Is Dexamethasone 4mg a More Effective Anti-Emetic than Dexamethasone 8mg for the Prevention of Early Post-Operative Nausea and Vomiting in Women Undergoing Laparoscopic Gynecological Surgery?

Postoperative nausea and vomiting (PONV) is a common problem in the surgical setting. It affects as much as 20 to 80 percent of patients undergoing surgery (D\u27souza, Swami, & Bhagwat, 2011). PONV can lead to increased patient costs and recovery time by causing the patient to stay in the healthcare facility for a longer period of time. A retrospective cohort study was completed to examine whether or not there was a significant difference between patients who received 4mg and 8mg of dexamethasone in the incidence of PONV. All patients studied received ondansetron intraoperatively as their primary anti-emetic. English speaking patients who met the following inclusion criteria were included in the retrospective chart review: those who are female, those have underwent laparoscopic gynecological surgery and received dexamethasone, those who are non-smokers, and those who are aged 18-60 with an American Society of Anesthesiologists (ASA) score of II or less. Patients that met the following exclusion criteria were not counted towards the chart review: those who are an ASA III or above, those who did not follow the recommended fasting time prior to surgery, those with a history of motion sickness, those with a history of PONV, those who are taking routine anti-emetics, those whose are deaf, those who are blind, those who are smokers, and those outside the age range for 18-60 years. Statistical analysis using a Chi-Square test was used to evaluate whether the patients receiving 4mg of dexamethasone experienced more PONV that those who received 8mg

Astrometric Discovery of GJ 164B

We discovered a low-mass companion to the M-dwarf GJ 164 with the CCD-based imaging system of the Stellar Planet Survey (STEPS) astrometric program. The existence of GJ 164B was confirmed with Hubble Space Telescope NICMOS imaging observations. A high-dispersion spectral observation in V sets a lower limit of delta m> 2.2 mag between the two components of the system. Based upon our parallax value of 0.082 +/- 0.008, we derive the following orbital parameters: P = 2.04 +/- 0.03 y, a = 1.03 +/- 0.03 AU, and Mtotal = 0.265 +/- 0.020 MSun. The component masses are MA = 0.170 +/- 0.015 MSun and MB = 0.095 +/- 0.015 MSun. Based on its mass, colors, and spectral properties, GJ 164B has spectral type M6-8 V.Comment: pdf file 14 pages with 6 fig

Polyploidy Did Not Predate the Evolution of Nodulation in All Legumes

BACKGROUND: Several lines of evidence indicate that polyploidy occurred by around 54 million years ago, early in the history of legume evolution, but it has not been known whether this event was confined to the papilionoid subfamily (Papilionoideae; e.g. beans, medics, lupins) or occurred earlier. Determining the timing of the polyploidy event is important for understanding whether polyploidy might have contributed to rapid diversification and radiation of the legumes near the origin of the family; and whether polyploidy might have provided genetic material that enabled the evolution of a novel organ, the nitrogen-fixing nodule. Although symbioses with nitrogen-fixing partners have evolved in several lineages in the rosid I clade, nodules are widespread only in legume taxa, being nearly universal in the papilionoids and in the mimosoid subfamily (e.g., mimosas, acacias)--which diverged from the papilionoid legumes around 58 million years ago, soon after the origin of the legumes. METHODOLOGY/PRINCIPAL FINDINGS: Using transcriptome sequence data from Chamaecrista fasciculata, a nodulating member of the mimosoid clade, we tested whether this species underwent polyploidy within the timeframe of legume diversification. Analysis of gene family branching orders and synonymous-site divergence data from C. fasciculata, Glycine max (soybean), Medicago truncatula, and Vitis vinifera (grape; an outgroup to the rosid taxa) establish that the polyploidy event known from soybean and Medicago occurred after the separation of the mimosoid and papilionoid clades, and at or shortly before the Papilionoideae radiation. CONCLUSIONS: The ancestral legume genome was not fundamentally polyploid. Moreover, because there has not been an independent instance of polyploidy in the Chamaecrista lineage there is no necessary connection between polyploidy and nodulation in legumes. Chamaecrista may serve as a useful model in the legumes that lacks a paleopolyploid history, at least relative to the widely studied papilionoid models

