Search

ObjectivesTo evaluate the prevalence of carotid intima-media thickness and plaques in a cohort of persons living with HIV, the role of cardiovascular risk factors, the impact of the antiretroviral regimens, and the difference between naïve and experienced patients in the onset of carotid lesions.MethodsThis project was initiated in 2019 and involves eight Italian Centers. Carotid changes were detected using a power color-Doppler ultrasonography with 7.5 MHz probes. The following parameters are evaluated: intima-media thickness of both the right and left common and internal carotids: Data regarding risk factors for CVD, HIV viral load, CD4+ cell counts, serum lipids, glycaemia, and body mass index. The associations between pathological findings and potential risk factors were evaluated by logistical regression, with odds ratios (OR) and 95% confidence intervals (95% CI).ResultsAmong 1147 evaluated patients, aged 52 years on average, 347 (30.2%) had pathological findings (15.8% plaques and 14.5% IMT). Besides usual risk factors, such as older age, male sex, and dyslipidemia, CD4+ cell nadir ConclusionsOur data show that the overall percentage of carotid impairments nowadays remains high. Color-Doppler ultrasonography could play a pivotal role in identifying and quantifying atherosclerotic lesions among persons living with HIV, even at a very premature stage, and should be included in the algorithms of comorbidity management of these patients.

This paper demonstrates that cannabis can evoke “peak-experiences”—the name psychologist Abraham Maslow gave to fleeting moments of expanded perception indicative of self-transcendence—when used alongside more traditional religious practices such as meditation, fasting, contemplative prayer, and sacramental ritual. For that reason, religious seekers around the globe have deployed cannabis as a deliberate psychoactive to trigger the peak-experiences that stir feelings of ecstasy, wonder, and awe and resolve the “dichotomies, polarities, and conflicts of life.” As such, peak-experiences exemplify a form of spiritual revelation that has played a pivotal role in the history of religion, and because of its ability to elicit unitive consciousness at the heart of mystical insight, cannabis has been utilized as a mild entheogen across culture and tradition for millennia.

ContextInterscholastic heat policies for football have not been evidence based. Therefore, their effectiveness in mitigating exertional heat illness has not been assessed.ObjectiveTo discuss the development of the Georgia High School Association heat policy and assess the effectiveness of revised guidelines.DesignDescriptive epidemiology study.SettingGeorgia high schools.Patients or Other ParticipantsInterscholastic football players in grades 9 through 12.Main Outcome Measure(s)Heat syncope and heat exhaustion (HS/HE) illness rates (IRs) were calculated per 1000 athlete-exposures (AEs), and relative risk (RR) was calculated as a ratio of postpolicy (POST) IR divided by prepolicy (PRE) IR.ResultsA total of 214 HS/HE cases (172 PRE, 42 POST) and 341 348 AEs (178 230 PRE, 163 118 POST) were identified. During the first 5 days of the PRE period, approximately 50% of HS/HE illnesses occurred; HS/HE IRs doubled when practice sessions increased from 2 to 2.5 hours and tripled for practices ≥3 hours. The HS/HE IRs in the PRE period increased from 0.44/1000 AEs for wet-bulb globe temperatures (WBGTs) of 2.0/1000 AEs for WBGTs from 87°F (30.6°C) to 89.9°F (32.2°C). The RRs comparing PRE and POST policy periods were 0.29 for WBGTs of 90°F (>32.3°C).ConclusionsResults from the PRE period guided the Georgia High School Association to revise its heat and humidity policy to include a mandated 5-day acclimatization period when no practices may exceed 2 hours and the use of WBGT-based activity-modification categories. The new policy reduced HS/HE IRs by 35% to 100%, depending on the WBGT category. Our results may be generalizable to other states with hot and humid climates similar to that of Georgia.

