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IntroductionTobacco companies frequently distribute coupons for their products. This marketing tactic may be particularly effective among young adults, who tend to be especially price-sensitive. Young adulthood is also a stage during which many individuals initiate established cigarette smoking and are especially vulnerable to the effects of tobacco marketing.MethodsWe used five waves of data from the US Population Assessment on Tobacco and Health Study (2013–2019) to assess the longitudinal relationship between cigarette coupon receipt and initiation of established cigarette smoking among young adults (18–24 years) who did not report current smoking and had smoked <100 cigarettes in their lifetime at baseline. Initiation of established cigarette smoking was defined as reporting current cigarette use and having smoked ≥100 cigarettes at follow-up. To test this relationship, we fit four discrete time survival models to an unbalanced person-period data set. The first model included our time-varying coupon receipt variable, which was lagged one wave. Subsequent models added sociodemographic, cigarette smoking exposure and other tobacco use variables.ResultsAdopting the model adjusting for sociodemographic variables, respondents who received a coupon were found to be more likely to initiate established cigarette smoking at follow-up (adjusted HR (aHR): 2.31, 95% CI 1.41 to 3.80). This relationship remained significant when controlling for all covariates in the fully adjusted model (aHR: 1.96, 95% CI 1.18 to 3.26).ConclusionsThese findings show that receiving tobacco coupons may increase the likelihood that young adults will initiate established cigarette smoking, underscoring the need to address the effects of this tobacco marketing tactic.

Purpose To examine trends in single, dual, and polytobacco use between 2014-2020 for US youth and to identify disparities in these trends by grade level, sex, and race/ethnicity.Design A secondary analysis of the National Youth Tobacco Survey (NYTS).Subjects A total of 122 566 students.Measures Past 30-day exclusive use of cigarettes, e-cigarettes, other combustibles (cigars, little cigars, cigarillos, hookah, pipe tobacco, bidis) and smokeless tobacco (snus, smokeless, dissolvable); dual use of each product with e-cigarettes; polyuse with e-cigarettes; dual/polyuse without e-cigarettes.Analysis Multivariable modified Poisson regression.Results Compared to 2014, exclusive e-cigarette use (APR = 2.51, 95% CI: 1.96, 3.21) trended upward while exclusive cigarette (APR = .34, 95% CI: .23, .50), ‘other’ combustibles (APR = .47, 95% CI: .37, .58), and smokeless tobacco (APR = .40, 95% CI: .25, .65) use trended downward in 2020. Polytobacco use with and without e-cigarettes trended downward in 2020 compared to 2014. We also saw differences in trends across sociodemographic groups. Comparing 2020 to 2014, exclusive e-cigarette use was higher for females than males, ‘other’ combustible tobacco use remained stable for Non-Hispanic Black students but decreased for other racial/ethnic groups, and dual e-cigarette/cigarette use trended upward more for middle school students than high school students.Conclusions Despite decreased trends in tobacco product use without e-cigarettes between 2014-2020, differences in tobacco product use trends by grade level, sex, and race/ethnicity were identified. Prevention efforts targeting disparities in tobacco product use are needed.

IntroductionThe US Food and Drug Administration most recently announced its intention to ban menthol cigarettes and cigars nationwide in April 2021. Implementation of the ban will require evidence that it would improve public health. This paper simulates the potential public health impact of a ban on menthol in cigarettes and cigars through its impacts on smoking initiation, smoking cessation and switching to nicotine vaping products (NVPs).MethodsAfter calibrating an established US simulation model to reflect recent use trends in cigarette and NVP use, we extended the model to incorporate menthol and non-menthol cigarette use under a status quo scenario. Applying estimates from a recent expert elicitation on the behavioural impacts of a menthol ban, we developed a menthol ban scenario with the ban starting in 2021. We estimated the public health impact as the difference between smoking and vaping-attributable deaths and life-years lost in the status quo scenario and the menthol ban scenario from 2021 to 2060.ResultsAs a result of the ban, overall smoking was estimated to decline by 15% as early as 2026 due to menthol smokers quitting both NVP and combustible use or switching to NVPs. These transitions are projected to reduce cumulative smoking and vaping-attributable deaths from 2021 to 2060 by 5% (650 000 in total) and reduce life-years lost by 8.8% (11.3 million). Sensitivity analyses showed appreciable public health benefits across different parameter specifications.Conclusions and relevanceOur findings strongly support the implementation of a ban on menthol in cigarettes and cigars.

