Ankle fracture surgery on a pregnant patient complicated by intraoperative emergency caesarian section.

We report the case of a woman in the third trimester of pregnancy who sustained an ankle fracture dislocation that could not be adequately closed reduced. After discussions with the patient, her obstetrician, and the anesthesiologists, she was indicated for surgical fixation. A heart tone monitor was used to assess fetal health during the procedure. During surgical incision, the fetus went into distress, and an emergency caesarian section was performed. After delivery of the infant and abdominal closer, surgery was completed. Due to a cohesive team effort, both the patient and her infant had excellent outcomes. There are many important considerations in the surgical management of the pregnant patient with traumatic orthopaedic injuries. Of especial importance to the orthopaedic surgeon is the impact of patient positioning on uteroplacental blood flow. This report discusses factors that should be taken into account by any orthopaedist who plans to operate on a pregnant patient

Investigations of excitation energy transfer and intramolecular interactions in a nitrogen corded distrylbenzene dendrimer system.

The photophysics of an amino-styrylbenzene dendrimer (A-DSB) system is probed by time-resolved and steady state luminescence spectroscopy. For two different generations of this dendrimer, steady state absorption, emission, and photoluminescence excitation spectra are reported and show that the efficiency of energy transfer from the dendrons to the core is very close to 100%. Ultrafast time-resolved fluorescence measurements at a range of excitation and detection wavelengths suggest rapid (and hence efficient) energy transfer from the dendron to the core. Ultrafast fluorescence anisotropy decay for different dendrimer generations is described in order to probe the energy migration processes. A femtosecond time-scale fluorescence depolarization was observed with the zero and second generation dendrimers. Energy transfer process from the dendrons to the core can be described by a Förster mechanism (hopping dynamics) while the interbranch interaction in A-DSB core was found to be very strong indicating the crossover to exciton dynamics

Intoxicated eyewitnesses:the effect of a fully balanced placebo design on event memory and metacognitive control

Few studies have examined the impact of alcohol on metacognition for witnessed events. We used a 2x2 balanced placebo design, where mock-witnesses expected and drank alcohol, did not expect but drank alcohol, did not expect nor drank alcohol, or expected but did not drink alcohol. Participants watched a mock-crime in a bar-lab, followed by free recall and a cued-recall test with or without the option to reply ‘don’t know’ (DK). Intoxicated mock-witnesses’ free recall was less complete but not less accurate. During cued-recall, alcohol led to lower accuracy, and reverse placebo participants gave more erroneous and fewer correct responses. Permitting and clarifying DK responses was associated with fewer errors and more correct responses for sober individuals; and intoxicated witnesses were less likely to opt out of erroneous responding to unanswerable questions. Our findings highlight the practical and theoretical importance of examining pharmacological effects of alcohol and expectancies in real-life settings

Ankle Fracture Surgery on a Pregnant Patient Complicated by Intraoperative Emergency Caesarian Section

We report the case of a woman in the third trimester of pregnancy who sustained an ankle fracture dislocation that could not be adequately closed reduced. After discussions with the patient, her obstetrician, and the anesthesiologists, she was indicated for surgical fixation. A heart tone monitor was used to assess fetal health during the procedure. During surgical incision, the fetus went into distress, and an emergency caesarian section was performed. After delivery of the infant and abdominal closer, surgery was completed. Due to a cohesive team effort, both the patient and her infant had excellent outcomes. There are many important considerations in the surgical management of the pregnant patient with traumatic orthopaedic injuries. Of especial importance to the orthopaedic surgeon is the impact of patient positioning on uteroplacental blood flow. This report discusses factors that should be taken into account by any orthopaedist who plans to operate on a pregnant patient

Forces on Bins - The Effect of Random Friction

In this note we re-examine the classic Janssen theory for stresses in bins, including a randomness in the friction coefficient. The Janssen analysis relies on assumptions not met in practice; for this reason, we numerically solve the PDEs expressing balance of momentum in a bin, again including randomness in friction.Comment: 11 pages, LaTeX, with 9 figures encoded, gzippe