The nEXO neutrinoless double beta decay experiment is designed to use a time projection chamber and 5000 kg of isotopically enriched liquid xenon to search for the decay in $^{136}$Xe. Progress in the detector design, paired with higher fidelity in its simulation and an advanced data analysis, based on the one used for the final results of EXO-200, produce a sensitivity prediction that exceeds the half-life of $10^{28}$ years. Specifically, improvements have been made in the understanding of production of scintillation photons and charge as well as of their transport and reconstruction in the detector. The more detailed knowledge of the detector construction has been paired with more assays for trace radioactivity in different materials. In particular, the use of custom electroformed copper is now incorporated in the design, leading to a substantial reduction in backgrounds from the intrinsic radioactivity of detector materials. Furthermore, a number of assumptions from previous sensitivity projections have gained further support from interim work validating the nEXO experiment concept. Together these improvements and updates suggest that the nEXO experiment will reach a half-life sensitivity of $1.35\times 10^{28}$ yr at 90% confidence level in 10 years of data taking, covering the parameter space associated with the inverted neutrino mass ordering, along with a significant portion of the parameter space for the normal ordering scenario, for almost all nuclear matrix elements. The effects of backgrounds deviating from the nominal values used for the projections are also illustrated, concluding that the nEXO design is robust against a number of imperfections of the model., Comment: 26 pages, 19 figures, version accepted by Journal of Phys. G

We have experimentally determined the production rate of $^{39}\mathrm{Ar}$ and $^{37}\mathrm{Ar}$ from cosmic ray neutron interactions in argon at sea level. Understanding these production rates is important for argon-based dark matter experiments that plan to utilize argon extracted from deep underground because it is imperative to know what the ingrowth of $^{39}\mathrm{Ar}$ will be during the production, transport, and storage of the underground argon. These measurements also allow for the prediction of $^{39}\mathrm{Ar}$ and $^{37}\mathrm{Ar}$ concentrations in the atmosphere which can be used to determine the presence of other sources of these isotopes. Through controlled irradiation with a neutron beam that mimics the cosmic ray neutron spectrum, followed by direct counting of $^{39}\mathrm{Ar}$ and $^{37}\mathrm{Ar}$ decays with sensitive ultralow background proportional counters, we determined that the production rate from cosmic ray neutrons at sea level is expected to be $(759\ifmmode\pm\else\textpm\fi{}128)\phantom{\rule{0.16em}{0ex}}\mathrm{atoms}/({\mathrm{kg}}_{\mathrm{Ar}}\mathrm{day})$ for $^{39}\mathrm{Ar}$, and $(51.0\ifmmode\pm\else\textpm\fi{}7.4)\phantom{\rule{0.16em}{0ex}}\mathrm{atoms}/({\mathrm{kg}}_{\mathrm{Ar}}\mathrm{day})$ for $^{37}\mathrm{Ar}$. We also performed a survey of the alternate production mechanisms based on the state of knowledge of the associated cross sections to obtain a total sea-level cosmic ray production rate of $(1048\ifmmode\pm\else\textpm\fi{}133)\phantom{\rule{0.16em}{0ex}}\mathrm{atoms}/({\mathrm{kg}}_{\mathrm{Ar}}\mathrm{day})$ for $^{39}\mathrm{Ar}, (56.7\ifmmode\pm\else\textpm\fi{}7.5)\phantom{\rule{0.16em}{0ex}}\mathrm{atoms}/({\mathrm{kg}}_{\mathrm{Ar}}\mathrm{day})$ for $^{37}\mathrm{Ar}$ in underground argon, and $(92\ifmmode\pm\else\textpm\fi{}13)\phantom{\rule{0.16em}{0ex}}\mathrm{atoms}/({\mathrm{kg}}_{\mathrm{Ar}}\mathrm{day})$ for $^{37}\mathrm{Ar}$ in atmospheric argon.

A personal recollection of events that preceded the construction of Supergravity and of some subsequent developments., Comment: Ettore Majorana Medal address. Contribution to the Proceedings of the International School of Subnuclear Physics, 54th Course: THE NEW PHYSICS FRONTIERS IN THE LHC-2 ERA, Erice, 14 June - 23 June 2016

