Anesthetics used in infants and children are implicated in the development of neurocognitive disorders. Although propofol induces neuroapoptosis in developing brain, the underlying mechanisms require elucidation and may have an energetic basis. We studied substrate utilization in immature swine anesthetized with either propofol or isoflurane for 4 hours. Piglets were infused with 13-Carbon-labeled glucose and leucine in the common carotid artery to assess citric acid cycle (CAC) metabolism in the parietal cortex. The anesthetics produced similar systemic hemodynamics and cerebral oxygen saturation by near-infrared spectroscopy. Compared with isoflurane, propofol depleted ATP and glycogen stores. Propofol decreased pools of the CAC intermediates, citrate, and a-ketoglutarate, while markedly increasing succinate along with decreasing mitochondrial complex II activity. Propofol also inhibited acetyl-CoA entry into the CAC through pyruvate dehydrogenase, while promoting glycolytic flux with marked lactate accumulation. Although oxygen supply appeared similar between the anesthetic groups, propofol yielded a metabolic phenotype that resembled a hypoxic state. Propofol impairs substrate flux through the CAC in the immature cerebral cortex. These impairments occurred without systemic metabolic perturbations that typically accompany propofol infusion syndrome. These metabolic abnormalities may have a role in the neurotoxity observed with propofol in the vulnerable immature brain.
Normal operation of RFID detection systems may cause inhibition of temporary pacing systems consistent with oversensing from EMI. Precaution should be taken, including considering pacing asynchronously to avoid effects of inhibition.
Why do states accept refugees? While there are a number of factors that influence a state’s decision to accept refugees, interstate relations play an important yet understudied role in refugee flows. In this paper, we build on previous work that has suggested that states with an adversarial relationship will be more likely to accept refugees. We incorporate existing conceptualization and theory from the rivalry literature and extend this logic to state strategy of refugee acceptance to provide one of the first empirical evaluations of refugee acceptance by states. Specifically, we argue that the issues rivals are contending over will change the incentives and disincentives for admitting a rival’s refugees. We anticipate that rivals disputing over ideology will be more likely to accept their rival’s refugees than rivals contending over other rivalry types. We test and find evidence for our arguments using a data set of all directed dyads from 1960 to 2006.
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