Objective: The objective of the current research was to examine the association between time spent on social media and serious psychological distress between 2013 and 2017, a period when the rates of both were trending upward.Methods: The current study analyzed population-based data from 3 waves of the Ontario Student Drug Use and Health Survey (N= 15,398). Multivariate logistic regression models were used to examine the association between time spent on social media and serious psychological distress controlling for theoretically relevant covariates. Interactions were tested to assess whether the association changed over time.Results: The prevalence of serious psychological distress increased from 10.9% in 2013 to 16.8% in 2017 concomitantly with substantial increases in social media usage, especially at the highest levels. In the multivariate context, we found a significant interaction between social media use and the survey year which indicates that the association between time spent on social media and psychological distress has decreased from 2013 to 2017.Conclusion: Although both social media use and psychological distress increased between 2013 and 2017, the interaction between these variables indicates that the strength of this association has decreased over time. This finding suggests that the higher rate of heavy social media use in 2017 compared to 2013 is not actually associated with the higher rate of serious psychological distress during the same time period. From a diffusion of innovation perspective, it is possible that more recent adopters of social media may be less prone to psychological distress. More research is needed to understand the complex and evolving association between social media use and psychological distress. Researchers attempting to isolate the factors associated with the recent increases in psychological distress could benefit from broadening their investigation to factors beyond time spent on social media.

Animal nervous system organization is crucial for all body functions and its disruption can lead to severe cognitive and behavioural impairment1. This organization relies on features across scales—from the localization of synapses at the nanoscale, through neurons, which possess intricate neuronal morphologies that underpin circuit organization, to stereotyped connections between different regions of the brain2. The sheer complexity of this organ means that the feat of reconstructing and modelling the structure of a complete nervous system that is integrated across all of these scales has yet to be achieved. Here we present a complete structure–function model of the main neuropil in the nematode Caenorhabditis elegans—the nerve ring—which we derive by integrating the volumetric reconstructions from two animals with corresponding3synaptic and gap-junctional connectomes. Whereas previously the nerve ring was considered to be a densely packed tract of neural processes, we uncover internal organization and show how local neighbourhoods spatially constrain and support the synaptic connectome. We find that the C. elegansconnectome is not invariant, but that a precisely wired core circuit is embedded in a background of variable connectivity, and identify a candidate reference connectome for the core circuit. Using this reference, we propose a modular network architecture of the C. elegansbrain that supports sensory computation and integration, sensorimotor convergence and brain-wide coordination. These findings reveal scalable and robust features of brain organization that may be universal across phyla.

Knowledge of connectivity in the nervous system is essential to understanding its function. Here we describe connectomes for both adult sexes of the nematode Caenorhabditis elegans, an important model organism for neuroscience research. We present quantitative connectivity matrices that encompass all connections from sensory input to end-organ output across the entire animal, information that is necessary to model behaviour. Serial electron microscopy reconstructions that are based on the analysis of both new and previously published electron micrographs update previous results and include data on the male head. The nervous system differs between sexes at multiple levels. Several sex-shared neurons that function in circuits for sexual behaviour are sexually dimorphic in structure and connectivity. Inputs from sex-specific circuitry to central circuitry reveal points at which sexual and non-sexual pathways converge. In sex-shared central pathways, a substantial number of connections differ in strength between the sexes. Quantitative connectomes that include all connections serve as the basis for understanding how complex, adaptive behavior is generated.  Quantitative connectivity matrices (or connectomes) for both adult sexes of the nematode Caenorhabditis elegansare presented that encompass all connections from sensory input to end-organ output across the entire animal.