Suboxone films are U.S. Food and Drug Administration approved to treat opioid dependence. While the package insert states that films should not be cut, physicians often prescribe film fractions for treatment and tapering. There is no data to support this practice, and this study was initiated to evaluate cutting methods, content uniformity, and stability of split films. Suboxone 8-mg buprenorphine/2-mg naloxone films were split using four methods: 1) ruler/razor cut, 2) scissor cut, 3) fold/rip, and 4) fold/scissor cut. United States Pharmacopeia Chapter905was used to evaluate the weight variation and content uniformity of split films. The stability of split films stored in polybags was evaluated over 7 days. A stability-indicating high-performance liquid chromatography method was used for content uniformity and stability evaluation. The weight variation results were acceptable for the half films from all four cutting methods, but this was not true for the quarter films. The method of ruler/razor cut was determined most favorable and used for the content uniformity test. Based on the high-performance liquid chromatography results, the half films from the ruler/razor cut method met the passing criteria of United States Pharmacopeia Chapter905with acceptance values of 9.8 to 10.4 for buprenorphine and 8.4 to 11.5 for naloxone (=15 is considered passing). The stability results indicated that both actives retained97.7% of initial strength. Four cutting methods were found to be acceptable for splitting Suboxone films into half but not quarter fractions. The half films from the ruler/razor cut method also passed United States Pharmacopeia Chapter905content uniformity test. Both actives remained stable for 7 days when the half films were stored in polybags at room temperature.

Context: Knowledge about the specific environmental and practice risks to participants in American intercollegiate football during preseason practices is limited. Identifying risks may mitigate occurrences of exertional heat illness (EHI). Objective: To evaluate the associations among preseason practice day, session number, and wet bulb globe temperature (WBGT) and the incidence of EHI. Design: Descriptive epidemiology study. Setting: Sixty colleges and universities representing 5 geographic regions of the United States. Patients or Other Participants: National Collegiate Athletic Association football players. Main Outcome Measure(s): Data related to preseason practice day, session number, and WBGT. We measured WBGT every 15 minutes during the practice sessions and used the mean WBGT from each session in the analysis. We recorded the incidence of EHIs and calculated the athlete-exposures (AEs). Results: A total of 553 EHI cases and 365 810 AEs were reported for an overall EHI rate of 1.52/1000 AEs (95% confidence interval [CI] = 1.42, 1.68). Approximately 74% (n = 407) of the reported EHI cases were exertional heat cramps (incidence rate = 1.14/1000 AEs; 95% CI = 1.03, 1.25), and about 26% (n = 146) were a combination of exertional heat syncope and heat exhaustion (incidence rate = 0.40/1000 AEs; 95% CI = 0.35, 0.48). The highest rate of EHI occurred during the first 14 days of the preseason period, and the greatest risk was during the first 7 days. The risk of EHI increased substantially when the WBGT was 82.0°F (27.8°C) or greater. Conclusions: We found an increased rate of EHI during the first 14 days of practice, especially during the first 7 days. When the WBGT was greater than 82.0°F (27.8°C), the rate of EHI increased. Sports medicine personnel should take all necessary preventive measures to reduce the EHI risk during the first 14 days of practice and when the environmental conditions are greater than 82.0°F (27.8°C) WBGT.

Few studies have been conducted on individuals’ knowledge of sport-related concussions (SRCs) in South Korea. The purpose of this study was to examine South Korean athletes’ knowledge and recognition of SRC. A cross-sectional survey assessing (a) the recognition of specific signs and symptoms associated with SRC; (b) history of SRC; and (c) knowledge of the return-to-play decision (RTP) process after SRC was distributed to 410 high school and collegiate student-athletes from a variety of sports. No participants correctly identified all 9 items on the checklist of SRC signs and symptoms. While 8.9% reported a history of SRC, approximately 50% of those never reported their postconcussion signs and symptoms. Furthermore, 63.9% of the athletes who reported SRC made RTP decisions on their own. These results reflect the lack of knowledge in South Korean athletics of common signs, symptoms, and appropriate RTP decisions following concussion.

