Ketoprofen gel improves low back pain in addition to IV dexketoprofen: a randomized placebo-controlled trial

Objective Oligoanalgesia is common in emergency departments (EDs), and pain management is of concern for ED physicians. The aim of this study was to reveal the effect of ketoprofen gel in patients presenting with mechanical low back pain to the ED. Method All the study patients received intravenous dexketoprofen additional to study drugs. After dexketoprofen, 2 g of 2.5% ketoprofen gel or placebo was administered to the site with pain and tenderness. Pain relief at 15 and 30 minutes was measured by visual analog scale scores. Rescue drug need and adverse effects were also recorded. Results A total of 140 patients were enrolled into the study. The mean age of the study patients was 35 ± 12, and 56% (n = 79) of them were male. The mean pain reduction at 30 minutes was 52 ± 18 for ketoprofen gel and 37 ± 17 for placebo, and ketoprofen gel was better than placebo at 30 minutes (mean difference, 16 mm; 95% confidence interval, 10-21). Ten patients (14%) in the placebo group and 2 patients (3%) in the ketoprofen gel group needed rescue drug (P = .35). Conclusion Ketoprofen gel improves pain in patients presenting with mechanical low back pain to ED at 30 minutes in addition to intravenous dexketoprofen when compared to placebo. © 2016 Elsevier Inc

Activated prothrombin complex in the management of direct thrombin inhibitor-associated intracerebral haemorrhage.

Intracerebral haematoma expansion independently predicts poor functional outcome and mortality. Therefore, it is important to act quickly to arrest this expansion. Whilst a direct antidote to dabigatran remains in development, the use of factor VIII inhibitor bypassing activity may offer a practical strategy for arresting haemorrhage in individuals taking direct thrombin inhibitors.NRE is supported by a Research Training Fellowship from The Dunhill Medical Trust [grant number RTF44/0114].This is the author accepted manuscript. The final version is available from Oxford University Press at http://dx.doi.org/10.1093/qjmed/hcv219

The reliability of national videos related to the kidney stones on YouTube

Objective: Kidney stones are one of the most common disorders of the urinary tract. With increasing awareness, a larger proportion of patients are seeking medical knowledge from the Internet. In present study, the features, reliability and efficacy of videos on YouTube related to the treatment of kidney stones were evaluated. Material and methods: In December 2014, YouTube was searched using keywords “nephrolithiasis”; “renal calculi”; “renal stones”; and “kidney stones” for videos uploaded containing relevant information about the disease. Only videos in Turkish were included in the study. Two physician viewers watched each video and classified them as useful, partially useful and useless according to European Association of Urology (EAU) Guidelines. The source, length, number of views, number of favourable opinions, and days since uploaded date of the all videos were evaluated. Results: A total of 600 videos were analysed The median length of videos was 6.7±10.4 (median: 3, IQR: 0.03-58) minutes . Each video was viewed at an average of 2368 (min: 11, max: 97133) times. Most of the videos (32.8%) were created by academicians and physicians. Nearly half (47.4%) of the videos were uploaded in 2014. The majority of the videos (62.5%) contained information for treatment. Percutaneous nephrolithotomy and ureterorenoscopy were the most common treatment modalities (32.8% and 28.0%, respectively) in these videos. A statistically significant difference was not detected between view numbers and source of videos (p=0.87). However, there was a statistically significant difference between usefulness to the viewers and source of videos. Hospital -based videos were detected to be more useful (p=0.000). Conclusion: As a result, videos that would be prepared in internet environment by professional individuals or organizations in a way which would attract attention and be easily comprehended by the public could contribute to the knowledge and education of our society about the stone disease which is commonly seen in our country. © 2016 by Turkish Association of Urology

Doping management for high-power fiber lasers: 100 W, few-picosecond pulse generation from an all-fiber-integrated amplifier

Cataloged from PDF version of article.Thermal effects, which limit the average power, can be minimized by using low-doped, longer gain fibers, whereas the presence of nonlinear effects requires use of high-doped, shorter fibers to maximize the peak power. We propose the use of varying doping levels along the gain fiber to circumvent these opposing requirements. By analogy to dispersion management and nonlinearity management, we refer to this scheme as doping management. As a practical first implementation, we report on the development of a fiber laser-amplifier system, the last stage of which has a hybrid gain fiber composed of high-doped and low-doped Yb fibers. The amplifier generates 100 W at 100 MHz with pulse energy of 1 mu J. The seed source is a passively mode-locked fiber oscillator operating in the all-normal-dispersion regime. The amplifier comprises three stages, which are all-fiber-integrated, delivering 13 ps pulses at full power. By optionally placing a grating compressor after the first stage amplifier, chirp of the seed pulses can be controlled, which allows an extra degree of freedom in the interplay between dispersion and self-phase modulation. This way, the laser delivers 4.5 ps pulses with similar to 200 kW peak power directly from fiber, without using external pulse compression. (C) 2012 Optical Society of Americ