To examine co-occurring mental health problems among a population-based sample of high school students in Ontario, Canada, to understand their prevalence, associated risk factors, and relationship with mental health service access and utilization. The data were derived from the 2013 Ontario Student Drug Use and Health Survey, a biennial survey of students attending publicly funded Ontario schools, from a subsample of students who completed both the internalizing and substance use portions of the survey (n= 2945). Rates of co-occurring problems were calculated for the previous 12 months. Service use for students with co-occurring problems was also calculated for the past 12 months. Odds ratios were estimated using binary logistic regression models correcting for the survey design. In an adjusted model, youth with internalizing symptoms were 2.40 times more likely and youth with substance use problems were 2.24 times more likely to have accessed mental health services during the past 12 months than youth without these problems. Youth with co-occurring internalizing and substance use problems were 6.74 times more likely (95% CI 4.66–9.76, p< 0.001) to have accessed mental health services during the past year compared with youth without co-occurring problems, but only 52.8% of youth with co-occurring problems (95% CI 45.6–59.9%) used mental health services. The findings suggest that just over half of Ontario students in grades 9 through 12 who have co-occurring internalizing and substance use problems are utilizing mental health services. Further research should examine the factors related to service use in this population in order to better inform policy and program development. Examiner les troubles de santé mentale concomitants dans un échantillon populationnel d’élèves du secondaire en Ontario, au Canada, pour comprendre la prévalence de ces troubles, les facteurs de risque associés et leurs liens avec l’accès et le recours aux services de santé mentale. Nos données sont dérivées du Sondage sur la consommation de drogues et la santé des élèves de l’Ontario de 2013, une enquête bisannuelle auprès des élèves fréquentant l’école publique dans la province; elles proviennent d’un sous-échantillon d’élèves ayant rempli à la fois les parties du sondage sur l’intériorisation et sur la consommation de substances (n= 2 945). Les taux de problèmes concomitants ont été calculés pour les 12 mois antérieurs. L’utilisation des services par les élèves présentant des problèmes concomitants a aussi été calculée pour les 12 mois antérieurs. Les rapports de cotes ont été estimés au moyen de modèles de régression logistique binaires après correction du plan de sondage. Selon un modèle ajusté, les jeunes présentant des symptômes d’intériorisation étaient 2,40 fois plus susceptibles, et les jeunes présentant des problèmes de consommation de substances, 2,24 fois plus susceptibles, d’avoir eu accès à des services de santé mentale au cours des 12 mois antérieurs que les jeunes ne présentant pas de tels problèmes. Les jeunes ayant des problèmes concomitants d’intériorisation et de consommation de substances étaient 6,74 fois plus susceptibles (IC de 95 % : 4,66-9,76, p< 0,001) d’avoir eu accès à des services de santé mentale au cours de l’année antérieure que les jeunes sans problèmes concomitants, mais seulement 52,8 % des jeunes ayant des problèmes concomitants (IC de 95 % : 45,6 %-59,9 %) avaient utilisé des services de santé mentale. Ces résultats indiquent qu’un peu plus de la moitié des élèves de l’Ontario de la 9eà la 12eannée ayant des problèmes concomitants d’intériorisation et de consommation de substances ont recours aux services de santé mentale. Il faudrait pousser la recherche pour examiner les facteurs liés à l’utilisation des services dans cette population afin d’éclairer l’élaboration des politiques et des programmes.

•Varroamites are a key threat to honey bee colonies.•Genetic resources shed light on Varroabiology and interactions with their hosts.•Work describing reproductive cues and host finding shows mite vulnerabilities.•Varroaand honey bees carry shared and unique microbes.•Novel rearing and delivery methods are needed to understand and control mites.

As expanded Medicaid coverage reduces financial barriers to receiving health care among formerly incarcerated adults, more information is needed to understand the factors that predict prompt use of health care after release among insured adults with a history of substance use. This study's aim was to estimate the associations between characteristics suggested by the Andersen behavioral model of health service use and measures of health care use during the immediate reentry period and in the presence of Medicaid coverage.

The article discusses the repressive regime of the Egyptian President Abdel Fattah el-Sisi, including his claims of fighting terrorism in his oppression of the Islamic organization Muslim Brotherhood and the regime's mass killing and arrest of its citizens. The Sisi regime's relationship with the Syrian Civil War is discussed. Sisi's policy towards Gaza, including its efforts against the Islamic party Hamas, is discussed.