To investigate the role of the period of emergence of the first words and its interactions with other risk factors in predicting the development of speech sound disorder (SSD) among 4- to 5-year-old children.After 373 children underwent otolaryngology and speech pathology examinations, their parents answered a questionnaire about potential risk factors for speech impairment. The presence of SSD was identified by a speech pathologist who administered Fanzago's Articulation Test to each child. Multivariate logistic analysis was used to explore the relationships between variables and outcomes.Mean age at first words was 17.8 ± 6.5 months of life; 25.7% of patients suffered from SSD, and 3.7% from stuttering. A family history of language impairment was found in 12.9% of the sample, whereas a family history of reading difficulty was reported in only 5.4% of cases. No differences in terms of mean age (p = 0.3) or gestational age (p = 0.16) were found between children affected by SSD and those who were not. Multivariate logistic analysis revealed that male sex (p 0.001), a family history of language impairment (p 0.001) and stuttering (p = 0.001) were significantly associated to SSD. Age at first words did not result a predictor of speech impairment.In contrast to male sex (p 0.001), family history of language impairment (p 0.001) and stuttering (p = 0.001) which resulted significantly associated to SSD, age at first words does not seem to be a predictor of SSD (p = 0.11); however, it remains a useful indicator of language delay and, when considered in association with other language milestones, can be a reason of concern for parents and caregivers about their children's developmental and speech therapy needs.

Objectives To evaluate a behavioral intervention to reduce head impact exposure in youth playing American football. Design Nested randomized controlled trial. Methods Participants, ages 14–17 years, wore head impact sensors (SIM-G™) during two seasons of play. Those randomized to the intervention group underwent weekly tackling/blocking drills performed without helmets (WoH) and shoulder pads while the control group trained as normal, matching frequency and duration. Research personnel provided daily oversight to maintain fidelity. Head impact frequency (≥10 g) per athlete exposure (ImpAE) was analyzed over time (two 11-week seasons) using mixed effect models or ANCOVA. Secondary outcomes included exposure-type (training, game) and participation level (entry-level versus upper-level secondary education). Results One-hundred fifteen participants (59 WoH, 56 control) met compliance criteria, contributing 47,382 head impacts and 10,751 athlete exposures for analysis. WoH had fewer ImpAE during games compared to control participants at weeks 4 (p = 0.0001 season 1, p = 0.0005 season 2) and 7 (p = 0.0001 both seasons). Upper-level WoH participants had less ImpAE during games than their matched controls at weeks 4 (p = 0.017 and p = 0.026) and 7 (p = 0.037 and p = 0.014) in both seasons, respectively. Upper-level WoH also had fewer ImpAE during training at week 7 (p = 0.015) in season one. Conclusions Tackling and blocking drills performed without a helmet during training reduced the frequency of head impacts during play, especially during games. However, these differences disappeared by the end of the season. Future research should explore the frequency of behavioral intervention and a dose-response relationship considering years of player experience. Trial registration ClinicalTrials.gov # NCT02519478.

Adenosine is a potent endogenous mediator of vasodilation. Compounded sterile solutions of adenosine are used in cardiac catheterization lab to perform stress tests on the heart. These tests are used to determine the fractional flow reserve (FFR) and are commonly used in the management and diagnosis of cardiovascular conditions. The purpose of this study was to assess the physical and chemical stability of 2 mg/mL adenosine in 0.9% Sodium Chloride Injection, USP in polyvinyl chloride [PVC]) and polyolefin infusion bags stored at room temperature (20°C-25°C) and under refrigeration (2°C-8°C). The compounding and analytical methods used in this study were very similar to those described in the prior publications from the authors’ laboratory. To ensure a uniform starting concentration of all stability samples, a batch of 2 mg/mL adenosine solution was prepared and then packaged into empty PVC and polyolefin infusion bags. These stability samples were prepared in triplicate for each bag type and storage temperature (a total of 12 samples). The infusion bag samples were assessed for stability immediately after preparation and after 1 day, 3 days, 7 days, and 14 days. At each time point, the infusion bags were first visually inspected against a light background for color change, clarity, and particulates. Aliquots were drawn from each sample at each time point for pH analysis and high-performance liquid chromatography (HPLC) analysis. Over 14 days of storage at room temperature or refrigeration, no considerable change in visual appearance or pH was observed in any bags. All samples retained 90% to 110% of the initial drug concentration. No significant degradation peaks were observed in the HPLC chromatograms.