The Surviving Sepsis Campaign: Basic/Translational Science Research Priorities∗

© 2020 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved. Objectives: Expound upon priorities for basic/translational science identified in a recent paper by a group of experts assigned by the Society of Critical Care Medicine and the European Society of Intensive Care Medicine. Data Sources: Original paper, search of the literature. Study Selection: By several members of the original task force with specific expertise in basic/translational science. Data Extraction: None. Data Synthesis: None. Conclusions: In the first of a series of follow-up reports to the original paper, several members of the original task force with specific expertise provided a more in-depth analysis of the five identified priorities directly related to basic/translational science. This analysis expounds on what is known about the question and what was identified as priorities for ongoing research. It is hoped that this analysis will aid the development of future research initiatives

Particle Systems with Stochastic Passing

We study a system of particles moving on a line in the same direction. Passing is allowed and when a fast particle overtakes a slow particle, it acquires a new velocity drawn from a distribution P_0(v), while the slow particle remains unaffected. We show that the system reaches a steady state if P_0(v) vanishes at its lower cutoff; otherwise, the system evolves indefinitely.Comment: 5 pages, 5 figure

Mars oxygen production system design

The design and construction phase is summarized of the Mars oxygen demonstration project. The basic hardware required to produce oxygen from simulated Mars atmosphere was assembled and tested. Some design problems still remain with the sample collection and storage system. In addition, design and development of computer compatible data acquisition and control instrumentation is ongoing

Distinct sites of opiate reward and aversion within the midbrain identified using a herpes simplex virus vector expressing GluR1

Repeated administration of morphine increases expression of GluR1 (an AMPA glutamate receptor subunit) in the ventral tegmental area (VTA) of the midbrain, an important neural substrate for the rewarding actions of morphine. Microinjections of a herpes simplex virus (HSV) vector that causes local overexpression of GluR1 (HSV-GluR1) into the VTA can enhance the ability of morphine to establish conditioned place preferences, suggesting that altered GluR1 expression in this region is directly associated with changes in the rewarding efficacy of morphine. We now report that in rats given HSV-GluR1 directly into the VTA, morphine is most rewarding when maximal transgene expression is in the rostral VTA, whereas morphine is aversive when maximal transgene expression is in the caudal VTA. Dual-labeling immunohistochemistry shows that this difference cannot be explained by a different fraction of dopaminergic neurons infected in the rostral versus caudal VTA. No such anatomical specificity is seen in rats given VTA microinjections of HSV-LacZ, a vector expressing a control protein (beta-galactosidase). These results suggest that distinct substrates within the VTA itself differentially contribute to the rewarding and aversive properties of opiates

Daily bathing with chlorhexidine-based soap and the prevention of Staphylococcus aureus transmission and infection

OBJECTIVE: Determine if daily bathing with chlorhexidine-based soap decreased methicillin-resistant Staphylococcus aureus (MRSA) transmission and ICU-acquired S. aureus infection among ICU patients. DESIGN: Prospective pre-post-intervention study with control unit SETTING: 1,250 bed tertiary-care teaching hospital PATIENTS: Medical and surgical intensive care unit (ICU) patients METHODS: Active surveillance for MRSA colonization was performed in both ICUs. In June 2005, a chlorhexidine bathing protocol was implemented in the surgical ICU. Changes in S. aureus transmission and infection rate before and after implementation were analyzed using time-series methodology. RESULTS: The intervention unit had a 20.68% decrease in MRSA acquisition after institution of the bathing protocol [pre-intervention 12.64 vs. post-intervention 10.03 cases/1000 patient-days-at-risk (95% CI: −5.19 – −0.04, p = 0.046)]. There was no significant change in MRSA acquisition in the control ICU during the study period [10.97 pre-June 2005 vs. 11.33/1000 patient-days at risk post-June 2005 (95% CI −37.40 – 15.19, p = 0.40)]. There was a 20.77% decrease in all S. aureus (including MRSA) acquisition in the intervention ICU from 2002-2007 [19.73 pre-intervention to 15.63 cases per 1000 patient-days at risk post-intervention (95% CI −7.25 – −0.95, p=0.012)]. The incidence of ICU-acquired MRSA infections decreased by 41.37% in the intervention ICU (1.96 pre-intervention vs. 1.15 infections per 1000 patient-days at risk post-intervention; p=0.001). CONCLUSIONS: Institution of daily chlorhexidine bathing in an ICU resulted in a decrease in the transmission of S. aureus, including MRSA. These data support the use of routine daily chlorhexidine baths to decrease rates of S. aureus transmission and infections