Transient neurologic symptoms following spinal anesthesia with isobaric mepivacaine: A decade of experience at Toronto Western Hospital

Background: Transient neurologic symptoms (TNSs) can be distressing for patients and providers following uneventful spinal anesthesia. Spinal mepivacaine may be less commonly associated with TNS than lidocaine; however, reported rates of TNS with intrathecal mepivacaine vary considerably. Materials and Methods: We conducted a retrospective cohort study reviewing the internal medical records of surgical patients who underwent mepivacaine spinal anesthesia at Toronto Western Hospital over the last decade to determine the rate of TNS. We defined TNS as new onset back pain that radiated to the buttocks or legs bilaterally. Results: We found one documented occurrence of TNS among a total of 679 mepivacaine spinal anesthetics (0.14%; CI: 0.02–1.04%) that were performed in 654 patients. Conclusion: Our retrospective data suggest that the rate of TNS associated with mepivacaine spinal anesthesia is lower than that previously reported in the literature

The crystal structure of Pneumolysin at 2.0 Å resolution reveals the molecular packing of the pre-pore complex

Pneumolysin is a cholesterol-dependent cytolysin (CDC) and virulence factor of Streptococcus pneumoniae. It kills cells by forming pores assembled from oligomeric rings in cholesterol-containing membranes. Cryo-EM has revealed the structures of the membrane-surface bound pre-pore and inserted-pore oligomers, however the molecular contacts that mediate these oligomers are unknown because high-resolution information is not available. Here we have determined the crystal structure of full-length pneumolysin at 1.98 Å resolution. In the structure, crystal contacts demonstrate the likely interactions that enable polymerisation on the cell membrane and the molecular packing of the pre-pore complex. The hemolytic activity is abrogated in mutants that disrupt these intermolecular contacts, highlighting their importance during pore formation. An additional crystal structure of the membrane-binding domain alone suggests that changes in the conformation of a tryptophan rich-loop at the base of the toxin promote monomer-monomer interactions upon membrane binding by creating new contacts. Notably, residues at the interface are conserved in other members of the CDC family, suggesting a common mechanism for pore and pre-pore assembly

Teacher and student perceptions of academic and professional literacies in ESP at tertiary and applied colleges in Kuwait

This thesis reports a qualitative study of the perceptions of academic and professional literacies of ESP teachers and their students in a Kuwaiti vocational higher education institution. The specific foci were threefold: (1) the ESP teachers’ perceptions of academic and professional literacy practices and the classroom practices and course content they see asimportant to support effective literacy teaching; (2) the ESP students' perceptions of academic and professional literacies and of the classroom practices and course content supportive of their professional literacy acquisition; (3) the effects of these perceptions on teaching and learning. The research employed three qualitative research methodologies to focus on the experience of the individual and present a holistic understanding of the phenomena investigated: (1) semi-structured interviews; (2) classroom observations; (3) document collection. The participants included eight ESP teachers (two from each of the four colleges offering ESP courses at PAAET) and twenty-four ESP learners (three learners taught by each of the teachers recruited). Each participant was interviewed twice: once before the classroom observation period and once after. The first interviews and observation periods determined the questions for the second interviews and relevant documents were collected from participants whenever possible. The focus on the individual and an in-depth analysis of his/her experience provided a rich data set regardless of the relatively small sample that this qualitative study worked with. The study indicates (1) that ESP teacher and learner perceptions of literacy practices needs are context-derived, transferrable from one context to another, and include communication and social norms of the discourse community; (2) ESP teachers’ perceptions of these literacy practices shaped their pedagogical choices; (3) ESP teacher and learner understandings of the learners’ future professional contexts played a significant role in learner engagement in the ESP classroom; (4) limitations in understanding of situated literacy practices were obstacles to the ESP teachers’ ability to develop their ESP courses. The study has implications for the training of ESP teachers and for the role of target situation analysis in ESP course design. It also has implications for the involvement of ESP students, as stakeholders, in discussions around the design of ESP programs

Evaluation of EIT systems and algorithms for handling full void fraction range in two-phase flow measurement

