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Introduction: External ventricular drains (EVDs) and intracranial pressure (ICP) monitors are widely used in the Neurological Critical Care Unit (NCCU) to measure ICP and divert cerebrospinal fluid (CSF). EVDs and ICP monitors have historically been placed by neurosurgeons; however, with recent staffing of NCCUs by neurointensivists, a growing number of EVDs and ICP monitors are being placed by these specialists.Results: Limited data are available concerning the safety or feasibility of such placements by neurointensivists. We present our experience with EVD and ICP monitor placement by a neurointensivist in the NCCU. A retrospective chart review of 29 patients with EVD placement and 7 patients with ICP monitors--all placed by a single neurointensivist--was conducted for patients admitted to the NCCU from August 2005 to January 2008.Discussion: These findings were compared to published outcomes from neurosurgeon placements. All 29 patients with EVDs remained infection-free, with CSF pleocytosis occurring in one patient (3.4%). All 7 patients receiving ICP monitors remained free from infection. Complications after drain placement occurred in 20.7% (n = 6) of patients, with all six complications being EVD tract hematoma measuring less than 5 cm(3).Conclusion: Patients receiving ICP monitors had no complications. These complication rates are comparable to published rates, which suggest that placement of EVDs and ICP monitors by neurointensivists may be safe and effective. However, small sample size (n = 36) prohibits definitive safety and efficacy conclusions. For this reason, further research analyzing a larger patient sample is warranted. [ABSTRACT FROM AUTHOR]

Background: Checkpoint-inhibitor immunotherapies have had a profound effect in the treatment of cancer by inhibiting down-regulation of T-cell response to malignancy. The cardiotoxic potential of these agents was first described in murine models and, more recently, in numerous clinical case reports of pericarditis, myocarditis, pericardial effusion, cardiomyopathy, and new arrhythmias. The objective of our study was to determine the frequency of and associated risk factors for cardiotoxic events in patients treated with immune checkpoint inhibitors., Methods: Medical records of patients who underwent immunotherapy with durvalumab, ipilimumab, nivolumab, and pembrolizumab at Wake Forest Baptist Health were reviewed. We collected retrospective data regarding sex, cancer type, age, and cardiovascular disease risk factors and medications. We aimed to identify new diagnoses of heart failure, atrial fibrillation, ventricular fibrillation/tachycardia, myocarditis, and pericarditis after therapy onset. To assess the relationship between CVD risk factors and the number of cardiac events, a multivariate model was applied using generalized linear regression. Incidence rate ratios were calculated for every covariate along with the adjusted P-value. We applied a multivariate model using logistic regression to assess the relationship between CVD risk factors and mortality. Odds ratios were calculated for every covariate along with the adjusted P-value. Adjusted P-values were calculated using multivariable regression adjusting for other covariates., Results: Review of 538 medical records revealed the following events: 3 ventricular fibrillation/tachycardia, 12 pericarditis, 11 atrial fibrillation with rapid ventricular rate, 0 myocarditis, 8 heart failure. Significant risk factors included female gender, African American race, and tobacco use with IRR 3.34 (95% CI 1.421, 7.849; P = 0.006), IRR 3.39 (95% CI 1.141, 10.055; P = 0.028), and IRR 4.21 (95% CI 1.289, 13.763; P = 0.017) respectively., Conclusions: Our study revealed 34 significant events, most frequent being pericarditis (2.2%) and atrial fibrillation (2.0%) with strongest risk factors being female gender, African American race, and tobacco use. Patients who meet this demographic, particularly those with planned pembrolizumab treatment, may benefit from early referral to a cardio-oncologist. Further investigation is warranted on the relationship between CTLA-4 and PD-L1 expression and cardiac adverse events with ICIs, particularly for these subpopulations., (© 2022. The Author(s).)

Polydactyl zinc finger (ZF) proteins have prominent roles in gene regulation and often execute multiple regulatory functions. To understand how these proteins perform varied regulation, we studiedDrosophila Suppressor of Hairy-wing [Su(Hw)], an exemplar multifunctional polydactyl ZF protein. We identified separation-of-function (SOF) alleles that encode proteins disrupted in a single ZF that retain one of the Su(Hw) regulatory activities. Through extended in vitro analyses of the Su(Hw) ZF domain, we show that clusters of ZFs bind individual modules within a compound DNA consensus sequence. Through in vivo analysis of SOF mutants, we find that Su(Hw) genomic sites separate into sequence subclasses comprised of combinations of modules, with subclasses enriched for different chromatin features. These data suggest a Su(Hw) code, wherein DNA binding dictates its cofactor recruitment and regulatory output. We propose that similar DNA codes might be used to confer multiple regulatory functions of other polydactyl ZF proteins., (© The Author(s) 2017. Published by Oxford University Press on behalf of Nucleic Acids Research.)

