A study of the elements copper through uranium in Sirius A: Contributions from STIS and ground-based spectra

We determine abundances or upper limits for all of the 55 stable elements from copper to uranium for the A1 Vm star Sirius. The purpose of the study is to assemble the most complete picture of elemental abundances with the hope of revealing the chemical history of the brightest star in the sky, apart from the Sun. We also explore the relationship of this hot metallic-line (Am) star to its cooler congeners, as well as the hotter, weakly- or non-magnetic mercury-manganese (HgMn) stars. Our primary observational material consists of {\em Hubble Space Telescope} ($HST$) spectra taken with the Space Telescope Imaging Spectrograph (STIS) in the ASTRAL project. We have also used archival material from the %\citep/{ayr10}. $COPERNICUS$ satellite, and from the $HST$ Goddard High-Resolution Spectrograph (GHRS), as well as ground-based spectra from Furenlid, Westin, Kurucz, Wahlgren, and their coworkers, ESO spectra from the UVESPOP project, and NARVAL spectra retrieved from PolarBase. Our analysis has been primarily by spectral synthesis, and in this work we have had the great advantage of extensive atomic data unavailable to earlier workers. We find most abundances as well as upper limits range from 10 to 100 times above solar values. We see no indication of the huge abundance excesses of 1000 or more that occur among many chemically peculiar (CP) stars of the upper main sequence. The picture of Sirius as a hot Am star is reinforced.Comment: With 6 Figures and 4 Tables; accepted for publication in Ap

A randomised clinical trial of intrapartum fetal monitoring with computer analysis and alerts versus previously available monitoring

<p>Abstract</p> <p>Background</p> <p>Intrapartum fetal hypoxia remains an important cause of death and permanent handicap and in a significant proportion of cases there is evidence of suboptimal care related to fetal surveillance. Cardiotocographic (CTG) monitoring remains the basis of intrapartum surveillance, but its interpretation by healthcare professionals lacks reproducibility and the technology has not been shown to improve clinically important outcomes. The addition of fetal electrocardiogram analysis has increased the potential to avoid adverse outcomes, but CTG interpretation remains its main weakness. A program for computerised analysis of intrapartum fetal signals, incorporating real-time alerts for healthcare professionals, has recently been developed. There is a need to determine whether this technology can result in better perinatal outcomes.</p> <p>Methods/design</p> <p>This is a multicentre randomised clinical trial. Inclusion criteria are: women aged ≥ 16 years, able to provide written informed consent, singleton pregnancies ≥ 36 weeks, cephalic presentation, no known major fetal malformations, in labour but excluding active second stage, planned for continuous CTG monitoring, and no known contra-indication for vaginal delivery. Eligible women will be randomised using a computer-generated randomisation sequence to one of the two arms: continuous computer analysis of fetal monitoring signals with real-time alerts (intervention arm) or continuous CTG monitoring as previously performed (control arm). Electrocardiographic monitoring and fetal scalp blood sampling will be available in both arms. The primary outcome measure is the incidence of fetal metabolic acidosis (umbilical artery pH < 7.05, BD_ecf> 12 mmol/L). Secondary outcome measures are: caesarean section and instrumental vaginal delivery rates, use of fetal blood sampling, 5-minute Apgar score < 7, neonatal intensive care unit admission, moderate and severe neonatal encephalopathy with a marker of hypoxia, perinatal death, rate of internal monitoring, tracing quality, and signal loss. Analysis will follow an intention to treat principle. Incidences of primary and secondary outcomes will be compared between groups. Assuming a reduction in metabolic acidosis from 2.8% to 1.8%, using a two-sided test with alpha = 0.05, power = 0.80, and 10% loss to follow-up, 8133 women need to be randomised.</p> <p>Discussion</p> <p>This study will provide evidence of the impact of intrapartum monitoring with computer analysis and real-time alerts on the incidence of adverse perinatal outcomes, intrapartum interventions and signal quality. (Current controlled trials ISRCTN42314164)</p

The impact of single and shared rooms on family centred care in children's hospitals

Aim: To explore whether and how spatial aspects of children’s hospital wards (single and shared rooms) impact upon family centred care. Background: Family centred care has been widely adopted in paediatric hospitals internationally. Recent hospital building programmes in many countries have prioritised the provision of single rooms over shared rooms. Limited attention has, however, been paid to the potential impact of spatial aspects of paediatric wards on family centred care. Design: Qualitative, ethnographic. Methods: Phase 1; observation within 4 wards of a specialist children’s hospital. Phase 2; interviews with 17 children aged 5-16 years and 60 parents/carers. Sixty nursing and support staff also took part in interviews and focus group discussions. All data were subjected to thematic analysis. Results: Two themes emerged from the data analysis: ‘role expectations’ and ‘family-nurse interactions’. The latter theme comprised 3 sub-themes: ‘family support needs’, ‘monitoring children’s wellbeing’ and ‘survey-assess-interact within spatial contexts’. Conclusion: Spatial configurations within hospital wards significantly impacted upon the relationships and interactions between children, parents and nurses, which played out differently in single and shared rooms. Increasing the provision of single rooms within wards is therefore likely to directly affect how family centred care manifests in practice. Relevance to clinical practice: Nurses need to be sensitive to the impact of spatial characteristics, and particularly of single and shared rooms, on families’ experiences of children’s hospital wards. Nurses’ contribution to and experience of family centred care can be expected to change significantly when spatial characteristics of wards change and, as is currently the vogue, hospitals maximise the provision of single rather than shared rooms

Anti-Transforming Growth Factor ß Antibody Treatment Rescues Bone Loss and Prevents Breast Cancer Metastasis to Bone

Breast cancer often metastasizes to bone causing osteolytic bone resorption which releases active TGFβ. Because TGFβ favors progression of breast cancer metastasis to bone, we hypothesized that treatment using anti-TGFβ antibody may reduce tumor burden and rescue tumor-associated bone loss in metastatic breast cancer. In this study we have tested the efficacy of an anti-TGFβ antibody 1D11 preventing breast cancer bone metastasis. We have used two preclinical breast cancer bone metastasis models, in which either human breast cancer cells or murine mammary tumor cells were injected in host mice via left cardiac ventricle. Using several in vivo, in vitro and ex vivo assays, we have demonstrated that anti-TGFβ antibody treatment have significantly reduced tumor burden in the bone along with a statistically significant threefold reduction in osteolytic lesion number and tenfold reduction in osteolytic lesion area. A decrease in osteoclast numbers (p = 0.027) in vivo and osteoclastogenesis ex vivo were also observed. Most importantly, in tumor-bearing mice, anti-TGFβ treatment resulted in a twofold increase in bone volume (p<0.01). In addition, treatment with anti-TGFβ antibody increased the mineral-to-collagen ratio in vivo, a reflection of improved tissue level properties. Moreover, anti-TGFβ antibody directly increased mineralized matrix formation in calverial osteoblast (p = 0.005), suggesting a direct beneficial role of anti-TGFβ antibody treatment on osteoblasts. Data presented here demonstrate that anti-TGFβ treatment may offer a novel therapeutic option for tumor-induced bone disease and has the dual potential for simultaneously decreasing tumor burden and rescue bone loss in breast cancer to bone metastases. This approach of intervention has the potential to reduce skeletal related events (SREs) in breast cancer survivors