Preventing pain on injection of propofol: A comparison between lignocaine pre-treatment and lignocaine added to propofol

Publisher's copy made available with the permission of the publisherA randomized double-blind study compared two methods of preventing the pain from injection of propofol, lignocaine pre-treatment followed by propofol and lignocaine added to propofol. One hundred patients received a 4 ml solution intravenously with a venous tourniquet for 1 minute, followed by propofol mixed with 2 ml of solution. Patients were divided into two treatment groups of 50 patients each: 4 ml 1% lignocaine pre-treatment followed by propofol and 2 ml saline, or 4 ml saline followed by propofol and 2 ml 2% lignocaine. Pain was assessed with a 100 mm visual analogue scale after induction and in recovery. The incidence of injection pain was 8% in the propofol mixed with lignocaine group, and 28% in the lignocaine pre-treatment group. This difference is statistically significant (P=0.017). For those patients who had pain, the mean pain score was 26.5 on induction for the propofol with lignocaine group (n=4), while the mean score was 44.4 for the pre-treatment group (n=13). The difference was not statistically significant (P=0.25). None of the propofol mixed with lignocaine group recalled pain, while 13 of the pre-treatment group did so. Lignocaine pre-treatment does not improve the immediate or the recalled comfort of patients during propofol induction when compared to lignocaine added to propofol. It is recommended that lignocaine should be added to propofol for induction rather than given before induction.P. Lee, W. J. Russellhttp://www.aaic.net.au/Article.asp?D=200339

National Ignition Facility frequency converter development

A preliminary error budget for the third harmonic converter for the National Ignition Facility (NIF) laser driver has been developed using a root-sum-square-accumulation of error sources. Such a budget sets an upper bound on the allowable magnitude of the various effects that reduce conversion efficiency. Development efforts on crystal mounting technology and crystal quality studies are discussed

Thermodynamic Potential for Superfluid 3He in Aerogel

We present a free energy functional for superfluid 3He in the presence of homogeneously distributed impurity disorder which extends the Ginzburg-Landau free energy functional to all temperatures. We use the new free energy functional to calculate the thermodynamic potential, entropy, heat capacity and density of states for the B-phase of superfluid 3He in homogeneous, isotropic aerogel.Comment: 10 pages, 4 figure

Grazing protozoa and the evolution of the Escherichia coli O157:H7 Shiga toxin-encoding prophage

Humans play little role in the epidemiology of Escherichia coli O157:H7, a commensal bacterium of cattle. Why then does E. coli O157:H7 code for virulence determinants, like the Shiga toxins (Stxs), responsible for the morbidity and mortality of colonized humans? One possibility is that the virulence of these bacteria to humans is coincidental and these virulence factors evolved for and are maintained for other roles they play in the ecology of these bacteria. Here, we test the hypothesis that the carriage of the Stx-encoding prophage of E. coli O157:H7 increases the rate of survival of E. coli in the presence of grazing protozoa, Tetrahymena pyriformis. In the presence but not the absence of Tetrahymena, the carriage of the Stx-encoding prophage considerably augments the fitness of E. coli K-12 as well as clinical isolates of E. coli O157 by increasing the rate of survival of the bacteria in the food vacuoles of these ciliates. Grazing protozoa in the environment or natural host are likely to play a significant role in the ecology and maintenance of the Stx-encoding prophage of E. coli O157:H7 and may well contribute to the evolution of the virulence of these bacteria to colonize humans

A two-species model of a two-dimensional sandpile surface: a case of asymptotic roughening

We present and analyze a model of an evolving sandpile surface in (2 + 1) dimensions where the dynamics of mobile grains ({\rho}(x, t)) and immobile clusters (h(x, t)) are coupled. Our coupling models the situation where the sandpile is flat on average, so that there is no bias due to gravity. We find anomalous scaling: the expected logarithmic smoothing at short length and time scales gives way to roughening in the asymptotic limit, where novel and non-trivial exponents are found.Comment: 7 Pages, 6 Figures; Granular Matter, 2012 (Online

Tunable local polariton modes in semiconductors

We study the local states within the polariton bandgap that arise due to deep defect centers with strong electron-phonon coupling. Electron transitions involving deep levels may result in alteration of local elastic constants. In this case, substantial reversible transformations of the impurity polariton density of states occur, which include the appearance/disappearance of the polariton impurity band, its shift and/or the modification of its shape. These changes can be induced by thermo- and photo-excitation of the localized electron states or by trapping of injected charge carriers. We develop a simple model, which is applied to the $O_P$ center in $GaP$. Further possible experimental realizations of the effect are discussed.Comment: 7 pages, 3 figure