Individual Differences in Personality Predict How People Look at Faces

Determining the ways in which personality traits interact with contextual determinants to shape social behavior remains an important area of empirical investigation. The specific personality trait of neuroticism has been related to characteristic negative emotionality and associated with heightened attention to negative, emotionally arousing environmental signals. However, the mechanisms by which this personality trait may shape social behavior remain largely unspecified.We employed eye tracking to investigate the relationship between characteristics of visual scanpaths in response to emotional facial expressions and individual differences in personality. We discovered that the amount of time spent looking at the eyes of fearful faces was positively related to neuroticism.This finding is discussed in relation to previous behavioral research relating personality to selective attention for trait-congruent emotional information, neuroimaging studies relating differences in personality to amygdala reactivity to socially relevant stimuli, and genetic studies suggesting linkages between the serotonin transporter gene and neuroticism. We conclude that personality may be related to interpersonal interaction by shaping aspects of social cognition as basic as eye contact. In this way, eye gaze represents a possible behavioral link in a complex relationship between genes, brain function, and personality

Permeability of Noble Gases through Kapton, Butyl, Nylon, and "Silver Shield"

Noble gas permeabilities and diffusivities of Kapton, butyl, nylon, and "Silver Shield" are measured at temperatures between 22C and 115C. The breakthrough times and solubilities at 22C are also determined. The relationship of the room temperature permeabilities to the noble gas atomic radii is used to estimate radon permeability for each material studied. For the noble gases tested, Kapton and Silver Shield have the lowest permeabilities and diffusivities, followed by nylon and butyl, respectively.Comment: 14 pages, 7 figure

Induction of Cytotoxic T Lymphocyte Antigen 4 (Ctla-4) Restricts Clonal Expansion of Helper T Cells

Cytotoxic T lymphocyte antigen (CTLA)-4 plays an essential role in immunologic homeostasis. How this negative regulator of T cell activation executes its functions has remained controversial. We now provide evidence that CTLA-4 mediates a cell-intrinsic counterbalance to restrict the clonal expansion of proliferating CD4+ T cells. The regulation of CTLA-4 expression and function ensures that, after ∼3 cell divisions of expansion, most progeny will succumb to either proliferative arrest or death over the ensuing three cell divisions. The quantitative precision of the counterbalance hinges on the graded, time-independent induction of CTLA-4 expression during the first three cell divisions. In contrast to the limits imposed on unpolarized cells, T helper type 1 (Th1) and Th2 effector progeny may be rescued from proliferative arrest by interleukin (IL)-12 and IL-4 signaling, respectively, allowing appropriately stimulated progeny to proceed to the stage of tissue homing. These results suggest that the cell-autonomous regulation of CTLA-4 induction may be a central checkpoint of clonal expansion of CD4+ T cells, allowing temporally and spatially restricted growth of progeny to be dictated by the nature of the threat posed to the host

REDUCE-IT USA: Results From the 3146 Patients Randomized in the United States.

BackgroundSome trials have found that patients from the United States derive less benefit than patients enrolled outside the United States. This prespecified REDUCE-IT (Reduction of Cardiovascular Events with Icosapent Ethyl - Intervention Trial) subgroup analysis was conducted to determine the degree of benefit of icosapent ethyl in the United States.MethodsREDUCE-IT randomized 8179 statin-treated patients with qualifying triglycerides ≥135 and <500 mg/dL and low-density lipoprotein cholesterol >40 and ≤100 mg/dL and a history of atherosclerosis or diabetes mellitus to icosapent ethyl 4 g/d or placebo. The primary composite end point was cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, coronary revascularization, or hospitalization for unstable angina. The key secondary composite end point was cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke. A hierarchy was prespecified for examination of individual and composite end points.ResultsA total of 3146 US patients (38.5% of the trial) were randomized and followed for a median of 4.9 years; 32.3% were women and 9.7% were Hispanic. The primary composite end point occurred in 24.7% of placebo-treated patients versus 18.2% of icosapent ethyl-treated patients (hazard ratio [HR], 0.69 [95% CI, 0.59-0.80]; P=0.000001); the key secondary composite end point occurred in 16.6% versus 12.1% (HR, 0.69 [95% CI, 0.57-0.83]; P=0.00008). All prespecified hierarchical end points were meaningfully and significantly reduced, including cardiovascular death (6.7% to 4.7%; HR, 0.66 [95% CI, 0.49-0.90]; P=0.007), myocardial infarction (8.8% to 6.7%; HR, 0.72 [95% CI, 0.56-0.93]; P=0.01), stroke (4.1% to 2.6%; HR, 0.63 [95% CI, 0.43-0.93]; P=0.02), and all-cause mortality (9.8% to 7.2%; HR, 0.70 [95% CI, 0.55-0.90]; P=0.004); for all-cause mortality in the US versus non-US patients, Pinteraction=0.02. Safety and tolerability findings were consistent with the full study cohort.ConclusionsWhereas the non-US subgroup showed significant reductions in the primary and key secondary end points, the US subgroup demonstrated particularly robust risk reductions across a variety of individual and composite end points, including all-cause mortality.Clinical trial registrationURL: https://www.clinicaltrials.gov. Unique identifier: NCT01492361

