38 results on '"Ryan Wheeler"'
Search Results
2. 8. Negotiating NAGPRA: Rediscovering the Human Side of Science
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Malinda Stafford Blustain and Ryan Wheeler
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- 2018
3. 7. Trials and Redemption at the Peabody Museum
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Malinda Stafford Blustain and Ryan Wheeler
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- 2018
4. 12. Reflections and Stories
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Malinda Stafford Blustain and Ryan Wheeler
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- 2018
5. 9. Pecos Pathways: A Model for Lasting Partnerships
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Malinda Stafford Blustain and Ryan Wheeler
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- 2018
6. Index
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Malinda Stafford Blustain and Ryan Wheeler
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- 2018
7. 6. A Retrospective Interpretation of the Origins of American Agriculture
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Malinda Stafford Blustain and Ryan Wheeler
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- 2018
8. 10. Teaching Science at the Peabody Museum
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Malinda Stafford Blustain and Ryan Wheeler
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- 2018
9. Contributors
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Malinda Stafford Blustain and Ryan Wheeler
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- 2018
10. Series Editors’ Introduction
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Malinda Stafford Blustain and Ryan Wheeler
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- 2018
11. 4. Laying the Foundations for Northeastern North American Archaeology
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Malinda Stafford Blustain and Ryan Wheeler
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- 2018
12. 3. A. V. Kidder, Pecos Pueblo, and the Robert S. Peabody Museum: A Continuing Legacy
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Malinda Stafford Blustain and Ryan Wheeler
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- 2018
13. List of Illustrations
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Malinda Stafford Blustain and Ryan Wheeler
- Published
- 2018
14. Introduction: Present and Past at the Robert S. Peabody Museum of Archaeology
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Malinda Stafford Blustain and Ryan Wheeler
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- 2018
15. 5. Recent Research at Maine Sites
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Malinda Stafford Blustain and Ryan Wheeler
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- 2018
16. 2. A History of Research: Focusing on the Peopling of the Americas
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Malinda Stafford Blustain and Ryan Wheeler
- Published
- 2018
17. Acknowledgments
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Malinda Stafford Blustain and Ryan Wheeler
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- 2018
18. 1. A Biographical History of the Robert S. Peabody Museum of Archaeology
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Malinda Stafford Blustain and Ryan Wheeler
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- 2018
19. Title Page, Copyright
- Author
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Malinda Stafford Blustain and Ryan Wheeler
- Published
- 2018
20. Beyond NAGPRA/Not NAGPRA
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Ryan Wheeler, Jaime Arsenault, and Marla Taylor
- Subjects
Ocean Engineering - Abstract
Institutions have been slow to respond to calls from Indigenous nations, organizations, and scholars to require free, prior, and informed consent before authorizing use of their cultural heritage materials in publications, exhibition, and research. In the United States, the Native American Graves Protection and Repatriation Act of 1990 fundamentally changed the relationship between museums, archaeologists, and Indigenous nations, requiring institutions to inventory their collections and consult with descendant communities on repatriation of specific Indigenous collections. In response, institutions and their personnel have come to view Indigenous collections as those subject to NAGPRA and those that are not—NAGPRA/Not NAGPRA. Many Indigenous nations, however, do not accept this demarcation, resulting in continued frustration and trauma for those descendant communities. This case study follows the evolving relationship between the White Earth Band of the Minnesota Chippewa Tribe and the Robert S. Peabody Institute of Archaeology. Beginning with repatriation, the relationship has expanded to consider how the museum and Indigenous nation can collaborate on the care and curation of cultural heritage materials that remain at the Peabody Institute. Most recently, White Earth and the Peabody have executed an MOU that governs how the museum will handle new acquisitions, found-in-collections materials, and donor offers. The relationship with the White Earth also has influenced how the Peabody Institute approaches its holdings of Indigenous cultural heritage materials more broadly, blurring the line between NAGPRA and Not NAGPRA collections. The Peabody Institute is working to revise its collections policy to require free, prior, and informed consent prior to use of Indigenous cultural heritage materials in publications, exhibitions, and research.
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- 2022
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21. Data management systems on GPUs: promises and challenges.