In the aqueous-based two-phase flow, if the void fraction of dispersed phase exceeds 0.25, conventional electrical impedance tomography (EIT) produces a considerable error due to the linear approximation of the sensitivity back-projection (SBP) method, which limits the EIT's wider application in the process industry. In this paper, an EIT sensing system which is able to handle full void fraction range in two-phase flow is reported. This EIT system employs a voltage source, conducts true mutual impedance measurement and reconstructs an online image with the modified sensitivity back-projection (MSBP) algorithm. The capability of the Maxwell relationship to convey full void fraction is investigated. The limitation of the linear sensitivity back-projection method is analysed. The MSBP algorithm is used to derive relative conductivity change in the evaluation. A series of static and dynamic experiments demonstrating the mean void fraction obtained using this EIT system has a good agreement with reference void fractions over the range from 0 to 1. The combination of the new EIT system and MSBP algorithm would significantly extend the applications of EIT in industrial process measurement

Primary undifferentiated embryonal sarcoma of the liver mistaken for hydatid disease

Primary undifferentiated embryonal sarcoma of the liver is a rare tumor with a peak incidence between the ages of 6 and 10 years. We report a case of a primary hepatic undifferentiated embryonal sarcoma arising in a 21-year-old male mistaken for hydatid disease of the liver. The rapid recurrence of this tumor along the site of attempted percutaneous drainage illustrates some important management points regarding this malignancy

Search for chargino-neutralino production with mass splittings near the electroweak scale in three-lepton final states in √s=13 TeV pp collisions with the ATLAS detector

A search for supersymmetry through the pair production of electroweakinos with mass splittings near the electroweak scale and decaying via on-shell W and Z bosons is presented for a three-lepton final state. The analyzed proton-proton collision data taken at a center-of-mass energy of √s=13  TeV were collected between 2015 and 2018 by the ATLAS experiment at the Large Hadron Collider, corresponding to an integrated luminosity of 139  fb−1. A search, emulating the recursive jigsaw reconstruction technique with easily reproducible laboratory-frame variables, is performed. The two excesses observed in the 2015–2016 data recursive jigsaw analysis in the low-mass three-lepton phase space are reproduced. Results with the full data set are in agreement with the Standard Model expectations. They are interpreted to set exclusion limits at the 95% confidence level on simplified models of chargino-neutralino pair production for masses up to 345 GeV

Search for direct stau production in events with two hadronic tau-leptons in root s=13 TeV pp collisions with the ATLAS detector

A search for the direct production of the supersymmetric partners ofτ-leptons (staus) in final stateswith two hadronically decayingτ-leptons is presented. The analysis uses a dataset of pp collisions corresponding to an integrated luminosity of139fb−1, recorded with the ATLAS detector at the LargeHadron Collider at a center-of-mass energy of 13 TeV. No significant deviation from the expected StandardModel background is observed. Limits are derived in scenarios of direct production of stau pairs with eachstau decaying into the stable lightest neutralino and oneτ-lepton in simplified models where the two staumass eigenstates are degenerate. Stau masses from 120 GeV to 390 GeV are excluded at 95% confidencelevel for a massless lightest neutralino

Effects of perceived cocaine availability on subjective and objective responses to the drug

<p>Abstract</p> <p>Rationale</p> <p>Several lines of evidence suggest that cocaine expectancy and craving are two related phenomena. The present study assessed this potential link by contrasting reactions to varying degrees of the drug's perceived availability.</p> <p>Method</p> <p>Non-treatment seeking individuals with cocaine dependence were administered an intravenous bolus of cocaine (0.2 mg/kg) under 100% ('unblinded'; N = 33) and 33% ('blinded'; N = 12) probability conditions for the delivery of drug. Subjective ratings of craving, high, rush and low along with heart rate and blood pressure measurements were collected at baseline and every minute for 20 minutes following the infusions.</p> <p>Results</p> <p>Compared to the 'blinded' subjects, their 'unblinded' counterparts had similar craving scores on a multidimensional assessment several hours before the infusion, but reported higher craving levels on a more proximal evaluation, immediately prior to the receipt of cocaine. Furthermore, the 'unblinded' subjects displayed a more rapid onset of high and rush cocaine responses along with significantly higher cocaine-induced heart rate elevations.</p> <p>Conclusion</p> <p>These results support the hypothesis that cocaine expectancy modulates subjective and objective responses to the drug. Provided the important public health policy implications of heavy cocaine use, health policy makers and clinicians alike may favor cocaine craving assessments performed in the settings with access to the drug rather than in more neutral environments as a more meaningful marker of disease staging and assignment to the proper level of care.</p