Stratospheric Gravity Wave Fluxes and Scales during DEEPWAVE

During the Deep Propagating Gravity Wave Experiment (DEEPWAVE) project in June and July 2014, the Gulfstream V research aircraft flew 97 legs over the Southern Alps of New Zealand and 150 legs over the Tasman Sea and Southern Ocean, mostly in the low stratosphere at 12.1-km altitude. Improved instrument calibration, redundant sensors, longer flight legs, energy flux estimation, and scale analysis revealed several new gravity wave properties. Over the sea, flight-level wave fluxes mostly fell below the detection threshold. Over terrain, disturbances had characteristic mountain wave attributes of positive vertical energy flux (EFz), negative zonal momentum flux, and upwind horizontal energy flux. In some cases, the fluxes changed rapidly within an 8-h flight, even though environmental conditions were nearly unchanged. The largest observed zonal momentum and vertical energy fluxes were MFx = −550 mPa and EFz = 22 W m−2, respectively. A wide variety of disturbance scales were found at flight level over New Zealand. The vertical wind variance at flight level was dominated by short “fluxless” waves with wavelengths in the 6–15-km range. Even shorter scales, down to 500 m, were found in wave breaking regions. The wavelength of the flux-carrying mountain waves was much longer—mostly between 60 and 150 km. In the strong cases, however, with EFz \u3e 4 W m−2, the dominant flux wavelength decreased (i.e., “downshifted”) to an intermediate wavelength between 20 and 60 km. A potential explanation for the rapid flux changes and the scale “downshifting” is that low-level flow can shift between “terrain following” and “envelope following” associated with trapped air in steep New Zealand valleys

Effects of antenatal betamethasone on preterm human and mouse ductus arteriosus: comparison with baboon data.

BackgroundAlthough studies involving preterm infants ≤34 weeks gestation report a decreased incidence of patent ductus arteriosus after antenatal betamethasone, studies involving younger gestation infants report conflicting results.MethodsWe used preterm baboons, mice, and humans (≤276/7 weeks gestation) to examine betamethasone's effects on ductus gene expression and constriction both in vitro and in vivo.ResultsIn mice, betamethasone increased the sensitivity of the premature ductus to the contractile effects of oxygen without altering the effects of other contractile or vasodilatory stimuli. Betamethasone's effects on oxygen sensitivity could be eliminated by inhibiting endogenous prostaglandin/nitric oxide signaling. In mice and baboons, betamethasone increased the expression of several developmentally regulated genes that mediate oxygen-induced constriction (K+ channels) and inhibit vasodilator signaling (phosphodiesterases). In human infants, betamethasone increased the rate of ductus constriction at all gestational ages. However, in infants born ≤256/7 weeks gestation, betamethasone's contractile effects were only apparent when prostaglandin signaling was inhibited, whereas at 26-27 weeks gestation, betamethasone's contractile effects were apparent even in the absence of prostaglandin inhibitors.ConclusionsWe speculate that betamethasone's contractile effects may be mediated through genes that are developmentally regulated. This could explain why betamethasone's effects vary according to the infant's developmental age at birth