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Yi-Cheng Tu, Anand Kumar 0001, Di Yu, Ran Rui, and Ryan Wheeler
- Published
- 2013
- Full Text
- View/download PDF
22. Leveraging legacy archaeological collections as proxies for climate and environmental research
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Bonnie Newsom, Torben C. Rick, Sky Heller, S. Terry Childs, Ryan Wheeler, Daniel H. Sandweiss, Frankie St. Amand, and Elizabeth J. Reitz
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010506 paleontology ,Multidisciplinary ,060102 archaeology ,Climate Change ,Research ,Best practice ,Archaeology, Climate, and Global Change Special Feature ,Climate change ,06 humanities and the arts ,Environment ,01 natural sciences ,Archaeology ,Collections management ,Indigenous ,Cultural heritage ,Geography ,Environmental Science ,Humans ,0601 history and archaeology ,Climate model ,Stewardship ,Public engagement ,History, Ancient ,0105 earth and related environmental sciences - Abstract
Understanding the causes and consequences of previous climate changes is essential for testing present-day climate models and projections. Archaeological sites are paleoenvironmental archives containing unique ecological baselines with data on paleoclimate transformations at a human timescale. Anthropogenic and nonanthropogenic forces have destroyed many sites, and others are under immediate threat. In the face of this loss, previously excavated collections from these sites—referred to as legacy collections—offer a source of climate and other paleoenvironmental information that may no longer exist elsewhere. Here, we 1) review obstacles to systematically using data from legacy archaeological collections, such as inconsistent or unreported field methods, inadequate records, unsatisfactory curation, and insufficient public knowledge of relevant collections; 2) suggest best practices for integrating archaeological data into climate and environmental research; and 3) summarize several studies to demonstrate the benefits and challenges of using legacy collections as archives of local and regional environmental proxies. Data from archaeological legacy collections contribute regional ecological baselines as well as serve to correct shifting baselines. They also enable regional climate reconstructions at various timescales and corroborate or refine radiocarbon dates. Such uses of legacy collections raise ethical concerns regarding ownership of and responsibility for cultural resources and highlight the importance of Indigenous involvement in planning and executing fieldwork and stewardship of cultural heritage. Finally, we discuss methodologies, practices, and policies pertaining to archaeological legacy collections and support calls for discipline-wide shifts in collections management to ensure their long-term utility in multidisciplinary research and public engagement.
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- 2020
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23. Spatiotemporal analysis of urban heat island intensification in the city of Minneapolis-St. Paul and Chicago metropolitan areas using Landsat data from 1984 to 2016
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Ryan Wheeler, Mbongowo J. Mbuh, and Amanda Cook
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010504 meteorology & atmospheric sciences ,Spatiotemporal Analysis ,Geography, Planning and Development ,0211 other engineering and technologies ,food and beverages ,02 engineering and technology ,01 natural sciences ,Metropolitan area ,Geography ,Physical geography ,Urban heat island ,021101 geological & geomatics engineering ,0105 earth and related environmental sciences ,Water Science and Technology - Abstract
Most major cities worldwide are affected Urban Heat Islands – a condition of relatively higher temperatures being observed in one area compared to another that can be caused by a decrease in greens...
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- 2019
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24. Post-PKS enzyme complexes
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Redding Gober, Ryan Wheeler, and Jürgen Rohr
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Pharmacology ,PKS enzyme ,chemistry.chemical_classification ,biology ,010405 organic chemistry ,Chemistry ,Organic Chemistry ,Complex formation ,Pharmaceutical Science ,Multienzyme complexes ,biology.organism_classification ,01 natural sciences ,Biochemistry ,0104 chemical sciences ,010404 medicinal & biomolecular chemistry ,Enzyme ,Combinatorial biosynthesis ,Drug Discovery ,polycyclic compounds ,Molecular Medicine ,Bacteria - Abstract
Natural products are produced by bacteria, plants, and fungi and have yielded some of the most clinically active and widely used drugs available. Several of the natural products that are produced by type II PKSs have novel scaffolds or unique rearrangements that are, in large part, due to the post PKS enzymes. Protein–protein interactions between post-PKS tailoring enzymes hamper the use of combinatorial biosynthesis in the development of novel natural product-derived drugs. Several co-dependent post-PKS enzymes have been characterized in nature, but their significance in regards to complex formation and co-dependence has been largely overlooked. Here, we report an in-depth analysis of two such post-PKS pathways, gilvocarcin and mithramycin, for which indications exist to postulate multienzyme complexes to facilitate substrate protection and channeling.
