43 research outputs found
Laser spectroscopy with nanometric gas cells : distance dependence of atom-surface interaction and collisions under confinement
The high sensitivity of Laser Spectroscopy has made possible the exploration
of atomic resonances in newly designed "nanometric" gas cells, whose local
thickness varies from 20nm to more than 1000 nm. Following the initial
observation of the optical analogous of the coherent Dicke microwave narrowing,
the newest prospects include the exploration of long-range atom surface van der
Waals interaction with spatial resolution in an unprecedented range of
distances, modification of atom dielectric resonant coupling under the
influence of the coupling between the two neighbouring dielectric media, and
even the possible modification of interatomic collisions processes under the
effect of confinement
Experimental observations of temperature effects in the near-field regime of the Casimir-Polder interaction
We investigate the temperature dependence of the Casimir-Polder interaction
in the electrostatic limit. This unusual phenomenon relies on the coupling
between a virtual atomic transition and a thermal excitation of surface
polariton modes. We first focus on the scenario where a Cs(8P3/2) atom is next
to a CaF2 or a BaF2 surface. Our theoretical predictions show a strong
temperature dependence of the van der Waals coefficient at experimentally
accessible conditions. A series of spectroscopic measurements performed in a
specially designed Cs vapour cell containing a CaF2 tube is presented. Our
results illustrate the sensitivity of atom surface-interaction experiments to
the quality and chemical stability of the surface material and emphasize the
need of using more durable materials, such as sapphire. We finally discuss
selective reflection experiments on Cs(7D3/2) in an all-sapphire cell that
clearly demonstrate a temperature dependent van der Waals coefficient.Comment: accepted for publication in Laser Physic
Testing the distance-dependence of the van der Waals interaction between an atom and a surface through spectroscopy in a vapor nanocell
This paper presents our current measurements in a vapor nanocell aiming at a
test of the distance-dependence of the atom-surface interaction, when simple
asymptotic descriptions may turn to be not valid. A state-of-the-art of
atom-surface interaction measurements is provided as an introduction, along
with the comparison with the theory of the van der Waals (or Casimir-Polder)
interaction; it is followed by a presentation of the most salient features of
nanocell spectroscop
Temperature dependence of the dielectric permittivity of CaF2, BaF2 and Al2O3: application to the prediction of a temperature dependent van der Waals surface interaction exerted onto a neighbouring Cs (8P{3/2}) atom
International audienceThe temperature behaviour in the range 22°C to 500 °C of the dielectric permittivity in the infrared range is investigated for CaF2, BaF2 and Al2O3 through reflectivity measurements. The dielectric permittivity is retrieved by fitting reflectivity spectra with a model taking into account multiphonon contributions. The results extrapolated from the measurements are applied to predict a temperature-dependent atom-surface van der Waals interaction. We specifically consider as the atom of interest Cs (8P3/2), the most relevant virtual couplings of which, fall in the range of thermal radiation and are located in the vicinity of the reststrahlen band of fluoride materials
Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial
Background
Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage.
Methods
In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283.
Findings
Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group.
Interpretation
Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset.
Funding
London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation
Receiver operating characteristics of the two scoring systems.
<p>Receiver operating characteristics of the two scoring systems.</p
Number and percentage of patients classified as DIC+ by expert analysis and their repartition according to the cut-offs of the three components of the new DIC score.
<p>Number and percentage of patients classified as DIC+ by expert analysis and their repartition according to the cut-offs of the three components of the new DIC score.</p
Comparison of Two Diagnostic Scores of Disseminated Intravascular Coagulation in Pregnant Women Admitted to the ICU
<div><p>Objective</p><p>To compare the validity of two previously published diagnostic scores of disseminated intravascular coagulation (DIC) in pregnant women admitted to ICU for an acute thrombotic or hemorrhagic complication of delivery and postpartum.</p><p>Methods</p><p>This was a population based retrospective study of 154 patients admitted to ICU for severe delivery and postpartum complications in a University Hospital. A recently published score (adapted to physiological changes of pregnancy and based on three components: platelet count, prothrombin time difference and fibrinogen) was compared to the International Society for Thrombosis and Hemostasis (ISTH) score (based on four components: platelet count, fibrinogen, prothrombin time, and fibrin related marker). Both scores were calculated at delivery, ICU admission (day 0), day 1 and day 2 during the postpartum ICU stay. The validity of both scores was assessed by comparison with the consensual and blinded analysis of two experts. The sensitivity, specificity, and area under the curve (AUC) of each score were calculated at each time and overall by generalized linear mixed model. The agreement between the two scores was evaluated by the Kappa coefficient.</p><p>Results</p><p>The new score had a sensitivity of 0.78, a specificity of 0.97 (p <0.01) and a global AUC of 96% while the ISTH score had a sensitivity of 0.31, a specificity of 0.99 and an AUC of 94% (p <0.01). The Kappa coefficient of correlation between both scores was 0.35. The lower sensitivity of the ISTH score was mainly explained by the lack of fibrinogen and fibrin-related peptides thresholds adapted to the physiological changes of coagulation induced by pregnancy.</p><p>Conclusion</p><p>The new DIC score seem highly discriminant in the subset of patients admitted to the ICU after delivery for an acute specific complication. The ISTH score is not recommended in pregnant women because of its poor sensitivity.</p></div
ROC (Receiver operating characteristics) curve analysis of the sequential diagnostic power of the two scores.
<p>The Curve analysis of each day: day of delivery (Delivery), Day 0, Day 1, Day 2 and curve analysis of the sum of all measured values (Global). The figure on the left represents the ROC curves of the new DIC score. The figure on the right represents the ROC curves of the ISTH score.</p
Number and percentage of patients classified as DIC+ by expert analysis and their repartition according to the cut-offs of the four components of the ISTH score.
<p>Number and percentage of patients classified as DIC+ by expert analysis and their repartition according to the cut-offs of the four components of the ISTH score.</p