Background: Cerebral vasospasm leading to delayed ischemia is a common and serious complication of aneurysmal subarachnoid hemorrhage that often results in increased morbidity and mortality. Treatments for cerebral vasospasm, including triple-H therapy (therapeutic hypervolemia, hypertension, and hemodilution), nimodipine, balloon angioplasty, and intra-arterial vasodilators have limitations in their efficacy and safety profiles. Nicardipine, a calcium channel blocker, is available for intravenous administration for blood pressure reduction. A recent study reported its efficacy in the treatment of cerebral vasospasm when given intrathecally (IT). We present our experiences with IT nicardipine for treatment of cerebral vasospasm., Methods: IT nicardipine was administered to six patients with aneurysmal subarachnoid hemorrhage after prophylactic and aggressive therapeutic management for vasospasm failed., Results: In these patients, IT nicardipine treatment was followed within 8 hours by a 43.1 +/- 31.0 cm/s decrease in middle cerebral arterial flow velocity, as measured by transcranial Doppler ultrasound., Conclusions: Based on these positive results, we believe that larger scale studies evaluating the safety and efficacy of IT nicardipine for the management of cerebral vasospasm are warranted.

We present experiments on second-harmonic generation from arrays of magnetic split-ring resonators and arrays of complementary split-ring resonators. In both cases, the fundamental resonance is excited by the incident femtosecond laser pulses under normal incidence, leading to comparably strong second-harmonic signals. These findings are discussed in terms of Babinet's principle and in terms of a recently developed microscopic classical theory that leads to good agreement regarding the relative and the absolute nonlinear signal strengths. The hydrodynamic convective contribution is found to be the dominant source of second-harmonic generation--in contrast to a previous assignment [Science 313, 502 (2006)].

It is well known that refraction of light at interfaces leads to a beam displacement for oblique incidence of light onto a slab of material. In ray optics and for homogeneous isotropic materials, the sign of this beam displacement is strictly identical to the sign of the refractive index. Our numerical calculations reveal negative beam displacements from state-of-the-art double-fishnet-type photonic metamaterials. This holds true for the "main" polarization corresponding to a negative phase velocity for normal incidence as well as for the "secondary" polarization with positive phase velocity. To understand and interpret these results, we also present exact analytical calculations for thin metal films showing that, in wave optics, the sign of the beam displacement (i.e., the sign of refraction) is generally not identical to the sign of the refractive index.

Photonic metamaterials could provide optical nonlinearities far exceeding those of natural substances due to the combined action of (magnetic) resonances and local-field enhancements. Here, we present our experiments on second- and third-harmonic generation from magnetic metamaterials composed of nanoscale gold split-ring resonators and from control samples for excitation with 170-fs pulses centered at 1.5-microm wavelength. The strongest nonlinear signals are found for resonances with magnetic-dipole character.

We propose, fabricate, and study a double-layer chiral planar metamaterial that exhibits pronounced circular dichroism at near-infrared wavelengths. The antisymmetric oscillation modes of the two coupled layers allow local magnetic-dipole moments and enhanced polarization effects compared with similar single-layer systems where only electric-dipole moments occur. Experiment and rigorous theoretical calculations are in good agreement.

We analyze the influence of correlations on the optical properties of disordered metallic photonic crystal slabs experimentally and theoretically. Different disorder models with different nearest-neighbor correlations are considered. We present a theory that allows us to quantitatively calculate the optical properties of the different samples. We find that different kinds of correlations produce characteristic spectral features such as peak reduction and inhomogeneous broadening. These features are caused by reduced excitation efficiencies and the excitation of multiple resonances.

