High concentrations of flavor chemicals are present in electronic cigarette refill fluids.

We characterized the flavor chemicals in a broad sample of commercially available electronic cigarette (EC) refill fluids that were purchased in four different countries. Flavor chemicals in 277 refill fluids were identified and quantified by gas chromatography-mass spectrometry, and two commonly used flavor chemicals were tested for cytotoxicity with the MTT assay using human lung fibroblasts and epithelial cells. About 85% of the refill fluids had total flavor concentrations >1 mg/ml, and 37% were >10 mg/ml (1% by weight). Of the 155 flavor chemicals identified in the 277 refill fluids, 50 were present at ≥1 mg/ml in at least one sample and 11 were ≥10 mg/ml in 54 of the refill fluids. Sixty-one% (170 out of 277) of the samples contained nicotine, and of these, 56% had a total flavor chemical/nicotine ratio >2. Four chemicals were present in 50% (menthol, triacetin, and cinnamaldehyde) to 80% (ethyl maltol) of the samples. Some products had concentrations of menthol ("Menthol Arctic") and ethyl maltol ("No. 64") that were 30 times (menthol) and 100 times (ethyl maltol) their cytotoxic concentration. One refill fluid contained cinnamaldehyde at ~34% (343 mg/ml), more than 100,000 times its cytotoxic level. High concentrations of some flavor chemicals in EC refill fluids are potentially harmful to users, and continued absence of any regulations regarding flavor chemicals in EC fluids will likely be detrimental to human health

Synchronization of video recording and laser pulses including background light suppression

An apparatus for and a method of triggering a pulsed light source, in particular a laser light source, for predictable capture of the source by video equipment. A frame synchronization signal is derived from the video signal of a camera to trigger the laser and position the resulting laser light pulse in the appropriate field of the video frame and during the opening of the electronic shutter, if such shutter is included in the camera. Positioning of the laser pulse in the proper video field allows, after recording, for the viewing of the laser light image with a video monitor using the pause mode on a standard cassette-type VCR. This invention also allows for fine positioning of the laser pulse to fall within the electronic shutter opening. For cameras with externally controllable electronic shutters, the invention provides for background light suppression by increasing shutter speed during the frame in which the laser light image is captured. This results in the laser light appearing in one frame in which the background scene is suppressed with the laser light being uneffected, while in all other frames, the shutter speed is slower, allowing for the normal recording of the background scene. This invention also allows for arbitrary (manual or external) triggering of the laser with full video synchronization and background light suppression

Improved grade outcomes with an e-mailed “grade nudge”

Information provided at the moment a person makes a decision can influence behavior in predictable ways. The United Kingdom\u27s Behavioural Insights Team have used this idea to help improve the insulation of lofts, collect taxes, and even reduce litter. The authors of this article developed software that appends a personalized message to each assignment in the class regarding the student\u27s current grade. This “grade nudge” explains precisely how the assignment will impact the student\u27s final grade given their current standing in the class. Through a randomized trial, the authors show that the nudge improves student homework performance by about four percentage points

Lesson Plans for Teaching Economics with The Big Bang Theory

Using examples in the classroom from current and past television shows and movies is becoming increasingly common. Being able to relate ideas back to a popular clip or episode allows the instructor to reach students in ways the traditional lecture cannot. Building on the work of Tierney, Mateer, Smith, Wooten, and Geerling (2016), this paper introduces five lesson plans tied to clips from The Big Bang Theory that can be used in high school (9-12) economics courses

Mitral valve replacement in infants and children 5 years of age or younger: Evolution in practice and outcome over three decades with a focus on supra-annular prosthesis implantation

ObjectiveSuccessful mitral valve replacement in young children is limited by the lack of small prosthetic valves. Supra-annular prosthesis implantation can facilitate mitral valve replacement with a larger prosthesis in children with a small annulus, but little is known about its effect on the outcomes of mitral valve replacement in young children.MethodsOne hundred eighteen children underwent mitral valve replacement at 5 years of age or younger from 1976–2006. Mitral valve replacement was supra-annular in 37 (32%) patients.ResultsSurvival was 74% ± 4% at 1 year and 56% ± 5% at 10 years but improved over time (10-year survival of 83% ± 7% from 1994–2006). Factors associated with worse survival included earlier mitral valve replacement date, age less than 1 year, complete atrioventricular canal, and additional procedures at mitral valve replacement, but not supra-annular mitral valve replacement. As survival improved during our more recent experience, the risks of supra-annular mitral valve replacement became apparent; survival was worse among patients with a supra-annular prosthesis after 1991. A pacemaker was placed in 18 (15%) patients within 1 month of mitral valve replacement and was less likely in patients who had undergone supra-annular mitral valve replacement. Among early survivors, freedom from redo mitral valve replacement was 72% ± 5% at 5 years and 45% ± 7% at 10 years. Twenty-one patients with a supra-annular prosthesis underwent redo mitral valve replacement. The second prosthesis was annular in 15 of these patients and upsized in all but 1, but 5 required pacemaker placement for heart block.ConclusionsSupra-annular mitral valve replacement was associated with worse survival than annular mitral valve replacement in our recent experience. Patients with supra-annular mitral valve replacement were less likely to have operative complete heart block but remained at risk when the prosthesis was subsequently replaced