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- 2019
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25. Building a career planning course for STEM PhDs
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Jean Branan, Ryan Wheeler, and Xinrui Li
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0301 basic medicine ,Medical education ,ComputingMilieux_THECOMPUTINGPROFESSION ,Biomedical Engineering ,MEDLINE ,ComputerApplications_COMPUTERSINOTHERSYSTEMS ,Bioengineering ,Career planning ,Applied Microbiology and Biotechnology ,Job market ,Course (navigation) ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Molecular Medicine ,ComputingMethodologies_GENERAL ,Psychology ,030217 neurology & neurosurgery ,Biotechnology ,Career development - Abstract
Incorporating career development into PhD course offerings can help biomedical students better understand themselves, as well as the job market, and to adopt a 'can-do' attitude in developing their own paths.
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- 2018
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26. Discovery of a Cryptic Intermediate in Late Steps of Mithramycin Biosynthesis
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Prithiba Mitra, Xia Yu, Frank Herkules, Oleg V. Tsodikov, Ryan Wheeler, Caixia Hou, Jhong Min Chen, Dmitri N. Ivanov, and Jürgen Rohr
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chemistry.chemical_classification ,Biological Products ,010405 organic chemistry ,Stereochemistry ,General Medicine ,General Chemistry ,Plicamycin ,010402 general chemistry ,01 natural sciences ,Catalysis ,Article ,0104 chemical sciences ,chemistry.chemical_compound ,Enzyme ,Protein structure ,chemistry ,Biosynthesis ,Biocatalysis ,Oxidoreductase ,Side chain ,Isomerization ,Ion channel - Abstract
MtmOIV and MtmW catalyze the final two reactions in the mithramycin (MTM) biosynthetic pathway, the Baeyer-Villiger opening of the fourth ring of premithramycin B (PMB), creating the C3 pentyl side chain, strictly followed by reduction of the distal keto group on the new side chain. Unexpectedly this results in a C2 stereoisomer of mithramycin, iso-mithramycin (iso-MTM). Iso-MTM undergoes a non-enzymatic isomerization to MTM catalyzed by Mg(2+) ions. Crystal structures of MtmW and its complexes with co-substrate NADPH and PEG, suggest a catalytic mechanism of MtmW. The structures also show that a tetrameric assembly of this enzyme strikingly resembles of the ring-shaped β subunit of a vertebrate ion channel. We show that MtmW and MmOIV form a complex in the presence of PMB and NADPH, presumably to hand over the unstable MtmOIV product to MtmW, yielding iso-MTM, as a potential self-resistance mechanism against MTM toxicity.
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- 2019
27. Owls, Otters, and Pelicans in Watery Realms
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Joanna Ostapkowicz and Ryan Wheeler
- Abstract
This chapter explores the context of the three monumental animal and bird carvings found at the Hontoon/Thursby site on the St. Johns River: the owl, otter, and pelican. Archaeological and ethnographic information from Florida and surrounding areas is brought to play in interpreting the carvings and their placement at the site.
