Which Lipoprotein Measurements Are Clinically Useful?

Emerging lipid risk factors for cardiovascular disease include lipoprotein remnants, lipoprotein (a), small LDL particles, HDL subspecies, apolipoprotein B, apolipoprotein A-I, and oxidized LDL. Measurement of these levels should not be used for routine cardiovascular risk screening. (Strength of Recommendation [SOR]: C, based on expert opinion and lack of clinical outcomes trials

What is the interval for monitoring warfarin therapy once therapeutic levels are achieved?

The international normalized ratio (INR) should be measured monthly once therapeutic levels are achieved and are stable for at least 8 weeks, although treatment should be individualized and an increased frequency may be required by some patients (strength of recommendation [SOR]: C, consensus statements). For highly compliant patients with stable levels and a clear understanding of factors that influence anticoagulation (changes in health, diet, medications), routine monitoring may be extended to 6 weeks (SOR: B, single randomized controlled trial [RCT]) or longer (SOR: C, case series). Patient-managed warfarin therapy, using biweekly self-measurements, results in more time in therapeutic range than routine physicianmanaged care (SOR: A, RCTs)

Molecular-beam epitaxy of CrSi_2 on Si(111)

Chromium disilicide layers have been grown on Si(111) in a commercial molecular‐beam epitaxy machine. Thin layers (10 nm) exhibit two epitaxial relationships, which have been identified as CrSi_2(0001)//Si(111) with CrSi_2[1010]//Si[101], and CrSi_2(0001)//Si(111) with CrSi_2[1120]//Si[101]. The latter case represents a 30° rotation of the CrSi_2 layer about the Si surface normal relative to the former case. Thick (210 nm) layers were grown by four different techniques, and the best‐quality layer was obtained by codeposition of Cr and Si at an elevated temperature. These layers are not single crystal; the largest grains are observed in a layer grown at 825 °C and are 1–2 μm across

What is the appropriate use of sunscreen for infants and children?

The risk and benefits of sunscreen use for children under the age of 6 months are unknown. To avoid sunburn, infants should be kept out of direct sunlight and be covered with protective clothing (strength of recommendation [SOR]: C, expert opinion). For children aged >6 months, a liberal amount of water-resistant, child-safe, broadspectrum sunscreen (protecting from both UVA and UVB), with SPF [equal to or greater than] 15 should be rubbed well into all exposed skin before going outside (SOR: B, case-control and extrapolation of studies). Effectiveness may be increased if sunscreen is applied 30 minutes before exposure and reapplied every 2 hours, particularly if swimming (SOR: C, expert opinion). Tightly woven protective clothing, a wide-brimmed cap, and eye protection should also be used whenever possible

What is the best way to diagnose polycystic ovarian syndrome?

Polycystic ovarian syndrome (PCOS) is diagnosed for women of childbearing age presenting with 2 of the following: 1)oligo- or anovulatory menstrual irregularities, 2) evidence of hyperandrogenism in the absence of secondary cause; 3) enlarged ovaries with multiple small follicular cysts on transvaginal ultrasound (strength of recommendation [SOR]: C, based on expert opinion). Depending on the clinical presentation, secondary causes should be excluded (SOR: C, expert opinion). While not among the diagnostic criteria, insulin resistance is common, and patients with PCOS should be evaluated for metabolic abnormalities, particularly hyperlipidemia and glucose intolerance or diabetes (SOR: B, based on prospective cohort studies)

Analysis and Geometric Optimization of Single Electron Transistors for Read-Out in Solid-State Quantum Computing

The single electron transistor (SET) offers unparalled opportunities as a nano-scale electrometer, capable of measuring sub-electron charge variations. SETs have been proposed for read-out schema in solid-state quantum computing where quantum information processing outcomes depend on the location of a single electron on nearby quantum dots. In this paper we investigate various geometries of a SET in order to maximize the device's sensitivity to charge transfer between quantum dots. Through the use of finite element modeling we model the materials and geometries of an Al/Al2O3 SET measuring the state of quantum dots in the Si substrate beneath. The investigation is motivated by the quest to build a scalable quantum computer, though the methodology used is primarily that of circuit theory. As such we provide useful techniques for any electronic device operating at the classical/quantum interface.Comment: 13 pages, 17 figure

Connectivity differences between Gulf War Illness (GWI) phenotypes during a test of attention

One quarter of veterans returning from the 1990–1991 Persian Gulf War have developed Gulf War Illness (GWI) with chronic pain, fatigue, cognitive and gastrointestinal dysfunction. Exertion leads to characteristic, delayed onset exacerbations that are not relieved by sleep. We have modeled exertional exhaustion by comparing magnetic resonance images from before and after submaximal exercise. One third of the 27 GWI participants had brain stem atrophy and developed postural tachycardia after exercise (START: Stress Test Activated Reversible Tachycardia). The remainder activated basal ganglia and anterior insulae during a cognitive task (STOPP: Stress Test Originated Phantom Perception). Here, the role of attention in cognitive dysfunction was assessed by seed region correlations during a simple 0-back stimulus matching task (“see a letter, push a button”) performed before exercise. Analysis was analogous to resting state, but different from psychophysiological interactions (PPI). The patterns of correlations between nodes in task and default networks were significantly different for START (n = 9), STOPP (n = 18) and control (n = 8) subjects. Edges shared by the 3 groups may represent co-activation caused by the 0-back task. Controls had a task network of right dorsolateral and left ventrolateral prefrontal cortex, dorsal anterior cingulate cortex, posterior insulae and frontal eye fields (dorsal attention network). START had a large task module centered on the dorsal anterior cingulate cortex with direct links to basal ganglia, anterior insulae, and right dorsolateral prefrontal cortex nodes, and through dorsal attention network (intraparietal sulci and frontal eye fields) nodes to a default module. STOPP had 2 task submodules of basal ganglia–anterior insulae, and dorsolateral prefrontal executive control regions. Dorsal attention and posterior insulae nodes were embedded in the default module and were distant from the task networks. These three unique connectivity patterns during an attention task support the concept of Gulf War Disease with recognizable, objective patterns of cognitive dysfunction