Pharmacokinetics of propofol in severely obese surgical patients

BACKGROUND: Existing PK models of propofol include sparse data from very obese patients. The aim of this study was to develop a PK model based on standardised surgical conditions and spanning from normal-weight up to, and including, a high number of very obese patients. METHODS: Adult patients scheduled for laparoscopic cholecystectomy or bariatric surgery were studied. Anaesthesia was induced with propofol 2 mg/kg adjusted body weight over 2 min followed by 6 mg/kg/h adjusted body weight over 30 min. For the remainder of the operation anaesthesia was maintained with sevoflurane. Remifentanil was dosed according to clinical need. Eight arterial samples were drawn in a randomised block sampling regimen over a span of 24 h. Time-concentration data were analysed by population PK modelling using non-linear mixed-effects modelling. RESULTS: Four hundred and seventy four serum propofol concentrations were collected from 69 patients aged 19-60 years with a BMI 21.6-67.3 kg/m2 . Twenty one patients had a BMI above 50 kg/m2 . A 3-compartment PK model was produced wherein three different body weight descriptors and sex were included as covariates in the final model. Total body weight was found to be a covariate for clearance and Q3; lean body weight for V1, V2 and Q2; predicted normal weight for V3 and sex for V1. The fixed allometric exponent of 0.75 applied to all clearance parameters improved the performance of the model. Accuracy and precision were 1.4% and 21.7% respectively in post-hoc performance evaluation. CONCLUSION: We have developed a new PK model of propofol that is suitable for all adult weight classes. Specifically, it is based on data from an unprecedented number of individuals with very high BMI

Fault interpretation uncertainties using seismic data, and the effects on fault seal analysis: a case study from the Horda Platform, with implications for CO2 storage

Abstract. Significant uncertainties occur through varying methodologies when interpreting faults using seismic data. These uncertainties are carried through to the interpretation of how faults may act as baffles or barriers, or increase fluid flow. How fault segments are picked when interpreting structures, i.e. which seismic line orientation, bin spacing and line spacing are specified, as well as what surface generation algorithm is used, will dictate how rugose the surface is and hence will impact any further interpretation such as fault seal or fault growth models. We can observe that an optimum spacing for fault interpretation for this case study is set at approximately 100 m, both for accuracy of analysis but also for considering time invested. It appears that any additional detail through interpretation with a line spacing of ≤ 50 m adds complexity associated with sensitivities by the individual interpreter. Further, the locations of all seismic-scale fault segmentation identified on throw–distance plots using the finest line spacing are also observed when 100 m line spacing is used. Hence, interpreting at a finer scale may not necessarily improve the subsurface model and any related analysis but in fact lead to the production of very rough surfaces, which impacts any further fault analysis. Interpreting on spacing greater than 100 m often leads to overly smoothed fault surfaces that miss details that could be crucial, both for fault seal as well as for fault growth models. Uncertainty in seismic interpretation methodology will follow through to fault seal analysis, specifically for analysis of whether in situ stresses combined with increased pressure through CO2 injection will act to reactivate the faults, leading to up-fault fluid flow. We have shown that changing picking strategies alter the interpreted stability of the fault, where picking with an increased line spacing has shown to increase the overall fault stability. Picking strategy has shown to have a minor, although potentially crucial, impact on the predicted shale gouge ratio.</jats:p

Antigen-Presenting Activity of Non-Langerhans Epidermal Cells in Contact Hypersensitivity Reactions

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72263/1/j.1365-3083.1990.tb02914.x.pd

Stability and Representation Dependence of the Quantum Skyrmion

A constructive realization of Skyrme's conjecture that an effective pion mass ``may arise as a self consistent quantal effect'' based on an ab initio quantum treatment of the Skyrme model is presented. In this quantum mechanical Skyrme model the spectrum of states with $I=J$, which appears in the collective quantization, terminates without any infinite tower of unphysical states. The termination point depends on the model parameters and the dimension of the SU(2) representation. Representations, in which the nucleon and $\Delta_{33}$ resonance are the only stable states, exist. The model is developed for both irreducible and reducible representations of general dimension. States with spin larger than 1/2 are shown to be deformed. The representation dependence of the baryon observables is illustrated numerically.Comment: 19 pages, Late

Photochemical modelling in the Po basin with focus on formaldehyde and ozone

As part of the EU project FORMAT ( Formaldehyde as a Tracer of Oxidation in the Troposphere), a field campaign was carried out in the vicinity of Milan during the summer of 2002. Results from a 3-D regional chemical transport model (NILU RCTM) were used to interpret the observations focusing primarily on HCHO and ozone. The performance of the model was assessed by comparing model results with ground based and aircraft measurements. The model results show good agreement with surface measurements, and the model is able to reproduce the photochemical episodes during fair weather days. The comparison indicates that the model can represent well the HCHO concentrations as well as their temporal and spatial variability. The relationship between HCHO and (O-3 x H2O) was used to validate the model ability to predict the HCHO concentrations. Further analysis revealed the importance of the representativeness of different instruments: in-situ concentrations might be locally enhanced by emissions, while long path measurements over a forest can be influenced by rapid formation of HCHO from isoprene. The model is able to capture the plume from the city of Milan and the modelled levels agree generally well with the aircraft measurements, although the wind fields used in the model can lead to a displacement of the ozone plume. During the campaign period, O3 levels were seldom higher than 80 ppb, the peak surface ozone maxima reached 90 ppb. Those relatively low values can be explained by low emissions during the August vacation and unstable weather conditions in this period. The modelled Delta O-3/Delta NOz slope at Alzate of 5.1 agrees well with the measured slope of 4.9