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- 2019
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28. Iconography and Wetsite Archaeology of Florida’s Watery Realms
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Ryan Wheeler, Joanna Ostapkowicz, Ryan Wheeler, and Joanna Ostapkowicz
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- Indians of North America--Florida--Marco Island (Island)--Antiquities, Archaeological expeditions--Florida--Marco Island (Island)--History
- Abstract
Beginning with Frank Hamilton Cushing's famous excavations at Key Marco in 1896, a large and diverse collection of animal carvings, dugout canoes, and other wooden objects has been uncovered from Florida's watery landscapes. Iconography and Wetsite Archaeology of Florida's Watery Realms explores new discoveries and reexamines existing artifacts to reveal the influential role of water in the daily lives of Florida's early inhabitants. Contributors compare anthropomorphic wooden carvings such as the Key Marco cat statuette to figures found elsewhere in the Southeast, connecting Floridians with the Mississippian world. They use ethnographic data to argue that Newnans Lake was once an intersection between major watersheds and that the more than 100 canoes unearthed there likely facilitated travel throughout the peninsula. A second look at artifacts from the Fort Center pond reveals mortuary figurines were deposited intentionally and over the course of several centuries. Other sites discussed include Chassahowitzka Springs, Weedon Island Preserve, Pineland, and Hontoon Island. Essays address the challenges of excavating and preserving perishable artifacts from waterlogged sites, especially those in saltwater environments, highlight the value of revisiting museum collections to ask new questions and employ new analytical techniques, and emphasize the important role of the public in the discovery of wetland sites. This volume demonstrates that, despite the difficulties faced by archaeologists working with saturated deposits, these sites are vital for understanding Florida's prehistory. Contributors: Ryan J. Wheeler | Joanna Ostapkowicz | Michael A. Arbuthnot | Merald R. Clark | Julia B. Duggins | Michael Faught | Vernon James Knight | Phyllis Kolianos | William H. Marquardt | Lee A. Newsom | Daniel M. Seinfeld | S. Margaret Spivey-Faulkner | Karen Walker A volume in the Florida Museum of Natural History: Ripley P. Bullen Series
- Published
- 2019
29. Glory, Trouble, and Renaissance at the Robert S. Peabody Museum of Archaeology
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Malinda Stafford Blustain, Ryan Wheeler, Malinda Stafford Blustain, and Ryan Wheeler
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- Archaeological museums and collections--Massachusetts--Andover--History, Indians of North America--Material culture--Collectors and collecting--History, Indians of North America--Museums--History
- Abstract
Glory, Trouble, and Renaissance at the Robert S. Peabody Museum of Archaeology chronicles the seminal contributions, tumultuous history, and recent renaissance of the Robert S. Peabody Museum of Archaeology (RSPM). The only archaeology museum that is part of an American high school, it also did cutting-edge research from the 1930s through the 1970s, ultimately returning to its core mission of teaching and learning in the twenty-first century. Essays explore the early history and notable contributions of the museum's directors and curators, including a tour de force chapter by James Richardson and J. M. Adovasio that interweaves the history of research at the museum with the intriguing story of the peopling of the Americas. Other chapters tackle the challenges of the 1990s, including shrinking financial resources, the Native American Graves Protection and Repatriation Act and relationships with American Indian tribes, and the need to revisit the original mission of the museum, namely, to educate high school students. Like many cultural institutions, the RSPM has faced a host of challenges throughout its history. The contributors to this book describe the creative responses to those challenges and the reinvention of a museum with an unusual past, present, and future.
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- 2018
30. East-central Florida pre-Columbian wood sculpture: Radiocarbon dating, wood identification and strontium isotope studies
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Ian D. Bull, Fiona Brock, Joanna Ostapkowicz, Rick Schulting, Ryan Wheeler, Lee A. Newsom, Christophe Snoeck, Chemistry, and Analytical, Environmental & Geo-Chemistry
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010506 paleontology ,Archeology ,Sculpture ,010504 meteorology & atmospheric sciences ,archaeology ,01 natural sciences ,Archaeology ,Isotopes of strontium ,law.invention ,law ,Identification (biology) ,Radiocarbon dating ,Geology ,0105 earth and related environmental sciences - Abstract
