory disturbance, as measured by oxygen desaturation index (ODI)/AHI ratio, was higher in OSA patients with RLS versus OSA patients without RLS (0.85 ± 0.07 versus 0.68 ± 0.04; p < 0.0001).ConclusionRLS, most commonly due to a PFO, occurs 2.2 times more frequently in OSA patients compared to a control population that was matched for age and gender. The severity of sleep apnea is not greater in OSA patients who have a PFO. However, patients with OSA and a PFO are more likely to become symptomatic at a younger age with an equivalent decrease in nocturnal SpO2, and have grea

ObjectivesTo assess the presence of right-to-left shunting (RLS) in patients with obstructive sleep apnea (OSA), and compare clinical characteristics and parameters of the sleep studies of patients with and without RLS.BackgroundThe most common cause of RLS is due to intermittent flow through a patent foramen ovale (PFO). PFO occurs more frequently in patients with OSA and may be involved in the exacerbation of OSA.MethodsPatients with an abnormal polysomnogram seen at UCLA-Santa Monica Sleep Medicine Clinic were enrolled. A diagnosis of RLS was made using a transcranial Doppler (TCD) bubble study. Gender and age-matched controls were drawn from patients referred for cardiac catheterization who underwent a TCD. The frequency of RLS in OSA patients and the controls was evaluated. Clinical characteristics and polysomnogram parameters were compared between OSA patients with and without a RLS.ResultsA total of 100 OSA patients and 200 controls participated in the study. The prevalence of RLS was higher in patients with OSA compared to the control group (42% versus 19%; p < 0.0001). Patients with OSA and a RLS had a lower apnea-hypopnea index (AHI), less obstructive apnea, and fewer hypopnea episodes than patients with OSA without a RLS. The baseline and nadir SpO2 were similar in both groups and did not correlate with the level of RLS assessed by TCD. The degree of desaturation for a given respiratory disturbance, as measured by oxygen desaturation index (ODI)/AHI ratio, was higher in OSA patients with RLS versus OSA patients without RLS (0.85 ± 0.07 versus 0.68 ± 0.04; p < 0.0001).ConclusionRLS, most commonly due to a PFO, occurs 2.2 times more frequently in OSA patients compared to a control population that was matched for age and gender. The severity of sleep apnea is not greater in OSA patients who have a PFO. However, patients with OSA and a PFO are more likely to become symptomatic at a younger age with an equivalent decrease in nocturnal SpO2, and have grea

BackgroundStick and leaf insects (Phasmatodea) are an exclusively leaf-feeding order of insects with no record of omnivory, unlike other "herbivorous" Polyneoptera. They represent an ideal system for investigating the adaptations necessary for obligate folivory, including plant cell wall degrading enzymes (PCWDEs). However, their physiology and internal anatomy is poorly understood, with limited genomic resources available.ResultsWe de novo assembled transcriptomes for the anterior and posterior midguts of six diverse Phasmatodea species, with RNA-Seq on one exemplar species, Peruphasma schultei. The latter's assembly yielded >100,000 transcripts, with over 4000 transcripts uniquely or more highly expressed in specific midgut sections. Two to three dozen PCWDE encoding gene families, including cellulases and pectinases, were differentially expressed in the anterior midgut. These genes were also found in genomic DNA from phasmid brain tissue, suggesting endogenous production. Sequence alignments revealed catalytic sites on most PCWDE transcripts. While most phasmid PCWDE genes showed homology with those of other insects, the pectinases were homologous to bacterial genes.ConclusionsWe identified a large and diverse PCWDE repertoire endogenous to the phasmids. If these expressed genes are translated into active enzymes, then phasmids can theoretically break plant cell walls into their monomer components independently of microbial symbionts. The differential gene expression between the two midgut sections provides the first molecular hints as to their function in living phasmids. Our work expands the resources available for industrial applications of animal-derived PCWDEs, and facilitates evolutionary analysis of lower Polyneopteran digestive enzymes, including the pectinases whose origin in Phasmatodea may have been a horizontal transfer event from bacteria.

BackgroundStick and leaf insects (Phasmatodea) are an exclusively leaf-feeding order of insects with no record of omnivory, unlike other "herbivorous" Polyneoptera. They represent an ideal system for investigating the adaptations necessary for obligate folivory, including plant cell wall degrading enzymes (PCWDEs). However, their physiology and internal anatomy is poorly understood, with limited genomic resources available.ResultsWe de novo assembled transcriptomes for the anterior and posterior midguts of six diverse Phasmatodea species, with RNA-Seq on one exemplar species, Peruphasma schultei. The latter's assembly yielded >100,000 transcripts, with over 4000 transcripts uniquely or more highly expressed in specific midgut sections. Two to three dozen PCWDE encoding gene families, including cellulases and pectinases, were differentially expressed in the anterior midgut. These genes were also found in genomic DNA from phasmid brain tissue, suggesting endogenous production. Sequence alignments revealed catalytic sites on most PCWDE transcripts. While most phasmid PCWDE genes showed homology with those of other insects, the pectinases were homologous to bacterial genes.ConclusionsWe identified a large and diverse PCWDE repertoire endogenous to the phasmids. If these expressed genes are translated into active enzymes, then phasmids can theoretically break plant cell walls into their monomer components independently of microbial symbionts. The differential gene expression between the two midgut sections provides the first molecular hints as to their function in living phasmids. Our work expands the resources available for industrial applications of animal-derived PCWDEs, and facilitates evolutionary analysis of lower Polyneopteran digestive enzymes, including the pectinases whose origin in Phasmatodea may have been a horizontal transfer event from bacteria.

