Patient satisfaction during and following procedural sedation for ambulatory surgery

Background: Patient satisfaction is multidimensional. The clinician's perspective of a good outcome and the patient's experience of a satisfactory service are often two different end-points. The primary aim of our study was to assess the perioperative experience of patients undergoing procedural sedation. A secondary aim was to create a postoperative questionnaire which could be used as a measurement tool. The questions could also be used as an audit to assist with adherence to quality assurance and clinical governance. Method: A questionnaire was compiled to attempt to assess the perioperative aspects of procedural sedation. Five hundred consecutive patients undergoing procedural sedation for dental-related outpatient procedures were asked to complete a questionnaire. Patients who didn't complete it were excluded. Ninety-eight per cent of the patients returned the questionnaire and 489 questionnaires were evaluated. Results: A total of 489 patients were included. Ninetythree per cent of the patients expressed a good (7+/10) overall experience of procedural sedation, and 92.6% indicated that they would recommend it to others. Conclusion: Our study population showed a high level of satisfaction with their sedation experience. It is suggested that the devised questionnaire could be used successfully in future as an assessment tool or audit of patient satisfaction following procedural sedation for ambulatory surgery.DHE

Patient satisfaction during and following procedural sedation for ambulatory surgery

Background: Patient satisfaction is multidimensional. The clinician’s perspective of a good outcome and the patient’s experience of a satisfactory service are often two different end-points. The primary aim of our study was to assess the perioperative experience of patients undergoing procedural sedation. A  secondary aim was to create a postoperative questionnaire which could be used as a measurement tool. The questions could also be used as an audit to assist with adherence to quality assurance and clinical governance.Method: A questionnaire was compiled to attempt to assess the perioperative aspects of procedural  sedation. Five hundred consecutive patients undergoing procedural sedation for dental-related outpatient  procedures were asked to complete a questionnaire. Patients who didn’t complete it were excluded.  Ninety-eight per cent of the patients returned the questionnaire and 489 questionnaires were evaluated.Results: A total of 489 patients were included. Ninety-three per cent of the patients expressed a good (7+/10) overall experience of procedural sedation, and 92.6% indicated that they would recommend it to others.Conclusion: Our study population showed a high level of satisfaction with their sedation experience. It is suggested that the devised questionnaire could be used successfully in future as an assessment tool or audit of patient satisfaction following procedural sedation for ambulatory surgery.Keywords: patient satisfaction, postoperative questionnaire, procedural sedatio

Gravitational waves from intermediate-mass black holes in young clusters

Massive young clusters (YCs) are expected to host intermediate-mass black holes (IMBHs) born via runaway collapse. These IMBHs are likely in binaries and can undergo mergers with other compact objects, such as stellar mass black holes (BHs) and neutron stars (NSs). We derive the frequency of such mergers starting from information available in the Local Universe. Mergers of IMBH-NS and IMBH-BH binaries are sources of gravitational waves (GWs), which might allow us to reveal the presence of IMBHs. We thus examine their detectability by current and future GW observatories, both ground- and space-based. In particular, as representative of different classes of instruments we consider Initial and Advanced LIGO, the Einstein gravitational-wave Telescope (ET) and the Laser Interferometer Space Antenna (LISA). We find that IMBH mergers are unlikely to be detected with instruments operating at the current sensitivity (Initial LIGO). LISA detections are disfavored by the mass range of IMBH-NS and IMBH-BH binaries: less than one event per year is expected to be observed by such instrument. Advanced LIGO is expected to observe a few merger events involving IMBH binaries in a 1-year long observation. Advanced LIGO is particularly suited for mergers of relatively light IMBHs (~100 Msun) with stellar mass BHs. The number of mergers detectable with ET is much larger: tens (hundreds) of IMBH-NS (IMBH-BH) mergers might be observed per year, according to the runaway collapse scenario for the formation of IMBHs. We note that our results are affected by large uncertainties, produced by poor observational constraints on many of the physical processes involved in this study, such as the evolution of the YC density with redshift.[abridged]Comment: 29 pages, 4 figures, accepted for publication in Ap

Understanding the faint red galaxy population using large-scale clustering measurements from SDSS DR7

We use data from the SDSS to investigate the evolution of the large-scale galaxy bias as a function of luminosity for red galaxies. We carefully consider correlation functions of galaxies selected from both photometric and spectroscopic data, and cross-correlations between them, to obtain multiple measurements of the large-scale bias. We find, for our most robust analyses, a strong increase in bias with luminosity for the most luminous galaxies, an intermediate regime where bias does not evolve strongly over a range of two magnitudes in galaxy luminosity, and no evidence for an upturn in bias for fainter red galaxies. Previous work has found an increase in bias to low luminosities that has been widely interpreted as being caused by a strong preference for red dwarf galaxies to be satellites in the most massive halos. We can recover such an upturn in bias to faint luminosities if we push our measurements to small scales, and include galaxy clustering measurements along the line-of-sight, where we expect non-linear effects to be the strongest. The results that we expect to be most robust suggest that the low luminosity population of red galaxies is not dominated by satellite galaxies occupying the most massive haloes.Comment: Matches version accepted by MNRA