A suite of scientific approaches are applied to four pre- Columbian wood sculptures from east-central Florida, comprising new radiocarbon determinations, wood identification and strontium isotope analysis. The dates for three large zoomorphic carvings recovered from the St. Johns River at Hontoon Island place them between ca. AD 1300 and 1600, suggesting that they belonged to a tradition of erecting largescale pine carvings spanning at least some centuries. Two of the carvings have strontium isotope signals consistent with the immediate vicinity of the site, while the third differs significantly. Baseline data for biologically available strontium from sampled modern trees indicates considerable isotopic variability over short distances, making it difficult to determine the source of the wood used for this third carving. The only anthropomorphic sculpture, recovered from the vicinity of Tomoka State Park, dates to a similar time period, ca. AD 1440-1620. Our study confirms the wood's previous identification as belonging to the genus Peltophorum, a tropical hardwood thought not to be native to Florida. Its strontium isotope value is consistent with its find location, but equally may be found over much of southern Florida, where perhaps the species grew in the past. The results clarify the chronology for a stylistically distinctive carving tradition, as well as raising questions concerning the exchange of organic materials over varying distances. Highlights • 14C results for four east-central Florida carvings (Hontoon Island; Tomoka State Park) range ca. AD 1300-1600, spanning the proto-historic/historic periods • 87Sr/86Sr results for two of the three Hontoon carvings are consistent with the immediate locale, while the third suggests a different provenance • Pinus sp. was used at Hontoon, while Peltophorum sp., currently not native to Florida, was used at Tomoka
- Published
- 2017
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31. Evidence from phylogenetic and genome fingerprinting analyses suggests rapidly changing variation in Halorubrum and Haloarcula populations
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Andrea M. Makkay, Nikhil Ram Mohan, Matthew S. Fullmer, R. Thane Papke, J. Peter Gogarten, Antonio Ventosa, Ryan Wheeler, Adit Naor, and Universidad de Sevilla. Departamento de Microbiología y Parasitología
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Microbiology (medical) ,MLSA ,Sequence analysis ,lcsh:QR1-502 ,Biology ,Genome ,Microbiology ,lcsh:Microbiology ,law.invention ,Halobacteria ,03 medical and health sciences ,Data sequences ,environmental population ,law ,Original Research Article ,Polymerase chain reaction ,030304 developmental biology ,Genetics ,Environmental population ,0303 health sciences ,Aran-Bidgol lake ,Phylogenetic tree ,030306 microbiology ,Haplotype ,biology.organism_classification ,Genome fingerprinting ,genome fingerprinting ,Haloarcula ,Halorubrum - Abstract
Halobacteria require high NaCl concentrations for growth and are the dominant inhabitants of hypersaline environments above 15% NaCl. They are well-documented to be highly recombinogenic, both in frequency and in the range of exchange partners. In this study, we examine the genetic and genomic variation of cultured, naturally co-occurring environmental populations of Halobacteria. Sequence data from multiple loci (~2500 bp) identified many closely and more distantly related strains belonging to the genera Halorubrum and Haloarcula. Genome fingerprinting using a random priming PCR amplification method to analyze these isolates revealed diverse banding patterns across each of the genera and surprisingly even for isolates that are identical at the nucleotide level for five protein coding sequenced loci. This variance in genome structure even between identical multilocus sequence analysis (MLSA) haplotypes indicates that accumulation of genomic variation is rapid: faster than the rate of third codon substitutions.
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- 2014
32. Population and genomic analysis of the genus Halorubrum
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Antonio Ventosa, Shannon M. Soucy, Andrea M. Makkay, J. Peter Gogarten, Matthew S. Fullmer, Ryan Wheeler, R. Thane Papke, Kristen S. Swithers, and Universidad de Sevilla. Departamento de Microbiología y Parasitología
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Microbiology (medical) ,MLSA ,Sequence analysis ,halobacteria ,Lineage (evolution) ,Population ,lcsh:QR1-502 ,Biology ,intein ,Microbiology ,lcsh:Microbiology ,Halobacteria ,03 medical and health sciences ,Original Research Article ,education ,Gene ,030304 developmental biology ,Sequence (medicine) ,Genetics ,0303 health sciences ,education.field_of_study ,030306 microbiology ,Palindrome ,Multilocus Sequence Analysis (MLSA) ,Average Nucleotide Identity (ANI) ,CRISPR ,Homologous recombination ,Recombination - Abstract
The Halobacteria are known to engage in frequent gene transfer and homologous recombination. For stably diverged lineages to persist some checks on the rate of between lineage recombination must exist. We surveyed a group of isolates from the Aran-Bidgol endorheic lake in Iran and sequenced a selection of them. Multilocus Sequence Analysis (MLSA) and Average Nucleotide Identity (ANI) revealed multiple clusters (phylogroups) of organisms present in the lake. Patterns of intein and Clustered Regularly Interspaced Short Palindromic Repeats (CRISPRs) presence/absence and their sequence similarity, GC usage along with the ANI and the identities of the genes used in the MLSA revealed that two of these clusters share an exchange bias toward others in their phylogroup while showing reduced rates of exchange with other organisms in the environment. However, a third cluster, composed in part of named species from other areas of central Asia, displayed many indications of variability in exchange partners, from within the lake as well as outside the lake. We conclude that barriers to gene exchange exist between the two purely Aran-Bidgol phylogroups, and that the third cluster with members from other regions is not a single population and likely reflects an amalgamation of several populations.