38 p. incl. tables. 26 cm., United States and Its Territories, 1898-1930: The Age of Imperialism, (dlps) AEX3169.0001.001, (lccallno) JQ 1315 1913 F69, http://quod.lib.umich.edu/t/text/accesspolicy.html

38 p. incl. tables. 26 cm., Microfilm. [New York] New York Public Library Photographic Service, 1978. 1 reel. 35 mm., United States and Its Territories, 1898-1930: The Age of Imperialism, (dlps) AES2312.0001.001, http://name.umdl.umich.edu/AES2312.0001.001, http://quod.lib.umich.edu/t/text/accesspolicy.html

W. Cameron Forbes reports on his work in the Insular Government of the Philippines, which he states is understaffed. Forbes notes that the Commission has taken several important measures towards increasing autonomy of the Filipino people, most notably giving them the power to elect the third member of the provincial board. Business conditions are generally improving, with a decrease in imports and positive attitudes from the merchant class. Forbes considers the lack of good roads and the deterioration of those that exist to be the greatest failure of American efforts in the Philippines.

W. Cameron Forbes writes a letter that assesses the many departments and events taking place in the Philippines. The police are doing a good job and the bureau of Coast Guard and Transportation goes well. Prisons and prisoners are problematic, as are relationships between Filipinos who are hiring the lower classes and treating them badly. Forbes notes that he believes education and a sense of worth are important to instill in the population as a whole.

W. Cameron Forbes discusses his experiences as commissioner of the Philippines.

38 p. incl. tables. 26 cm., Microfilm. [New York] New York Public Library Photographic Service, 1978. 1 reel. 35 mm., United States and Its Territories, 1898-1930: The Age of Imperialism, (dlps) AES2312.0001.001, http://name.umdl.umich.edu/AES2312.0001.001, http://quod.lib.umich.edu/t/text/accesspolicy.html

38 p. incl. tables. 26 cm., United States and Its Territories, 1898-1930: The Age of Imperialism, (dlps) AEX3169.0001.001, (lccallno) JQ 1315 1913 F69, http://quod.lib.umich.edu/t/text/accesspolicy.html

Springhouse in Snake Time; Melville's The Confidence-Man: Epistemology and Art; Museum Piece No. 16228; To Make a Prairie: Language and Form in Emily Dickinson's Poems about Mental Experience; Women in the Fiction of F. Scott Fitzgerald; Faulkner's Absalom, Absalom! An Aesthetic Projection of the Religious Sense of Beauty; Sparkie and Did—Still Young; All Songs; The Dramatic Monologue in Robert Frost's The Pauper Witch of Grafton; On Sitting Up Late, Watching Kittens; The Unitarian Wife and the One-Eyed Man: Updike's Marry Me and Sunday Teasing; Death and Design in In Cold Blood: Capote's Nonfiction Novel as Allegory; Poem for David Janssen; A Valentine for Cheryl, This archival material has been provided for educational purposes. Ball State University Libraries recognizes that some historic items may include offensive content. Our statement regarding objectionable content is available at: https://dmr.bsu.edu/digital/about

Springhouse in Snake Time; Melville's The Confidence-Man: Epistemology and Art; Museum Piece No. 16228; To Make a Prairie: Language and Form in Emily Dickinson's Poems about Mental Experience; Women in the Fiction of F. Scott Fitzgerald; Faulkner's Absalom, Absalom! An Aesthetic Projection of the Religious Sense of Beauty; Sparkie and Did—Still Young; All Songs; The Dramatic Monologue in Robert Frost's The Pauper Witch of Grafton; On Sitting Up Late, Watching Kittens; The Unitarian Wife and the One-Eyed Man: Updike's Marry Me and Sunday Teasing; Death and Design in In Cold Blood: Capote's Nonfiction Novel as Allegory; Poem for David Janssen; A Valentine for Cheryl, This archival material has been provided for educational purposes. Ball State University Libraries recognizes that some historic items may include offensive content. Our statement regarding objectionable content is available at: https://dmr.bsu.edu/digital/about

208 p. 24 cm., United States and Its Territories, 1898-1930: The Age of Imperialism, (dlps) AFR0953.0001.001, (lccallno) HD 901 .D3 1910, http://quod.lib.umich.edu/t/text/accesspolicy.html

208 p. 24 cm., United States and Its Territories, 1898-1930: The Age of Imperialism, (dlps) AFR0953.0001.001, (lccallno) HD 901 .D3 1910, http://quod.lib.umich.edu/t/text/accesspolicy.html

Why Grow Old?; The Truth About the "Inferiority Complex"; Why We Sent Our Children Away to School; We Can Stamp Out Venereal Disease; Rheumatism in Childhood; The Weakling Who Was "Born Again"; What Can You Do for Infantile Paralysis?; Sing Your Way to New Energy; Henry Jeffers and His Life-Saving Milk; Taking the "Die" Out of Diet; Keep Young through Exercise; When Is a Husband Unfaithful? : Personal Problem Department; The Body Beautiful : Pictorial; How to Photograph Muscular Beauty; Red Headed Lady; Sleepy Time : Baby Pictorial; A Man Must Have Strength; For Feminine Shapeliness; a Little Meat Go a Long Way; Yogurt : Science or Folklore?; The Nutrition Staff, Volume This archival material has been provided for educational purposes. Ball State University Libraries recognizes that some historic items may include offensive content. Our statement regarding objectionable content is available at: https://dmr.bsu.edu/digital/about

This document contains reports written by the Governor-General of the Philippine Islands, the Secretary of the Interior, and the Executive Secretary.