Cosmological Constraints from the Clustering of the Sloan Digital Sky Survey DR7 Luminous Red Galaxies

We present the power spectrum of the reconstructed halo density field derived from a sample of Luminous Red Galaxies (LRGs) from the Sloan Digital Sky Survey Seventh Data Release (DR7). The halo power spectrum has a direct connection to the underlying dark matter power for k <= 0.2 h/Mpc, well into the quasi-linear regime. This enables us to use a factor of ~8 more modes in the cosmological analysis than an analysis with kmax = 0.1 h/Mpc, as was adopted in the SDSS team analysis of the DR4 LRG sample (Tegmark et al. 2006). The observed halo power spectrum for 0.02 < k < 0.2 h/Mpc is well-fit by our model: chi^2 = 39.6 for 40 degrees of freedom for the best fit LCDM model. We find \Omega_m h^2 * (n_s/0.96)^0.13 = 0.141^{+0.009}_{-0.012} for a power law primordial power spectrum with spectral index n_s and \Omega_b h^2 = 0.02265 fixed, consistent with CMB measurements. The halo power spectrum also constrains the ratio of the comoving sound horizon at the baryon-drag epoch to an effective distance to z=0.35: r_s/D_V(0.35) = 0.1097^{+0.0039}_{-0.0042}. Combining the halo power spectrum measurement with the WMAP 5 year results, for the flat LCDM model we find \Omega_m = 0.289 +/- 0.019 and H_0 = 69.4 +/- 1.6 km/s/Mpc. Allowing for massive neutrinos in LCDM, we find \sum m_{\nu} < 0.62 eV at the 95% confidence level. If we instead consider the effective number of relativistic species Neff as a free parameter, we find Neff = 4.8^{+1.8}_{-1.7}. Combining also with the Kowalski et al. (2008) supernova sample, we find \Omega_{tot} = 1.011 +/- 0.009 and w = -0.99 +/- 0.11 for an open cosmology with constant dark energy equation of state w.Comment: 26 pages, 19 figures, submitted to MNRAS. The power spectrum and a module to calculate the likelihoods is publicly available at http://lambda.gsfc.nasa.gov/toolbox/lrgdr/ . v2 fixes abstract formatting issu

High prevalence of non-accidental trauma among deceased children presenting at Level I trauma centers in the Netherlands

PURPOSE: Between 0.1—3% of injured children who present at a hospital emergency department ultimately die as a result of their injuries. These events are typically reported as unnatural causes of death and may result from either accidental or non-accidental trauma (NAT). Examples of the latter include trauma that is inflicted directly or resulting from neglect. Although consultation with a forensic physician is mandatory for all deceased children, the prevalence of fatal inflicted trauma or neglect among children is currently unclear. METHODS: This is a retrospective study that included children (0–18 years) who presented and died at one of the 11 Level I trauma centers in the Netherlands between January 1, 2014, and January 1, 2019. Outcomes were classified based on the conclusions of the Child Abuse and Neglect team or those of forensic pathologists and/or the court in cases referred for legally mandated autopsies. Cases in which conclusions were unavailable and there was no clear accidental cause of death were reviewed by an expert panel. RESULTS: The study included 175 cases of childhood death. Seventeen (9.7%) of these children died due to inflicted trauma (9.7%), 18 (10.3%) due to neglect, and 140 (80%) due to accidents. Preschool children (< 5 years old) were significantly more likely to present with injuries due to inflicted trauma and neglect compared to older children (44% versus 6%, p < 0.001, odds ratio [OR] 5.80, 95% confidence interval [CI] 2.66–12.65). Drowning accounted for 14 of the 18 (78%) pediatric deaths due to neglect, representing 8% of the total cases. Postmortem radiological studies and autopsies were performed on 37 (21%) of all cases of childhood death. CONCLUSION: One of every five pediatric deaths in our nationwide Level I trauma center study was attributed to NAT; 44% of these deaths were the result of trauma experienced by preschool-aged children. A remarkable number of fatal drownings were due to neglect. Postmortem radiological studies and autopsies were performed in only one-fifth of all deceased children. The limited use of postmortem investigations may have resulted in missed cases of NAT, which will result in an overall underestimation of fatal NAT experienced by children. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12024-021-00416-7