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- 2014
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33. Data management systems on GPUs
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Anand Kumar, Ryan Wheeler, Yi-Cheng Tu, Ran Rui, and Di Yu
- Subjects
Database ,Relational database management system ,Computer science ,business.industry ,Data management ,Graphics ,computer.software_genre ,Executor ,business ,Popularity ,computer ,Data administration - Abstract
The past decade has witnessed the popularity of push-based data management systems, in which the query executor passively receives data from either remote data sources (e.g., sensors) or I/O processes that scan database tables/files from local storage. Unlike traditional relational database management system (RDBMS) architectures that are mostly I/O-bound, push-based database systems often become heavily computation-bound since the data arrival rate could be very high. In this paper, we argue that modern multi-core hardware, especially Graphics Processing Units (GPU), provide the most cost-effective computing platform to catch up with the large amount of data streamed into a push-based database system. Based on that, we will open discussions on how to design and implement a query processing engine for such systems that run on GPUs.
- Published
- 2013
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34. Phenotype-driven preventive strategies for migraine and other headaches.
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Wheeler SD
- Subjects
- Headache classification, Headache drug therapy, Health Surveys, Humans, Migraine Disorders drug therapy, Headache prevention & control, Migraine Disorders prevention & control, Phenotype
- Abstract
Background: Satisfactory prevention of migraine and other headaches is fraught with difficulties in the real world. Tolerability and safety issues are of concern just as is effectiveness or efficacy and all often seem to be patient-dependent. Maximizing migraine prevention and getting treatment right the first time ought to result in improved patient outcomes. Identifying headache phenotypes recognizes that clinical phenomenology may define or approximate genotypes that may predict specific preventive treatments., Review Summary: The concept of phenotype-driven headache and migraine prevention relies heavily on the indomethacin-responsive headache experience wherein specific treatment is dictated by headache phenotype. Herein are described several additional headache phenotypes: migraine with typical and atypical aura, dopaminergic migraine, new daily-persistent headache, migraine with cluster or sinus features, short-lasting unilateral neuralgiform headache with conjunctival injection and tearing, hypnic headache, thunderclap headache, and imploding headache. Phenotype-driven preventive strategies are described that may offer reasonable first treatment choices, appropriate second choices, or choices when other treatments have failed., Conclusions: These headache preventive recommendations are based on the best available evidence; however, all reports are observational. Perhaps some of these choices will be tested in prospective, randomized, blinded and controlled trials in the future, but historically clinical medicine has relied on clinical observations. The observations reported herein may help define specific, effective treatments for some patients or simply inspire further discussion and research about patient-specific preventive treatment regimens.
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- 2009
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35. Donepezil treatment of topiramate-related cognitive dysfunction.
- Author
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Wheeler SD
- Subjects
- Adult, Cognition Disorders chemically induced, Donepezil, Female, Fructose adverse effects, Humans, Language Disorders chemically induced, Male, Middle Aged, Migraine Disorders drug therapy, Topiramate, Treatment Outcome, Cholinesterase Inhibitors therapeutic use, Cognition Disorders drug therapy, Fructose analogs & derivatives, Indans therapeutic use, Language Disorders drug therapy, Piperidines therapeutic use
- Abstract
Six migraine patients experienced significant topiramate-related cognitive and language dysfunction that improved with donepezil treatment and allowed uninterrupted topiramate use. These patients represent the first report of topiramate-related cognitive and language dysfunction that improved with a cholinesterase inhibitor. Although, the mechanism responsible for this effect is uncertain, cholinesterase inhibition resulting in cholinergic augmentation and enhanced cognition probably account for some if not most of the improvement.
- Published
- 2006
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36. Miscellaneous primary headache.