A shorter delay time from chronic pain diagnosis to spinal cord stimulation (SCS) implantation may make it more likely to achieve lasting therapeutic efficacy with SCS. The objective of this analysis was to determine the impact of pain‐to‐SCS time on patients’ post‐implant healthcare resource utilization (HCRU). A retrospective observational study was performed using a real‐world patient cohort derived from MarketScan®Commercial and Medicare Supplemental claims data bases from April 2008 through March 2013. The predictor variable was the time from the first diagnosis of chronic pain to permanent SCS implant. Using multivariable analysis, we studied the impact of pain‐to‐SCS time on HCRU in the first year post‐implant. For some regression tests, patients were grouped into terciles by HCRU. A total of 762 patients met inclusion criteria, with a median pain‐to‐SCS time of 1.35 years (Q1: 0.8, Q3: 1.9). For every one‐year increase in pain‐to‐SCS time, the odds increased by 33% for being in the high medical expenditures group (defined using the upper tercile: $4133 over above) over the low group (first lower: $603 or less). The odds increased by 39% for being in the high opioid prescriptions group (10–58 prescriptions) over the low group (0–1). The odds increased by 44% and 55%, respectively, for being in the high office visits (8–77) or hospitalizations (3–28) group over the low office visits (0–2) or hospitalizations (0) group. HCRU increased in the year following SCS implantation with longer pain‐to‐SCS time. These results suggest that considering SCS earlier in the care continuum for chronic pain may improve patient outcomes, with reductions in hospitalizations, clinic visits, and opioid usage.

Posttransplant lymphoproliferative disorder (PTLD) is a diversely manifesting group of lymphoid or plasmacytic proliferations found in solid organ and bone marrow transplant recipients. PTLD occurs as a result of immunosuppression and is often driven by the Epstein Barr virus. Although most commonly of B-cell origin, similar to B-cell lymphomas, PTLD can rarely present as a plasmacytic process, resembling multiple myeloma. Although more common in adults, 8 cases of plasmacytoma-like PTLD have been reported in pediatric renal and combined small bowel-liver transplant recipients. Here, we present a rare report of a plasmacytoma-like PTLD case in a pediatric heart transplant recipient.

Synapse elimination occurs in development, plasticity, and disease. Although the importance of synapse elimination has been documented in many studies, the molecular mechanisms underlying this process are unclear. Here, using the development of C. elegansRME neurons as a model, we have uncovered a function for the apoptosis pathway in synapse elimination. We find that the conserved apoptotic cell death (CED) pathway and axonal mitochondria are required for the elimination of transiently formed clusters of presynaptic components in RME neurons. This function of the CED pathway involves the activation of the actin-filament-severing protein, GSNL-1. Furthermore, we show that caspase CED-3 cleaves GSNL-1 at a conserved C-terminal region and that the cleaved active form of GSNL-1 promotes its actin-severing ability. Our data suggest that activation of the CED pathway contributes to selective elimination of synapses through disassembly of the actin filament network.

It is likely that countries in the Middle East will develop along the lines of their own particular histories, politics, and cultural idiosyncrasies. This does not mean that they have nothing to learn from Turkey but, in this moment of national empowerment, when Arabs in Egypt, Libya, Tunisia, Yemen, and perhaps Syria are throwing off decades of dictatorship, they will likely - despite an interest in Turkish political and economic development- seek their own solutions to the problems they confront. [ABSTRACT FROM AUTHOR]

It is likely that countries in the Middle East will develop along the lines of their own particular histories, politics, and cultural idiosyncrasies. This does not mean that they have nothing to learn from Turkey but, in this moment of national empowerment, when Arabs in Egypt, Libya, Tunisia, Yemen, and perhaps Syria are throwing off decades of dictatorship, they will likely -- despite an interest in Turkish political and economic development--seek their own solutions to the problems they confront. [ABSTRACT FROM AUTHOR]

The article discusses the socio-political situation in Egypt as of November 2010. It highlights the role of Egypt in Middle East politics and security policy since World War I, and as a pillar of the U.S.'s Middle East policy that helped create a regional political order aligned with the U.S.' objectives in the Middle East. It questions the ability of Egypt to continue to play this role as other regional powers emerge and domestic problems increasingly buffet the country. It discusses Egypt's foreign policy, and strategic priorities.

A fluorescent biosensor reports the localization of CDC-42 activity in the C. elegansembryo and was used to identify regulators of CDC-42 activity, one of which is involved in a novel regulatory loop that maintains cortical PAR polarity. CDC-42 activity regulates myosin II recruitment during the maintenance phase via the kinase MRCK-1.