Objective To test a helmetless-tackling behavioral intervention for reducing head impacts in National Collegiate Athletic Association Division I football players. Design Randomized controlled clinical trial. Setting Football field. Patients or Other Participants Fifty collegiate football players (intervention = 25, control = 25). Intervention(s) The intervention group participated in a 5-minute tackling drill without their helmets and shoulder pads twice per week in the preseason and once per week through the season. During this time, the control group performed noncontact football skills. Main Outcome Measure(s) Frequency of head impacts was recorded by an impact sensor for each athlete-exposure (AE). Data were tested with a 2 × 3 (group and time) repeated-measures analysis of variance. Significant interactions and main effects (P < .05) were followed with t tests. Results Head impacts/AE decreased for the intervention group compared with the control group by the end of the season (9.99 ± 6.10 versus 13.84 ± 7.27, respectively). The intervention group had 30% fewer impacts/AE than the control group by season's end (9.99 ± 6.10 versus 14.32 ± 8.45, respectively). Conclusion A helmetless-tackling training intervention reduced head impacts in collegiate football players within 1 season.

This review is devoted to some aspects of non-linear Supersymmetry in four dimensions that can be efficiently described via nilpotent superfields, in both rigid and curved Superspace. Our focus is mainly on the partial breaking of rigid N = 2 Supersymmetry and on a class of generalized Born-Infeld systems that originate from Special Geometry and on some prototype cosmological models, starting from the Supergravity embedding of Starobinsky inflation. However, as an aside we also review briefly some interesting two-field extensions of the Born-Infeld Lagrangian whose field equations enjoy extended duality symmetries.

In the eighteenth-century Chinese novel Honglou meng (Dream of the Red Chamber, 红楼梦), the numerous instances of pairing, mirroring, and doubling around the protagonist Jia Bao-yu serve to highlight a philosophical view of mutability grounded in Ying-Yang theory and Daoism, to emphasize the dynamic process of acquiring self-knowledge, and to subvert and problematize dualistic classification (truth/fiction, right/wrong, real/unreal). By considering the significance of the hero’s transformation in this context from the rejected Stone, into the Divine Luminescent Stone-in-Waiting, and then into Jia Bao-yu and his second self, I seek to expose the utopian dimensions of the text grounded in tension between Daoism and Confucianism and exemplified by Jia Bao-yu and Zhen Bao-yu respectively.

American Football players are among the most susceptible athletes to heat-related illnesses. Environmental conditions are an important factor when considering risk rates for these illnesses. Thus, we examine the spatio-temporal variations in the wet bulb globe temperature (WBGT), a commonly used metric for heat exposure, and quantify the hazard for extreme heat using safety thresholds specifically derived for athletes from the American College of Sports Medicine (ACSM). The objective is to provide better information on heat-related hazards to help mitigate the risk of exertional heat illnesses (EHI) among football players. We created a unique 15-year climatology (1991–2005) of August WBGTs for 217 locations across the contiguous United States using weather station observations and a WBGT model. Thirteen 3-h overlapping training session times ranging from 6–9 a.m. to 6–9 p.m. were examined to identify how the WBGT varies with the time of day the practice session was held and how frequently the WBGT during those sessions posed a hazard for extreme heat by exceeding two ACSM safety thresholds (30.1 °C and 32.3 °C). Maximum hazards for extreme heat are located in an arc across the Southern tier of the country, stretching from eastern Texas through to South Carolina as well as across southern Arizona and southeastern California. Climatologically, practice sessions early in the morning and later in the evening were best for minimizing heat exposure while those held from late morning through afternoon, particularly the noon-3 p.m. and 1–4 p.m. periods, had the highest WBGT values and were the practice periods that most frequently exceeded safety thresholds. Delaying the start of afternoon practices a few hours, however, may substantially reduce the likelihood of oppressive conditions and reduce the risk for heat illnesses.

The ImPACT (Immediate Postconcussion Assessment and Cognitive Testing) is a computerized neurocognitive test used to assist in the management of sport concussion management. A number of studies have documented the reliability and sensitivity of the ImPACT, but no studies have examined the equivalence of the ImPACT's alternate forms. The objective of our study was to determine the equivalence of the ImPACT's five alternate forms. Participants were administered alternate forms of ImPACT based on clinically relevant time frame derived from an extensive sports concussion database. Participants completed a baseline assessment followed by various combinations of the remaining alternate forms at 45 and 50 days. Inferential Confidence Intervals were calculated for each composite score for all alternate forms. We found non-equivalence between ImPACT form 1 and forms 2, 3, and 4 on the Verbal Memory and between forms 2 and 4. ImPACT forms 1 and 3 were not equivalent on the Visual Memory Composite. Finally, ImPACT forms 3 and 4 were not equivalent on the Visual Motor Speed and Reaction Time Composites. Alternate form equivalence is necessary to minimize measurement error and optimize clinical decision making. Clinicians using the ImPACT should consider non-equivalence of some forms on certain Composites when interpreting ImPACT following sports concussion.

