Is Intravenous Ramosetron 0.3 mg Effective In The Prevention Of Postoperative Nausea And Vomiting In Women Undergoing Gynecologic Surgery?

OBJECTIVE: The objective of this selective EBM review is to determine whether or not intravenous ramosetron 0.3 mg is effective in the prevention of postoperative nausea and vomiting (PONV) in women undergoing gynecologic surgery. STUDY DESIGN: Review of three English language primary research articles published later than 1995. DATA SOURCES: Randomized, double-blinded, controlled clinical trials comparing intravenous ramosetron to placebo or other control groups were identified using Ovid MEDLINE and Cochrane Library databases. OUTCOMES MEASURED: Measured outcomes include a complete response to the intervention within the first 24-48 hours, the incidence of postoperative nausea and vomiting, need for rescue antiemetic, severity of nausea, and patient satisfaction. RESULTS: All three RCTs analyzed found that intravenous ramosetron 0.3 mg administered during or immediately after surgery significantly decreased the incidence, compared to placebo, of patients experiencing any PONV. This effect was found to be particularly strong in the earliest postoperative period in all studies. In all three studies, ramosetron also significantly reduced the severity of nausea and increased patient satisfaction compared to placebo. Two out of the three studies showed that ramosetron reduced the need for rescue treatment of PONV in the postoperative period compared to placebo. Adverse effects were limited to drowsiness, dizziness, and headache and there were no significant difference in incidence between any groups in any of the studies. CONCLUSION: PONV is a significant source of distress for women undergoing gynecologic surgery. The studies analyzed in this review are concordant in their finding that ramosetron, a highly selective 5-HT3 antagonist, is a safe and effective option for completely preventing or reducing the severity of this troubling postoperative complication. The effectiveness of ramosetron in these studies is complemented by its availability as a less-expensive oral disintegrating tablet which may offset criticism of the high cost of currently available 5-HT3 antagonists. Future studies are needed to apply these findings to additional surgical populations

Renewable energy from the high seas: geo-spatial modelling of resource potential and legal implications for developing offshore wind projects beyond the national jurisdiction of coastal states

Offshore wind energy projects are currently restricted to the exclusive economic zones of coastal States. Recent advances in technology are raising the prospect of utilising excellent wind resources on the high seas. Using a global geo-spatial model we identify potential resource areas for this. In the shallow water case for bottom fixed foundations the largest locations are found on the Mascarene Plateau in the Indian Ocean and the Grand Banks in the North Atlantic. The deep water case for floating platforms identifies the largest regions on the Grand Banks/Flemish Cap and Rockall Bank/Hatton Ridge, both in the North Atlantic. The overall legal framework for wind energy projects on the high seas is the United Nations Convention in the Law of the Sea. Flag states will play a central regulatory role for high seas wind energy developments. There is the danger that flags of convenience might evolve and unduly undercut environmental and safety standards that are in place for projects on the territorial sea and EEZ. Such abuse of high seas freedom could compromise the UNCLOS principle of ‘due regard’. Marine spatial planning approaches and the establishment of cooperative mechanisms, led by the IMO, could safeguard against such potential misappropriation

Mechanoelectric Response of Single-Crystal Rubrene from Ab Initio Molecular Dynamics

A robust understanding of the mechanoelectric response of organic semiconductors is crucial for the development of materials for flexible electronics. In particular, the prospect of using external mechanical strain to induce a controlled modulation in the charge mobility of the material is appealing. Here we develop an accurate computational protocol for the prediction of the mechanical strain dependence of charge mobility. Ab initio molecular dynamics simulations with a van der Waals density functional are carried out to quantify the off-diagonal electronic disorder in the system as a function of strain by the explicit calculation of the thermal distributions of electronic coupling matrix elements. The approach is applied to a representative molecular organic semiconductor, single-crystal rubrene. We find that charge mobility along the high-mobility direction a⃗ increases with compressive strain, as one might expect. However, the increase is larger when compressive strain is applied in the perpendicular direction than in the parallel direction with respect to a⃗, in agreement with experimental reports. We show that this seemingly counterintuitive result is a consequence of a significantly greater suppression of electronic coupling fluctuations in the range of 50-150 cm-1, when strain is applied in the perpendicular direction. Thus our study highlights the importance of considering off-diagonal electron-phonon coupling in understanding the mechanoelectric response of organic semiconducting crystals. The computational approach developed here is well suited for the accurate prediction of strain-charge mobility relations and should provide a useful tool for the emerging field of molecular strain engineering