Constraining CMB-consistent primordial voids with cluster evolution

Using cosmological simulations, we make predictions for the distribution of clusters in a plausible non-gaussian model where primordial voids nucleated during inflation act together with scale-invariant adiabatic gaussian fluctuations as seeds for the formation of large-scale structure. This model agrees with most recent observations of the anisotropies of the cosmic microwave background (CMB) and can account for the excess of power measured on cluster scales by the Cosmic Background Imager (CBI), the large empty regions apparent in nearby galaxy redshift surveys and the number of giant arcs measured in deep cluster lensing surveys. We show that the z=0 cluster mass function differs from predictions for a standard LCDM cosmology with the same sigma_8. Moreover, as massive clusters also form much earlier in the "void" scenario, we show that integrated number counts of SZ sources and simple statistics of strong lensing can easily falsify this model.Comment: 12 pages, 9 figures, figure 1 and 2 available as .gif file. Matches accepted version (significant improvements but main conclusions unchanged

The Fourteenth Data Release of the Sloan Digital Sky Survey: First Spectroscopic Data from the extended Baryon Oscillation Spectroscopic Survey and from the second phase of the Apache Point Observatory Galactic Evolution Experiment

The fourth generation of the Sloan Digital Sky Survey (SDSS-IV) has been in operation since July 2014. This paper describes the second data release from this phase, and the fourteenth from SDSS overall (making this, Data Release Fourteen or DR14). This release makes public data taken by SDSS-IV in its first two years of operation (July 2014-2016). Like all previous SDSS releases, DR14 is cumulative, including the most recent reductions and calibrations of all data taken by SDSS since the first phase began operations in 2000. New in DR14 is the first public release of data from the extended Baryon Oscillation Spectroscopic Survey (eBOSS); the first data from the second phase of the Apache Point Observatory (APO) Galactic Evolution Experiment (APOGEE-2), including stellar parameter estimates from an innovative data driven machine learning algorithm known as "The Cannon"; and almost twice as many data cubes from the Mapping Nearby Galaxies at APO (MaNGA) survey as were in the previous release (N = 2812 in total). This paper describes the location and format of the publicly available data from SDSS-IV surveys. We provide references to the important technical papers describing how these data have been taken (both targeting and observation details) and processed for scientific use. The SDSS website (www.sdss.org) has been updated for this release, and provides links to data downloads, as well as tutorials and examples of data use. SDSS-IV is planning to continue to collect astronomical data until 2020, and will be followed by SDSS-V.Comment: SDSS-IV collaboration alphabetical author data release paper. DR14 happened on 31st July 2017. 19 pages, 5 figures. Accepted by ApJS on 28th Nov 2017 (this is the "post-print" and "post-proofs" version; minor corrections only from v1, and most of errors found in proofs corrected

The clustering of galaxies in the SDSS-III Baryon Oscillation Spectroscopic Survey: the low-redshift sample

We report on the small-scale (0.5 r h−1 Mpc) clustering of 78 895 massive (M* ~ 1011.3 M⊙) galaxies at 0.2 z 13 h−1 M⊙, a large-scale bias of ~2.0 and a satellite fraction of 12 ± 2 per cent. Thus, these galaxies occupy haloes with average masses in between those of the higher redshift BOSS CMASS sample and the original SDSS I/II luminous red galaxy sample

Methylobacterium Genome Sequences: A Reference Blueprint to Investigate Microbial Metabolism of C1 Compounds from Natural and Industrial Sources

Methylotrophy describes the ability of organisms to grow on reduced organic compounds without carbon-carbon bonds. The genomes of two pink-pigmented facultative methylotrophic bacteria of the Alpha-proteobacterial genus Methylobacterium, the reference species Methylobacterium extorquens strain AM1 and the dichloromethane-degrading strain DM4, were compared. Methodology/Principal Findings The 6.88 Mb genome of strain AM1 comprises a 5.51 Mb chromosome, a 1.26 Mb megaplasmid and three plasmids, while the 6.12 Mb genome of strain DM4 features a 5.94 Mb chromosome and two plasmids. The chromosomes are highly syntenic and share a large majority of genes, while plasmids are mostly strain-specific, with the exception of a 130 kb region of the strain AM1 megaplasmid which is syntenic to a chromosomal region of strain DM4. Both genomes contain large sets of insertion elements, many of them strain-specific, suggesting an important potential for genomic plasticity. Most of the genomic determinants associated with methylotrophy are nearly identical, with two exceptions that illustrate the metabolic and genomic versatility of Methylobacterium. A 126 kb dichloromethane utilization (dcm) gene cluster is essential for the ability of strain DM4 to use DCM as the sole carbon and energy source for growth and is unique to strain DM4. The methylamine utilization (mau) gene cluster is only found in strain AM1, indicating that strain DM4 employs an alternative system for growth with methylamine. The dcm and mau clusters represent two of the chromosomal genomic islands (AM1: 28; DM4: 17) that were defined. The mau cluster is flanked by mobile elements, but the dcm cluster disrupts a gene annotated as chelatase and for which we propose the name “island integration determinant” (iid).Conclusion/Significance These two genome sequences provide a platform for intra- and interspecies genomic comparisons in the genus Methylobacterium, and for investigations of the adaptive mechanisms which allow bacterial lineages to acquire methylotrophic lifestyles.Organismic and Evolutionary Biolog