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Wheeler SD
- Subjects
- Analgesics, Non-Narcotic administration & dosage, Anti-Inflammatory Agents, Non-Steroidal administration & dosage, Chronic Disease, Diagnosis, Differential, Headache drug therapy, Humans, Primary Health Care standards, Risk Factors, Sympathetic Nervous System physiopathology, Trigeminal Neuralgia drug therapy, United States, Headache diagnosis, Headache physiopathology, Trigeminal Neuralgia diagnosis, Trigeminal Neuralgia physiopathology
- Abstract
There are many types of miscellaneous primary headache, but two groups have been selected for discussion: trigeminal autonomic cephalalgias (TAC) and cephalalgias without autonomic dysfunction(CWAD). TAC are strictly unilateral and CWAD are usually bilateral. Sudden onset and relatively short duration characterize most,but some are frightening to patient and doctor alike. One, thunderclap headache, is symptomatic until proven otherwise. Although the others are rarely symptomatic, therapy can be difficult until it is recognized that diagnosis often predicts treatment.
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- 2004
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37. Hemicrania continua in African Americans.
- Author
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Wheeler SD
- Subjects
- Aged, Anti-Inflammatory Agents, Non-Steroidal therapeutic use, Female, Humans, Indomethacin therapeutic use, Male, Middle Aged, Migraine Disorders drug therapy, Migraine Disorders physiopathology, Black or African American, Migraine Disorders ethnology
- Abstract
Objective: The first six cases of hemicrania continua and episodica in African Americans are reported, differences from previous accounts noted, and important diagnostic features described., Background: Hemicrania continua is an indomethacin responsive chronic daily headache. Mild to moderate daily headache is strictly unilateral, constant but fluctuating. Superimposed severe headache attacks occur, last seconds to days, and are associated with ipsilateral orbital-nasal autonomic dysfunction., Results: Severe headache attacks are usually pulsatile, occur one to four times daily, and last 40 minutes to three days. Daily unilateral background headache was typically of a pressure, sharp, dull or pulling quality. Ipsilateral orbital-nasal autonomic symptoms were noted in all. Serious concomitant medical illnesses, e.g. coronary artery disease, diabetes, and hypertension, were frequent in this population., Conclusions: This is the first report of hemicrania continua and episodica in African Americans and the second in persons of African descent in the world's literature. Late age of onset, frequent serious medical illnesses, and family history of migraine differentiate this series from previous reports. The lack of reports in African Americans most likely reflects misdiagnosis rather than true prevalence. Thus, whenever any patient presents with chronic daily unilateral headache, ipsilateral autonomic symptoms should be assessed during severe headache attacks, and an indomethacin trial considered.
- Published
- 2002
38. Antiepileptic Drug Therapy in Migraine Headache.
- Author
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Wheeler SD
- Abstract
Severe migraine affects more than 28 million Americans. It is associated with episodic as well as long-term disability and suffering, yet it is underdiagnosed and undertreated. Acute treatments have advanced considerably, ignited by sumatriptan and the subsequent triptans; unfortunately migraine prevention has lagged far behind. There are no great migraine preventives! No migraine preventive agent studied in good randomized, double blind, placebo-controlled trials proved to be 50% better than placebo. Migraine trials typically focus on episodic migraine, a milder, gentler type of migraine that is selected for low frequency, lack of daily headaches, no preventive need, and previous failure to no more than a few preventive agents. These features are not typical of the usual migraine patient seen in most neurologic practices, thus the results of clinical trials may not carryover to real world situations. Treatment of frequent, chronic, or pervasive migraine is inadequate, and never has been studied in randomized controlled trials. Traditional migraine preventives, eg, beta-blockers, calcium channel blockers, and tricyclic antidepressants, are often ineffective in difficult or complicated populations. The antiepileptic drugs represent a category of pharmaceutics that target the neuronal instability and central hyperexcitability of migraine, and, through these actions, may be more effective than traditional preventives. Episodic migraine attacks are associated with peripheral and central sensitization; however, if attacks are frequent, severe, or long lasting, this sensitization may increase the risk of developing daily headaches. If antiepileptic drugs have an effect on central sensitization, perhaps mediated via glutamate inhibition or gamma-aminobutyric acid potentiation, it is appropriate to use these agents early in migraine treatment, particularly in the highly comorbid patient, possibly in conjunction with agents that antagonize the 5HT2 receptor. This report reviews the best currently available evidence on antiepileptic drugs in the prevention of episodic migraine, and tabulates potential drug-drug and cytochrome P450 interactions. All antiepileptic drugs presented are effective in migraine prevention. However, deciding on the best agent for each individual patient will require recognizing comorbidity and assessing antiepileptic drug pharmacodynamics, tolerability, and safety.
- Published
- 2002
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