Seismic anisotropy inferred from direct <i>S</i>-wave-derived splitting measurements and its geodynamic implications beneath southeastern Tibetan Plateau

The present study deals with detecting seismic anisotropy parameters beneath southeastern Tibet near Namcha Barwa Mountain using the splitting of direct S waves. We employ the reference station technique to remove the effects of source-side anisotropy. Seismic anisotropy parameters, splitting time delays, and fast polarization directions are estimated through analyses of a total of 501 splitting measurements obtained from direct S waves from 25 earthquakes ( ≥  5.5 magnitude) that were recorded at 42 stations of the Namcha Barwa seismic network. We observe a large variation in time delays ranging from 0.64 to 1.68 s, but in most cases, it is more than 1 s, which suggests a highly anisotropic lithospheric mantle in the region. A comparison between direct S- and SKS-derived splitting parameters shows a close similarity, although some discrepancies exist where null or negligible anisotropy has been reported earlier using SKS. The seismic stations with hitherto null or negligible anisotropy are now supplemented with new measurements with clear anisotropic signatures. Our analyses indicate a sharp change in lateral variations of fast polarization directions (FPDs) from consistent SSW–ENE or W–E to NW–SE direction at the southeastern edge of Tibet. Comparison of the FPDs with Global Positioning System (GPS) measurements, absolute plate motion (APM) directions, and surface geological features indicates that the observed anisotropy and hence inferred deformation patterns are not only due to asthenospheric dynamics but are a combination of lithospheric deformation and sub-lithospheric (asthenospheric) mantle dynamics. Direct S-wave-based station-averaged splitting measurements with increased back-azimuths tend to fill the coverage gaps left in SKS measurements

Maximizing team synergy in AI-related interdisciplinary groups: an interdisciplinary-by-design iterative methodology

In this paper, we propose a methodology to maximize the benefits of interdisciplinary cooperation in AI research groups. Firstly, we build the case for the importance of interdisciplinarity in research groups as the best means to tackle the social implications brought about by AI systems, against the backdrop of the EU Commission proposal for an Artificial Intelligence Act. As we are an interdisciplinary group, we address the multi-faceted implications of the mass-scale diffusion of AI-driven technologies. The result of our exercise lead us to postulate the necessity of a behavioural theory that standardizes the interaction process of interdisciplinary groups. In light of this, we conduct a review of the existing approaches to interdisciplinary research on AI appliances, leading to the development of methodologies like ethics-by-design and value-sensitive design, evaluating their strengths and weaknesses. We then put forth an iterative process theory hinging on a narrative approach consisting of four phases: (i) definition of the hypothesis space, (ii) building-up of a common lexicon, (iii) scenario-building, (iv) interdisciplinary self-assessment. Finally, we identify the most relevant fields of application for such a methodology and discuss possible case studies

Early cranial ultrasound findings among infants with neonatal encephalopathy in Uganda: an observational study.

BACKGROUND: In sub-Saharan Africa, the timing and nature of brain injury and their relation to mortality in neonatal encephalopathy (NE) are unknown. We evaluated cranial ultrasound (cUS) scans from term Ugandan infants with and without NE for evidence of brain injury. METHODS: Infants were recruited from a national referral hospital in Kampala. Cases (184) had NE and controls (100) were systematically selected unaffected term infants. All had cUS scans <36 h reported blind to NE status. RESULTS: Scans were performed at median age 11.5 (interquartile range (IQR): 5.2-20.2) and 8.4 (IQR: 3.6-13.5) hours, in cases and controls respectively. None had established antepartum injury. Major evolving injury was reported in 21.2% of the cases vs. 1.0% controls (P < 0.001). White matter injury was not significantly associated with bacteremia in encephalopathic infants (odds ratios (OR): 3.06 (95% confidence interval (CI): 0.98-9.60). Major cUS abnormality significantly increased the risk of neonatal death (case fatality 53.9% with brain injury vs. 25.9% without; OR: 3.34 (95% CI: 1.61-6.95)). CONCLUSION: In this low-resource setting, there was no evidence of established antepartum insult, but a high proportion of encephalopathic infants had evidence of major recent and evolving brain injury on early cUS imaging, suggesting prolonged or severe acute exposure to hypoxia-ischemia (HI). Early abnormalities were a significant predictor of death