Sensitive Radio Survey of Obscured Quasar Candidates

We study the radio properties of moderately obscured quasars over a range of redshifts to understand the role of radio activity in accretion using the Jansky Very Large Array (JVLA) at 6.0GHz and 1.4GHz. Our z~2.5 sample consists of optically-selected obscured quasar candidates, all of which are radio-quiet, with typical radio luminosities of $\nu L_{\nu}$[1.4 GHz] < $10^{40}$ erg s$^{-1}$. Only a single source is individually detected in our deep (rms~10 $\mu$Jy) exposures. This population would not be identified by radio-based selection methods used for distinguishing dusty star-forming galaxies and obscured active nuclei. In our pilot A-array study of z~0.5 radio-quiet quasars, we spatially resolve four of five objects on scales ~ 5 kpc and find they have steep spectral indices. Therefore, radio emission in these sources could be due to jet-driven or radiatively driven bubbles interacting with interstellar material on the scale of the host galaxy. Finally, we also study the population of ~ 200 faint (~40 $\mu$Jy - 40 mJy) radio sources observed over ~ 120 arcmin$^2$ of our data. 60% of these detections are matched in the SDSS and/or WISE and are, in roughly equal shares, active nuclei at a broad range of redshifts, passive galaxies with no other signs of nuclear activity and IR-bright but optically faint sources. Spectroscopically or photometrically confirmed star-forming galaxies constitute only a small minority of the matches. Such sensitive radio surveys allow us to address important questions of AGN evolution and evaluate the AGN contribution to the radio-quiet sky.Comment: 18 pages, submitted to MNRA

Assessing the Variation in Rail Interoperability in 11 European Countries, and Barriers to its Improvement

Work conducted within REORIENT, a Sixth Framework project for the European Commission (EC), is described. One objective of REORIENT was to explain the status of transformation of the European railway sector into a functionally integrated, liberalized, interoperable system. The status of interoperability within and between eleven countries in a corridor stretching from Greece to the Nordic countries was assessed, and conditions in the countries that appear to be barriers to achieving the EC’s goals were identified. (Barriers were defined as shortcomings in conditions that would facilitate the implementation of requirements presumed by the EC to lead to seamless international freight transport (“implementation conditions”)). The primary data source for the analysis was a set of interviews with the major actors and stakeholders associated with each country’s rail freight system. The (qualitative) information from the interviews was translated into numeric scores, which were subjected to statistical analysis. The primary objective of the statistical analysis was to provide an assessment of the relationships between the requirements and the implementation conditions. The statistical analysis involved both the identification of relevant relationships and an assessment of the strength of these relationships. Overall, we found that there was considerable variation in interoperability status across the countries on practically all of the requirements. However, there was also considerable variation in the status of the implementation conditions across the countries. As a result, we found that most of the variability was able to be explained by relationships that were found to exist between the requirements and implementation conditions.&nbsp;A ‘Barrier Significance Score’ (BSS) was computed for each country and for each implementation condition. These scores were used to assess the relative importance of barriers across the countries, and to identify the most critical barriers to be removed in order to improve interoperability. Large differences in BSS’s were found among countries. In general there are fewer barriers in Nordic countries and more barriers in the south

Reduction of radiation dose using 80 kV tube voltage: a feasible strategy?

Cardiolog

IVUS detects more coronary calcifications than MSCT; matter of both resolution and cross-sectional assessment?

Vascular Biology and Interventio

71 Pharmacokinetics of nasal administered tobramycin in patients with cystic fibrosis

Recent studies showed that the paranasal sinuses can constitute a niche for bacteria. To date no effective treatment for these bacteria is available. Off label administration of nasal antibiotics may be an option. However, first safety of this treatment has to be established. Objectives: With this pilot study in two patients the pharmacokinetic parameters of nasal administered tobramycin were investigated. Methods: In two hospitalised CF-patients, treated with intravenous tobramycin, after a wash-out period, 320 mg of tobramycin, dissolved in 200 ml isotonic saline, was administered to the nose using nasal lavage. Eleven venous blood samples were collected and with a Liquid Chromatography Tandem Mass Spectometer (LCMSMS) method, serum tobramycin concentrations were determined. Tobramycin pharmacokinetic parameters were calculated using the MW\Pharm software package. Systemic absorption was calculated by dividing AUC after nasal administration by AUC after intravenous administration corrected for the administered dose. Results: In patient 1, a female of 32 years old, the maximum concentration (Cmax) of tobramycin was 0.027 mg/L. This Cmax was reached 30 minutes after the nasal lavage with tobramycin (tmax). In total 0.20% (0.62 mg) of the tobramycin was systemically absorbed. In patient 2, a male of 36 years old, the Cmax was 0.029 mg/L. The tmax was 45 minutes and in total 0.16% (0.51 mg) of tobramycin was absorbed. Conclusion: Nasal lavage with 320 mg tobramycin did not result in toxic serum levels. The results of two patients showed a fast absorption of tobramycin and a slow elimination. Approximately 0.20% of the tobramycin was absorbed by the sinonasal mucosa

