Nicotine Screening and Cessation Education Among Patients Awaiting Total Joint Arthroplasty: A Quality Improvement Project.

Orthopedic surgical patients who use nicotine are at a high risk for postoperative complications including infection, respiratory failure, cardiac arrest, and death. Periprosthetic joint infections may result from nicotine-induced immunosuppression and microvascular changes, increasing perioperative morbidity and mortality. These complications result in higher health care costs, increased length of stay, and loss of reimbursement due to readmissions. Four weeks of nicotine cessation prior to arthroplasty decreases these risks; however, perioperative teams may lack reliable nicotine screening and cessation education methods. This project identified inconsistencies in nicotine screening and cessation counseling in the preoperative setting, which contributed to surgery cancellations among patients who required to demonstrate nicotine cessation preoperatively. Standardization of preoperative nicotine screening and patient cessation education resources can improve the identification of orthopedic patients who use nicotine and provide concrete, proven methods of achieving nicotine cessation prior to elective primary arthroplasty. Investment from perioperative staff is essential to ensure success.

Functional modeling identifies paralogous solanesyl-diphosphate synthases that assemble the side chain of plastoquinone-9 in plastids.

It is a little known fact that plastoquinone-9, a vital redox cofactor of photosynthesis, doubles as a precursor for the biosynthesis of a vitamin E analog called plastochromanol-8, the physiological significance of which has remained elusive. Gene network reconstruction, GFP fusion experiments, and targeted metabolite profiling of insertion mutants indicated that Arabidopsis possesses two paralogous solanesyl-diphosphate synthases, AtSPS1 (At1g78510) and AtSPS2 (At1g17050), that assemble the side chain of plastoquinone-9 in plastids. Similar paralogous pairs were detected throughout terrestrial plant lineages but were not distinguished in the literature and genomic databases from mitochondrial homologs involved in the biosynthesis of ubiquinone. The leaves of the atsps2 knock-out were devoid of plastochromanol-8 and displayed severe losses of both non-photoactive and photoactive plastoquinone-9, resulting in near complete photoinhibition at high light intensity. Such a photoinhibition was paralleled by significant damage to photosystem II but not to photosystem I. In contrast, in the atsps1 knock-out, a small loss of plastoquinone-9, restricted to the non-photoactive pool, was sufficient to eliminate half of the plastochromanol-8 content of the leaves. Taken together, these results demonstrate that plastochromanol-8 originates from a subfraction of the non-photoactive pool of plastoquinone-9. In contrast to other plastochromanol-8 biosynthetic mutants, neither the single atsps knock-outs nor the atsps1 atsps2 double knock-out displayed any defects in tocopherols accumulation or germination.

Spectral tunability of a plasmonic antenna with a dielectric nanocrystal.

We show that the positioning of a nanometer length scale dielectric object, such as a diamond nanocrystal, in the vicinity of a gold bowtie nanoantenna can be used to tune the plasmonic mode spectrum on the order of a linewidth. We further show that the intrinsic luminescence of gold enhanced in the presence of nanometer-scale roughness couples efficiently to the plasmon mode and carries the same polarization anisotropy. Our findings have direct implications for cavity quantum electrodynamics related applications of hybrid antenna-emitter complexes.

Beliefs and social norms about ephedra onset and perceived addiction among college male and female athletes.

In Spring 2003, a qualitative approach was used to investigate relevant beliefs and norms associated with ephedra initiation and perceived addiction to the drug among 43 primarily minority athletes, attending a historically Black university in the southwestern region of the United States, who self-identified as past users. In general, participants stated that their second ephedra use event occurred on the same day as or the day after initiation. The majority of participants perceived that addiction was established by routine and eccentric behavior. Male athletes stated they used ephedra for improved athletic performance while females stated they used the drug for weight loss. Male participants stated it is difficult to quit ephedra use because of the resulting decrease in athletic performance, sickness, and weight gain. Female athletes were more concerned with their appearance. These findings are important in determining the early extent to which addiction is self-identified.