The anterior–posterior axis of the Caenorhabditis elegans embryo is elaborated at the one-cell stage by the polarization of the partitioning (PAR) proteins at the cell cortex. Polarization is established under the control of the Rho GTPase RHO-1 and is maintained by the Rho GTPase CDC-42. To understand more clearly the role of the Rho family GTPases in polarization and division of the early embryo, we constructed a fluorescent biosensor to determine the localization of CDC-42 activity in the living embryo. A genetic screen using this biosensor identified one positive (putative guanine nucleotide exchange factor [GEF]) and one negative (putative GTPase activating protein [GAP]) regulator of CDC-42 activity: CGEF-1 and CHIN-1. CGEF-1 was required for robust activation, whereas CHIN-1 restricted the spatial extent of CDC-42 activity. Genetic studies placed CHIN-1 in a novel regulatory loop, parallel to loop described previously, that maintains cortical PAR polarity. We found that polarized distributions of the nonmuscle myosin NMY-2 at the cell cortex are independently produced by the actions of RHO-1, and its effector kinase LET-502, during establishment phase and CDC-42, and its effector kinase MRCK-1, during maintenance phase. CHIN-1 restricted NMY-2 recruitment to the anterior during maintenance phase, consistent with its role in polarizing CDC-42 activity during this phase.

Objectives/Hypothesis:Gastroesophageal reflux disease (GERD) is common in children, and extraesophageal reflux disease (EORD) has been implicated in the pathophysiology of otitis media (OM). We sought to 1) determine the incidence of pepsin/pepsinogen presence in the middle ear cleft of a large sample of pediatric patients undergoing myringotomy with tube placement for OM; 2) compare this with a control population of pediatric patients undergoing middle ear surgery (cochlear implantation) with no documented history of OM; 3) analyze potential risk factors for OM in children with EORD demonstrated by the presence of pepsin in the middle ear cleft; and 4) determine if pepsin positivity at the time of myringotomy with tube placement predisposes to posttympanostomy tube otorrhea.

OBJECTIVE To compare the postoperative complications of intracapsular tonsillectomy using a microdebrider with traditional electrodissection tonsillectomy. DESIGN Retrospective chart review. SETTING Tertiary care pediatric referral center. PATIENTS The medical records of 2944 patients undergoing tonsillectomy with or without adenoidectomy at our institution between January 1, 2002, and May 31, 2005, were reviewed. MAIN OUTCOME MEASURES Incidence of delayed postoperative hemorrhage, return to the hospital or emergency department for pain or dehydration, and the need for revision surgery. RESULTS There were 1731 patients in the intracapsular tonsillectomy group and 1212 in the traditional electrodissection tonsillectomy group. The incidence of delayed hemorrhage was 1.1% in the intracapsular tonsillectomy group and 3.4% in the traditional electrodissection tonsillectomy group (P &lt; .001). For delayed hemorrhage requiring treatment in the operating room for control, the incidence was 0.5% in the intracapsular tonsillectomy group and 2.1% in the traditional electrodissection tonsillectomy group (P &lt; .001). Treatment in the emergency department or hospital for pain or dehydration was necessary in 3.0% of the intracapsular tonsillectomy group and in 5.4% of the traditional electrodissection tonsillectomy group (P = .002). Eleven patients (0.64%) in the intracapsular tonsillectomy group required revision tonsillectomy. CONCLUSION Intracapsular tonsillectomy has a lower incidence of postoperative hemorrhage and pain leading to hospital-based evaluation compared with traditional electrodissection tonsillectomy.Arch Otolaryngol Head Neck Surg. 2007;133(9):925-928 --

AbstractThe bounds testing approach of Pesaran et al.(2001) allows examination of levels relationships between series when their orders of integration are either unknown or uncertain. In this paper it is shown that when the order of integration of a series is uncertain due to the presence of structural change, the bounds testing procedure is subject to severe size distortion and consequently detects spurious relationships between independent variables.

The frequency of tonsillectomy in the pediatric population and the significant amount of postoperative morbidity that accompanies surgical removal of the tonsils continues to engender significant debate regarding the optimal surgical technique. In addition, these factors also drive surgeons and manufacturers to devise new techniques and methodologies in limiting postoperative morbidity. This review discusses some of the most common techniques and innovations in tonsillectomy surgery and reviews current literature pertaining to these techniques. [Copyright &y& Elsevier]

The Dickey-Fuller unit root test is known to suffer severe oversizing in the presence of innovation variance breaks. In this paper, forward and reverse Dickey-Fuller regressions are proposed as a means of correcting this size distortion. The results of Monte Carlo experimentation show such an approach to result in both satisfactory size properties and increased power relative to previously suggested solutions.