We observe second-harmonic generation from metamaterials composed of split-ring resonators excited at 1.5-micrometer wavelength. Much larger signals are detected when magnetic-dipole resonances are excited, as compared with purely electric-dipole resonances. The experiments are consistent with calculations based on the magnetic component of the Lorentz force exerted on metal electrons-an intrinsic second-harmonic generation mechanism that plays no role in natural materials. This unusual mechanism becomes relevant in our work as a result of the enhancement and the orientation of the local magnetic fields associated with the magnetic-dipole resonances of the split-ring resonators.

We present magnetic metamaterials composed of 35 nm minimum feature-size gold split-ring resonators with a fundamental magnetic resonance at a wavelength of 900 nm. Corresponding calculations reveal excellent agreement with the experiments and show that the limits of size scaling have been reached.

This study was designed to determine the feasibility and efficacy of long-term nicotine replacement therapy (NRT) in helping persons with schizophrenia remain tobacco-free. Fifty smokers with a diagnosis of schizophrenia or schizo-affective disorder and whose symptoms had been stable for at least two months were enrolled in a program providing group support and NRT (patches) in individually adjusted doses set to maintain baseline nicotine intake. All participants attended weekly group support/motivation sessions. Smoking activity was determined by measuring carbon monoxide levels in expired air. Participants who quit tobacco use completely during the first three months were entered into a single-blind phase in which they received either placebo or active nicotine patches for up to six additional months, along with biweekly group sessions. Sixty days into the open-label phase, 66% of the subjects had reduced their use of tobacco by at least 75%. After 90 days of open-label treatment, 18 subjects (36%) were tobacco-free and qualified to enter the six-month, single-blind phase, eight on placebo and nine on active patches. A significantly greater proportion of those on placebo (8 of 8) compared with those on active patches (3 of 9) relapsed prior to completion of the 6-month period. This difference is statistically significant at the p = 0.009 level. The results of this study indicate that long-term use of NRT is feasible and effective for sustained tobacco-free success and may be an important strategy for reducing health risks due to tobacco use in this special population.

The carrier-envelope phase of a laser pulse has recently become an important quantity in extreme nonlinear optics. Because of the topological Gouy phase, it changes while the pulse propagates through the focus of a lens. This variation is measured by a simple solid-state-based approach. The experimental results are analyzed by comparison with simple analytical model calculations.

We present an omnidirectional matter waveguide on an atom chip. The guide is based on a combination of two current-carrying wires and a bias field pointing perpendicular to the chip surface. Thermal atoms are guided for more than two complete turns along a 25-mm-long spiral path (with curve radii as short as 200 microm) at various atom-surface distances (35-450 microm). An extension of the scheme for the guiding of Bose-Einstein condensates is outlined.

We report on experiments with cold thermal (7)Li atoms confined in combined magnetic and electric potentials. A novel type of three-dimensional trap was formed by modulating a magnetic guide using electrostatic fields. We observed atoms trapped in a string of up to six individual such traps, a controlled transport of an atomic cloud over a distance of 400 microm, and a dynamic splitting of a single trap into a double well potential. Applications for quantum information processing are discussed.

Measurements of charge injection from indium tin oxide (ITO) into the organic semiconductor, tetraphenyl diamine doped polycarbonate (PC:TPD), were carried out. The current injected at the contact was measured as a function of the hole mobility in the organic semiconductor, which was varied from 10(-6) to 10(-3) cm (2)/V x s by adjusting the concentration of the hole transport agent, TPD, in the PC host. These experiments reveal that the current injected at the contact is proportional to the hole mobility in the bulk. As a result, the ITO/PC:TPD contact is found to limit current flow in all samples, regardless of the hole mobility in PC:TPD.