Measurements with the Chandra X-Ray Observatory's flight contamination monitor

NASA's Chandra X-ray Observatory includes a Flight Contamination Monitor (FCM), a system of 16 radioactive calibration sources mounted to the inside of the Observatory's forward contamination cover. The purpose of the FCM is to verify the ground-to-orbit transfer of the Chandra flux scale, through comparison of data acquired during the ground calibration with those obtained in orbit, immediately prior to opening the Observatory's sun-shade door. Here we report results of these measurements, which place limits on the change in mirror--detector system response and, hence, on any accumulation of molecular contamination on the mirrors' iridium-coated surfaces.Comment: 7pages,8figures,for SPIE 4012, paper 7

Subsonic propellers in a strong wind as anomalous X-ray pulsars

The appearance of subsonic propellers situated in a strong wind is discussed. We show that it is similar to the appearance of anomalous X-ray pulsars (AXPs) provided the mass and the magnetic moment of neutron stars are 1.4 solar masses, and 2E+30 G cm^3, respectively, and the strength of the wind is M_c = 3E+17 g/s. Under these conditions, the spin periods of subsonic propellers are limited within the range of 5-15 s, and the expected spin-down rates are close to 7E-11 s/s. The mass accretion rate onto the stellar surface is limited to the rate of plasma penetration into its magnetosphere at the boundary. As this process is governed by the reconnection of the field lines, the accretion rate onto the stellar surface constitutes 1-2% of M_c. In this case the X-ray luminosity of the objects under consideration can be evaluated as 4E+35 erg/s. The model predicts the existence of at least two spatially separated sources of the X-ray emission: hot spots at the stellar surface, and the hot atmosphere surrounding the magnetosphere of the star. The ages of the subsonic propellers under the conditions of interest are limited to 10^5 yr.Comment: 5 pages, 1 figure, accepted for publication in A&

Linearly polarized X-ray flares following short gamma-ray bursts

Soft X-ray flares were detected to follow the short-duration gamma-ray burst GRB 050724. The temporal properties of the flares suggest that they are likely due to the late time activity of the central engine. We argue that if short GRBs are generated through compact star mergers, as is supported by the recent observations, the jet powering the late X-ray flares must be launched via magnetic processes rather than via neutrino-antineutrino annihilations. As a result, the X-ray flares following short GRBs are expected to be linearly polarized. The argument may also apply to the X-ray flares following long GRBs. Future observations with the upcoming X-ray polarimeters will test this prediction.Comment: 4 pages (no figure), accepted for publication in ApJL, typos correcte

Mycobacterium tuberculosis subverts negative regulatory pathways in human macrophages to drive immunopathology.

Tuberculosis remains a global pandemic and drives lung matrix destruction to transmit. Whilst pathways driving inflammatory responses in macrophages have been relatively well described, negative regulatory pathways are less well defined. We hypothesised that Mycobacterium tuberculosis (Mtb) specifically targets negative regulatory pathways to augment immunopathology. Inhibition of signalling through the PI3K/AKT/mTORC1 pathway increased matrix metalloproteinase-1 (MMP-1) gene expression and secretion, a collagenase central to TB pathogenesis, and multiple pro-inflammatory cytokines. In patients with confirmed pulmonary TB, PI3Kδ expression was absent within granulomas. Furthermore, Mtb infection suppressed PI3Kδ gene expression in macrophages. Interestingly, inhibition of the MNK pathway, downstream of pro-inflammatory p38 and ERK MAPKs, also increased MMP-1 secretion, whilst suppressing secretion of TH1 cytokines. Cross-talk between the PI3K and MNK pathways was demonstrated at the level of eIF4E phosphorylation. Mtb globally suppressed the MMP-inhibitory pathways in macrophages, reducing levels of mRNAs encoding PI3Kδ, mTORC-1 and MNK-1 via upregulation of miRNAs. Therefore, Mtb disrupts negative regulatory pathways at multiple levels in macrophages to drive a tissue-destructive phenotype that facilitates transmission