ObjectiveAdenoidectomy alone or with tonsillectomy (A±T) is an effective surgical intervention in the management of otitis media in children, especially when it is performed in conjunction with insertion of pressure equalization tubes (PETs). Otorrhea and persistent tympanic membrane (TM) perforation are frequent complications. This study evaluates the effectiveness of intermediate duration middle ear ventilation using laser tympanic membrane fenestration (LTMF) without tube insertion and as an adjunct to adenoidectomy in resolving middle ear disease within the first 90 days after surgery.

Data on real consumers' expenditure for seven major OECD economies(Australia, Canada, France, Germany, Japan, the UK and the US) are subjectedto Sichel's (1993) tests of business cycle asymmetry. The results derivedshow that the high cross-country correlations in consumers' expenditure maskvery different underlying cyclical properties. Interestingly, while Franceand Germany fail to exhibit any type of asymmetric adjustment, asymmetry ofsome form and to some degree is present for all of the other economiesconsidered. The implications of these findings are discussed.

Intermediate-duration middle ear ventilation appears to be a good treatment option for selected children with otitis media. Laser-assisted myringotomy is one way to provide such ventilation. It can provide prompt pain relief and resolution of middle ear effusion and effusion-related hearing loss, and it can provide an opportunity for surveillance of antibiotic-resistant organisms. We performed laser-assisted myringotomy on 97 ears of 54 children over a 5-month period. All children had acute or recurrent otitis media or persistent middle ear effusions. Our experience suggests that laser-assisted myringotomy is a feasible treatment option for selected patients. Practitioner experience and patient and family considerations will contribute to the decision whether to use general or topical anesthesia.

The power of the recently proposed Escribano–Pfann (1998) model ofasymmetryis examined via Monte Carlo simulation. As found previously for analternative asymmetric model, the power of this model is seen to be low.

The philosophy of science literature has played an increasing role in discussion of econometric methodology in recent years, and the Hendry methodology in particular has received much attention. Despite this, the encompassing principle has been overlooked in the methodological literature. This paper addresses this by examining the major methodological implications of the principle.

The limits of sequential processing continue to be overcome with parallel and distributed architectures and algorithms. In particular, the use of parallel processing for high-performance signal processing and other grand-challenge applications is becoming the norm. However, the costs associated with such systems make it critical to be able to forecast system behavior before a hardware prototype is constructed. Processor libraries and other functional modeling and simulation techniques allow the complexities of actual systems to be portrayed in the form of software-based prototypes with significantly more accuracy than traditional simulation methods. Although the simulation times often grow beyond practical limits, distributed simulation methods have the potential to reduce these times in a scalable fashion. One such method is to implement processor library models with a parallel programming language on perhaps the most flexible, available, cost-effective, and practical of all parallel computing platforms, the workstation cluster. This technique can in many cases achieve near- linear simulation speedup using existing computer resources.

In connection with several different synthetic projects we have had occasion to look for effective methods for the synthesis of enol acetates under basic conditions. The classical method1 involving acetic anhydride and sodium or potassium acetate generally provides average yields at best, and sometimes very poor yields. In searching for more effective alternatives, we have found several which work well for specific compounds, and one method which gives yields superior to the reported literature yields in all cases but one that we have examined. We wish to report briefly on that method.

The possible presence of non-linear dynamics in macro-systems has become a preoccupation of much recent research in macroeconomics. In this paper we explore some of the empirical issues in the context of a New-Keynesian model with rational expectations in asset markets and nominal inertia in pricing and Wdges. We inject non-linearities into the pricing and investment decisions of firms and explore how this affects the way in which the economy responds to supply and demand shocks of varying magnitude. We find that when the shocks are mild the response to negative and positive shocks is more or less linear. However, when the shocks are large, major asymmetries are triggered. There are significant differences in the response of the economy to shocks of different signs and different sizes. Since the non-linearities we identify in pricing and investment are empirically founded, our results have a number of implications for the conduct of economic policy.