The goal of this study was to intraindividually compare a complete versus a fragmented, directly 99mTc-labeled, monoclonal anti-carcinoembryonic antigen (CEA) antibody, with respect to their antigen-targeting kinetics, sensitivity, and diagnostic accuracy in patients with CEA-expressing tumors. Twenty-five patients were investigated with the 99mTc-labeled anti-CEA IgG1 BW 431/26 and the F(ab')2/Fab' fragment mixture F023C5 within 7 days. For quantitative analysis, the region of interest technique was applied to planar scans, whole-body scans, and single photon emission computed tomography slices 10 min to 48 h postinjection (PI). Final correlations were performed according to the histopathology after surgery or biopsy. Earliest tumor detection was possible with complete IgG1 4 h PI (52% of finally positive lesions). Twenty-four- or even 48-h scans were necessary in 48% of finally positive lesions; tumor detection with fragments was possible in 17% at 1 h PI and in 94% at 4 h PI. With both monoclonal antibodies, in 35%, single photon emission computed tomography was necessary for tumor detection. Absolute antibody uptake in tumor lesions was higher with complete monoclonal antibodies than with fragments. The sensitivity of fragments was higher in detecting primary tumors, local recurrences, and lymph node metastases. For detection of liver metastases, sensitivity was also higher for fragments than for IgG (87 versus 73%), but in scintigraphically positive lesions, tumor:background ratios were significantly lower with fragments (1.26 +/- 0.12 versus 1.70 +/- 0.32; P < 0.01). Therefore, fragments seem to be more suitable for earlier detection of lesions known for their good vascularization, vascular permeability, and antigen accessibility, such as local recurrences, lymph node metastases, and peritoneal carcinomatoses. In liver metastases (high interstitial pressure, low vascular leakage), sensitivity of fragments is higher, but their rapid serum and whole-body clearance lead to a lower absolute antibody uptake, with the consequence of significantly lower tumor:background ratios than with IgG.

Unlabelled: The goal of this study was to intraindividually compare complete versus fragmented directly labeled 99mTc monoclonal anti-CEA antibody with respect to antigen targeting and tumor uptake kinetics, sensitivity and diagnostic accuracy in colorectal cancer patients., Methods: Twenty-five patients were investigated with 99mTc-labeled anti-CEA IgG1 BW 431/26 and the F(ab')2/Fab' fragment mixture F023C5 within 7 days. For quantitative analysis, an ROI technique was applied to planar scans, whole-body scans and SPECT slices 10 min to 48 hr postinjection. Final correlations were performed according to histology after surgery or biopsy., Results: Earliest tumor detection with complete IgG1 was possible 4 hr postinjection (52% of finally positive lesions); imaging at 24 hr or even 48 hr was necessary in 48%. Tumor detection with fragments was possible in 17% at 1 hr postinjection and in 94% at 4 hr postinjection. In 35%, SPECT was necessary for tumor detection with both MAbs. Absolute antibody uptake in tumor lesions was higher with complete MAbs than with fragments., Conclusions: Lesions known for their good vascularization, vascular permeability and antigen accessibility were detected earlier and with higher sensitivity with fragments than with complete MAbs due to faster background clearance despite lower absolute antibody uptake.

Data on female participation in gang and non-gang delinquent activities were collected from black male delinquents in Los Angeles County Juvenile Hall by Shimota and Klein in the mid-1960s but never published. These data are presented, and are reanalyzed to show how females were systematically excluded from the planning and action phases of delinquent activities. An unexpected finding from the research is that female presence at the site of a delinquent activity had a suppressing effect on that activity. This material forms a baseline for contemporary, post-women's movement studies of female juvenile delinquency.

Sera from epileptic patients were assayed for phenobarbital and diphenylhydantoin by four different analytical procedures. Quantitative results obtained by radioimmunoassay (I) and enzyme immunoassay (II) were compared to each other and to the results obtained on aliquots of the same sample by gas-liquid chromatography (III) and ultraviolet spectrophotometry (IV). For phenobarbital the correlation coefficients were I vs. II, 0.909; I vs. III, 0.947; II vs. III, 0.917; I vs. IV, 0.950; II vs. IV, 0.953. For diphenylhydantoin the correlation coefficients were I vs. II, 0.953; I vs. III, 0.951; II vs. III, 0.957; I vs. IV, 0.862; II vs. IV, 0.898. The immunoassays can be substituted for liquid chromatography or ultraviolet spectrophotometry without changing the resulting clinical interpretations.

A large portion of the research carried out to date on juvenile delinquency and gang behavior has been concentrated on male delinquents. For example, Thrasher's study (1927) of 1,313 gangs in Chicago devoted less than a page to the question of whether or not females form gangs in the same way that males do. When females are included in delinquency studies, their behavior is almost always explained in psychological or social-psychological terms. The general reasoning is that females commit delinquent acts or join delinquent gangs because they are socially maladjusted, come from broken and unhappy homes, and do not relate well to the opposite sex. In this article, we juxtapose this theoretical perspective to a social structural explanation of both female juvenile delinquency and female gang membership, and then test these two alternative explanations for juvenile delinquency using data on black, female juveniles collected in Los Angeles during the mid-1960s.