Facilitating return to work through early specialist health-based interventions (FRESH): protocol for a feasibility randomised controlled trial

Background Over one million people sustain traumatic brain injury each year in the UK and more than 10 % of these are moderate or severe injuries, resulting in cognitive and psychological problems that affect the ability to work. Returning to work is a primary rehabilitation goal but fewer than half of traumatic brain injury survivors achieve this. Work is a recognised health service outcome, yet UK service provision varies widely and there is little robust evidence to inform rehabilitation practice. A single-centre cohort comparison suggested better work outcomes may be achieved through early occupational therapy targeted at job retention. This study aims to determine whether this intervention can be delivered in three new trauma centres and to conduct a feasibility, randomised controlled trial to determine whether its effects and cost effectiveness can be measured to inform a definitive trial. Methods/design Mixed methods study, including feasibility randomised controlled trial, embedded qualitative studies and feasibility economic evaluation will recruit 102 people with traumatic brain injury and their nominated carers from three English UK National Health Service (NHS) trauma centres. Participants will be randomised to receive either usual NHS rehabilitation or usual rehabilitation plus early specialist traumatic brain injury vocational rehabilitation delivered by an occupational therapist. The primary objective is to assess the feasibility of conducting a definitive trial; secondary objectives include measurement of protocol integrity (inclusion/exclusion criteria, intervention adherence, reasons for non-adherence) recruitment rate, the proportion of eligible patients recruited, reasons for non-recruitment, spectrum of TBI severity, proportion of and reasons for loss to follow-up, completeness of data collection, gains in face-to-face Vs postal data collection and the most appropriate methods of measuring primary outcomes (return to work, retention) to determine the sample size for a larger trial. Discussion To our knowledge, this is the first feasibility randomised controlled trial of a vocational rehabilitation health intervention specific to traumatic brain injury. The results will inform the design of a definitive trial

Outcomes of patients with perforated colon cancer:A systematic review

Introduction: Perforated colon cancer (PCC) is a distinct clinical entity with implications for treatment and prognosis, however data on PCC seems scarce. The aim of this systematic review is to provide a comprehensive overview of the recent literature on clinical outcomes of PCC. Materials and methods: A systematic literature search of MEDLINE (PubMed), Embase, Cochrane library and Google scholar was performed. Studies describing intentionally curative treatment for patients with PCC since 2010 were included. The main outcome measures consisted of short-term surgical complications and long-term oncological outcomes. Results: Eleven retrospective cohort studies were included, comprising a total of 2696 PCC patients. In these studies, various entities of PCC were defined. Comparative studies showed that PCC patients as compared to non-PCC patients have an increased risk of 30-day mortality (8–33% vs 3–5%), increased post-operative complications (33–56% vs 22–28%), worse overall survival (36–40% vs 48–65%) and worse disease-free survival (34–43% vs 50–73%). Two studies distinguished free-perforations from contained perforations, revealing that free-perforation is associated with significantly higher 30-day mortality (19–26% vs 0–10%), lower overall survival (24–28% vs 42–64%) and lower disease-free survival (15% vs 53%) as compared to contained perforations. Conclusion: Data on PCC is scarce, with various PCC entities defined in the studies included. Heterogeneity of the study population, definition of PCC and outcome measures made pooling of the data impossible. In general, perforation, particularly free perforation, seems to be associated with a substantial negative effect on outcomes in colon cancer patients undergoing surgery. Better definition and description of the types of perforation in future studies is essential, as outcomes seem to differ between types of PCC and might require different treatment strategies.</p

Tissue perfusion and oxygenation to monitor fluid responsiveness in critically ill, septic patients after initial resuscitation: a prospective observational study

Fluid therapy after initial resuscitation in critically ill, septic patients may lead to harmful overloading and should therefore be guided by indicators of an increase in stroke volume (SV), i.e. fluid responsiveness. Our objective was to investigate whether tissue perfusion and oxygenation are able to monitor fluid responsiveness, even after initial resuscitation. Thirty-five critically ill, septic patients underwent infusion of 250 mL of colloids, after initial fluid resuscitation. Prior to and after fluid infusion, SV, cardiac output sublingual microcirculatory perfusion (SDF: sidestream dark field imaging) and skin perfusion and oxygenation (laser Doppler flowmetry and reflectance spectroscopy) were measured. Fluid responsiveness was defined by a ≥5 or 10 % increase in SV upon fluids. In responders to fluids, SDF-derived microcirculatory and skin perfusion and oxygenation increased, but only the increase in cardiac output, mean arterial and pulse pressure, microvascular flow index and relative Hb concentration and oxygen saturation were able to monitor a SV increase. Our proof of principle study demonstrates that non-invasively assessed tissue perfusion and oxygenation is not inferior to invasive hemodynamic measurements in monitoring fluid responsiveness. However skin reflectance spectroscopy may be more helpful than sublingual SDF