Computer-generated reminders and quality of pediatric HIV care in a resource-limited setting

OBJECTIVES: To evaluate the impact of clinician-targeted computer-generated reminders on compliance with HIV care guidelines in a resource-limited setting. METHODS: We conducted this randomized, controlled trial in an HIV referral clinic in Kenya caring for HIV-infected and HIV-exposed children (<14 years of age). For children randomly assigned to the intervention group, printed patient summaries containing computer-generated patient-specific reminders for overdue care recommendations were provided to the clinician at the time of the child's clinic visit. For children in the control group, clinicians received the summaries, but no computer-generated reminders. We compared differences between the intervention and control groups in completion of overdue tasks, including HIV testing, laboratory monitoring, initiating antiretroviral therapy, and making referrals. RESULTS: During the 5-month study period, 1611 patients (49% female, 70% HIV-infected) were eligible to receive at least 1 computer-generated reminder (ie, had an overdue clinical task). We observed a fourfold increase in the completion of overdue clinical tasks when reminders were availed to providers over the course of the study (68% intervention vs 18% control, P < .001). Orders also occurred earlier for the intervention group (77 days, SD 2.4 days) compared with the control group (104 days, SD 1.2 days) (P < .001). Response rates to reminders varied significantly by type of reminder and between clinicians. CONCLUSIONS: Clinician-targeted, computer-generated clinical reminders are associated with a significant increase in completion of overdue clinical tasks for HIV-infected and exposed children in a resource-limited setting

Spatial patterns of climate change across the Paleocene–Eocene Thermal Maximum

This study was supported by Heising–Simons Founda-tion Grants 2016-015 (to J.E.T.), 2016-011 (to M.L. and L.R.K.), 2016-013 (toA.R.), 2016-014 (to G.J.H.), and 2016-012 (to C.J.P.). R.D.M.W. and J.W.B.R. acknowledge funding from the European Research Council under the European Union’s Horizon 2020 Research and Innovation Program Grant 805246. This material is based on work supported by the National Center for Atmospheric Research (NCAR), which is a major facility sponsored by NSF Cooperative Agreement 1852977. Computing and data storage resources, including the Cheyenne supercomputer (https://arc.ucar.edu/knowledgebase/70549542), were provided by the Computational and Information Systems Laboratory at NCAR.The Paleocene–Eocene Thermal Maximum (PETM; 56 Ma) is one of our best geological analogs for understanding climate dynamics in a “greenhouse” world. However, proxy data representing the event are only available from select marine and terrestrial sedimentary sequences that are unevenly distributed across Earth’s surface, limiting our view of the spatial patterns of climate change. Here, we use paleoclimate data assimilation (DA) to combine climate model and proxy information and create a spatially complete reconstruction of the PETM and the climate state that precedes it (“PETM-DA”). Our data-constrained results support strong polar amplification, which in the absence of an extensive cryosphere, is related to temperature feedbacks and loss of seasonal snow on land. The response of the hydrological cycle to PETM warming consists of a narrowing of the Intertropical Convergence Zone, off-equatorial drying, and an intensification of seasonal monsoons and winter storm tracks. Many of these features are also seen in simulations of future climate change under increasing anthropogenic emissions. Since the PETM-DA yields a spatially complete estimate of surface air temperature, it yields a rigorous estimate of global mean temperature change (5.6 ∘C; 5.4 ∘C to 5.9 ∘C, 95% CI) that can be used to calculate equilibrium climate sensitivity (ECS). We find that PETM ECS was 6.5 ∘C (5.7 ∘C to 7.4 ∘C, 95% CI), which is much higher than the present-day range. This supports the view that climate sensitivity increases substantially when greenhouse gas concentrations are high.Publisher PDFPeer reviewe