The fortieth anniversary of the original construction of Supergravity provides an opportunity to combine some reminiscences of its early days with an assessment of its impact on the quest for a quantum theory of gravity., Comment: 27 pages, LaTeX. Based in part on the talk delivered by S. F. at the "Infeld Colloquium and Discrete", in Warsaw, on December 1 2016, and on a joint CERN Courier article. Dedicated to John H. Schwarz on the occasion of his 75-th birthday. Comment and references added

Objective: To provide athletic trainers, health care professionals, and all those responsible for the care of athletes with clinical recommendations for preventing and managing sport-related dental and oral injuries.Background: Participation in competitive sports continues to grow at both the interscholastic and intercollegiate levels. Therefore, exposure to, and the incidence of athletic-related injury, including orofacial injury, will also likely increase. At the time of this writing, the leading governing agencies for interscholastic (National Federation of State High School Associations) and intercollegiate (National Collegiate Athletic Association) sports require only protective orofacial equipment (eg, mouthguards) for 5 and 4, respectively, of their sanctioned sports. Although orofacial injuries represent a small percentage of all sport-related injuries, the financial burden associated with these injuries (eg, tooth avulsion) can exceed $15 000 over an adult life. Therefore, effective management of sport-related dental injuries is critical to the long-term financial, physical, and emotional health of people who have experienced dental trauma.Recommendations: Based upon the current evidence regarding sport-related orofacial injury, we provide recommendations related to planning considerations, education, and mouthguard efficacy, material, fabrication, and care considerations. Additionally, suggested best practices for managing sport-related dental injury are also given for athletic trainers and other health care professionals.

Il cedro dell’Atlante [Cedrus atlantica (ENDL.) MANETTI EX CARRIÈRE], introdotto in Europa come pianta ornamentale, ha trovato largo impiego nei rimboschimenti in Francia, Spagna e Portogallo, mentre in Italia la sua diffusione è stata più recente e a oggi interessa oltre 2600 ettari, dimostrando ottime potenzialità, senza comportamenti invasivi. In Sicilia, benché poco diffusa, la specie sembra avere potenzialità di adattamento e di produzione interessanti. Il presente lavoro prende in considerazione 7 popolamenti di cedro dell'Atlante dislocati in ambiti diversi rappresentativi delle condizioni ambientali locali, compatibili con le esigenze ecologiche della specie, tra questi un rimboschimento sottoposto a interventi di diradamento. Sono state esaminate le caratteristiche dendro-auxometriche dei popolamenti al fine di valutarne le potenzialità produttive. I risultati mostrano che i popolamenti in esame hanno ottima capacità di affermazione, seguono gli sviluppi tipici della specie e hanno possibilità di produzione elevate, pari a quelle riscontrate in letteratura per le piantagioni realizzate in Francia. Inoltre si nota l'interessante ruolo paesaggistico, sia pur considerandone la natura alloctona, che questi popolamenti possono svolgere in ambiti di non facile colonizzazione per specie arboree. Infine si suggeriscono alcuni indirizzi di gestione volti ad assicurarne la migliore affermazione e la possibilità di rinnovazione, sia pur su scala locale. Atlas cedar (ENDL.) MANETTI EX CARRIÈRE] plantations in Sicily Atlas Cedar has been widely diffused in reforestation in Europe, particularly in France. In Italy, the Atlas Cedar cover about 2600 ha. This paper examines 7 cedar plantations in Sicily, in the various typical condition of the island, evaluating their dendrometric characters in order to estimate productivity and growth capacity. The results show that this specie is both highly suitable for wood production, and has a landscape restoration role in difficult ecological conditions such as the Mediterranean mountain environment is. The stand production is comparable with the better results reported for the French plantations. Some cultivation advices in order to better manage these stands and locally assure natural regeneration are also addressed.