Progress in operational modeling in support of oil spill response

Following the 2010 Deepwater Horizon accident of a massive blow-out in the Gulf of Mexico, scientists from government, industry, and academia collaborated to advance oil spill modeling and share best practices in model algorithms, parameterizations, and application protocols. This synergy was greatly enhanced by research funded under the Gulf of Mexico Research Initiative (GoMRI), a 10-year enterprise that allowed unprecedented collection of observations and data products, novel experiments, and international collaborations that focused on the Gulf of Mexico, but resulted in the generation of scientific findings and tools of broader value. Operational oil spill modeling greatly benefited from research during the GoMRI decade. This paper provides a comprehensive synthesis of the related scientific advances, remaining challenges, and future outlook. Two main modeling components are discussed: Ocean circulation and oil spill models, to provide details on all attributes that contribute to the success and limitations of the integrated oil spill forecasts. These forecasts are discussed in tandem with uncertainty factors and methods to mitigate them. The paper focuses on operational aspects of oil spill modeling and forecasting, including examples of international operational center practices, observational needs, communication protocols, and promising new methodologies

A standardization approach to compare treatment safety and effectiveness outcomes between clinical trials and real-world populations in psoriasis.

BACKGROUND: Patients recruited in randomized controlled trials (RCTs) for biologic therapies in psoriasis are not fully representative of the real-world psoriasis population. OBJECTIVES: Firstly, to investigate whether patient characteristics are associated with being included in a psoriasis RCT. Secondly, to estimate the differences in the incidence of severe adverse events (SAEs) and the response rate between RCT and real-world populations of patients on biologic therapies for psoriasis using a standardization method. METHODS: Data from the British Association of Dermatologists Biologics and Immunomodulators Register (BADBIR) were appended to individual participant-level data from two RCTs assessing ustekinumab in patients with psoriasis. Baseline variables were assessed for association of being in an RCT using a multivariable logistic regression model. Propensity score weights were derived to reweigh the registry population so that variables had the distribution of the trial population. We measured the C-statistic of the model with trial status as the dependent variable, and the risk differences in the incidence rate of SAEs in the first year and Psoriasis Area and Severity Index (PASI) after 6 months in the BADBIR cohort before and after weighting. RESULTS: In total 6790 registry and 2021 RCT participants were included. The multivariable logistic regression model had a C-statistic of 0.82 [95% confidence interval (CI) 0.81-0.83]. The risk differences for the incidence rate of SAEs and the proportion of patients with PASI < 1.5 were 9.27 (95% CI -3.91-22.5) per 1000 person-years and 0.95 (95% CI -1.98-4.15), respectively. CONCLUSIONS: Our results suggest that RCTs of biologic therapies in patients with psoriasis are not fully representative of the real-world population, but this lack of external validity does not account for the efficacy-effectiveness gap. What's already known about this topic? Patients with psoriasis who would not be eligible for randomized controlled trials (RCTs) investigating biologic therapies have a greater risk of serious adverse events and lower treatment effectiveness than patients who would have been eligible. What does this study add? Baseline patient characteristics were shown to be predictive of whether a patient would have been eligible for enrolment in an RCT for psoriasis biologic therapy. We did not find any efficacy-effectiveness gap between the sample representative of the real-world population of patients with psoriasis and the sample representative of the RCT population. Factors outside of baseline patient characteristics, such as observer effect and higher adherence in RCTs, may be more influential in any efficacy-effectiveness gap between trial and real-world populations of patients with psoriasis

Phase coexistence and transitions between antiferromagnetic and ferromagnetic states in a synthetic antiferromagnet

In synthetic antiferromagnets (SAFs), antiferromagnetic (AFM) order and synthesis using conventional sputtering techniques is combined to produce systems that are advantageous for spintronics applications. Here we present the preparation and study of SAF multilayers possessing both perpendicular magnetic anisotropy and the Dzyaloshinskii-Moriya interaction. The multilayers have an antiferromagnetically aligned ground state but can be forced into a full ferromagnetic (FM) alignment by applying an out-of-plane field ∼100mT. We study the spin textures in these multilayers in their ground state as well as around the transition point between the AFM and FM states at fields ∼40 mT by imaging the spin textures using complementary methods: photoemission electron, magnetic force, and Lorentz transmission electron microscopies. The transformation into a FM state by field proceeds by a nucleation and growth process, where skyrmionic nuclei form and then broaden into regions containing a ferromagnetically aligned labyrinth pattern that eventually occupies the whole film. Remarkably, this process occurs without any significant change in the net magnetic moment of the multilayer. The mix of antiferromagnetically and ferromagnetically aligned regions on the micron scale in the middle of this transition is reminiscent of a first-order phase transition that exhibits phase coexistence. These results are important for guiding the design of spintronic devices whose operation is based on spin textures in perpendicularly magnetized SAFs

Environmental monitoring : phase 5 final report (April 2019 - March 2020)

This report presents the results and interpretation for Phase 5 of an integrated environmental monitoring programme that is being undertaken around two proposed shale gas sites in England – Preston New Road, Lancashire and Kirby Misperton, North Yorkshire. The report should be read in conjunction with previous reports freely available through the project website1 . These provide additional background to the project, presentation of earlier results and the rationale for establishment of the different elements of the monitoring programme