Use of Intrapleural Fibrinolytic Therapy in a Trapped Lung following Acute Traumatic Haemothorax.

Retained haemothorax is a common sequela of traumatic haemothorax and refers to blood that cannot be drained from the pleural cavity. We report a case of trapped lung secondary to retained haemothorax in a patient who sustained a penetrating chest injury. Initial chest computed tomography (CT) showed a large haemothorax that was managed with an intercostal drain insertion (ICD). Repeat chest CT and thoracic ultrasonography performed after ICD removal showed an organized pleural space resembling haematoma. ICD was reinserted with administration of intrapleural fibrinolytic therapy (IPFT). Subsequent chest CT showed the development of a pleural rind and trapped lung. A second ICD was inserted, and further IPFT were administered together with aggressive negative pressure suction. Haemoglobin remained stable. The patient made a full recovery and imaging performed two weeks later showed minor blunting of the costophrenic angle. This case highlights the feasibility and safety of IPFT in the management of trapped lung associated with traumatic retained haemothorax as an alternative to surgery

RSFQ Circuitry Using Intrinsic π-Phase Shifts

The latching of temporary data is essential in the rapid single flux quantum (RSFQ) electronics family. Its pulse-driven nature requires two or more stable states in almost all cells. Storage loops must be designed to have exactly two stable states for binary data representation. In conventional RSFQ such loops are constructed to have two stable states, e.g. by using asymmetric bias currents. This bistability naturally occurs when phase-shifting elements are included in the circuitry, such as pi-Josephson junctions or a pi-phase shift associated with an unconventional (d-wave) order parameter symmetry. Both approaches can be treated completely analogously, giving the same results. We have demonstrated for the first time the correct operation of a logic circuit, a toggle-flip-flop, using rings with an intrinsic pi-phase shift (pi-rings) based on hybrid high-Tc to low-Tc Josephson junctions. Because of their natural bistability these pi-rings improve the device symmetry, enhance operation margins and alleviate the need for bias current lines.\ud \u

Patient-Related Barriers to Timely Dialysis Access Preparation: A Qualitative Study of the Perspectives of Patients, Family Members, and Health Care Providers

Rational & Objective A key aspect of smooth transition to dialysis is the timely creation of a permanent access. Despite early referral to kidney care, initiation onto dialysis is still suboptimal for many patients, which has clinical and cost implications. This study aimed to explore perspectives of various stakeholders on barriers to timely access creation. Study Design Qualitative study. Setting & Participants Semi-structured interviews with 96 participants (response rate, 67%), including patients with stage 4 chronic kidney disease (n = 30), new hemodialysis patients with (n = 18) and without (n = 20) permanent access (arteriovenous fistula), family members (n = 19), and kidney health care providers (n = 9). Analytical Approach Thematic analysis. Results Patients reported differential levels of behavioral activation toward access creation: avoidance/denial, wait and see, or active intention. 6 core themes were identified: (1) lack of symptoms, (2) dialysis fear and practical concerns (exaggerated fear, pain, cost, lifestyle disruptions, work-related concerns, burdening their families), (3) evaluating value against costs/risks of access creation (benefits, threat of operation, viability, prompt for early initiation), (4) preference for alternatives, (5) social influences (hearsay, family involvement, experiences of others), and (6) health care provider interactions (mistrust, interpersonal tension, lack of clarity on information). Themes were common to all groups, whereas nuanced perspectives of family members and health care providers were noted in some subthemes. Limitations Response bias. Conclusions Individual, interpersonal, and psychosocial factors compromise dialysis preparation and contribute to suboptimal dialysis initiation. Our findings support the need for interventions to improve patient and family engagement and address emotional concerns and misperceptions about preparing for dialysis

Towards microstructured optical fibre sensors: surface analysis of silanised lead silicate glass

While protocols to surface functionalise silica glass platforms are well-established, the surface coating of other glass types have received limited attention. Here we fully characterise the surface attachment of a fluoroionophore on extruded lead silicate glass slides and demonstrate these slides as a model for investigating the surface chemistry in a microstructured optical fibre (MOF). This model system allows the utilization of multiple, complementary surface-sensitive techniques that cannot be used within the internal surface of the fibre structure. In characterising the fluoroionophore attachment, we observe that the fluorescence intensity from fluorescence imaging, the atomic nitrogen percentage measured by X-ray photoelectron spectroscopy (XPS), the carbonyl bond component (287.5 eV) in the XPS high resolution carbon spectrum, and Principal Component Analysis (PCA) of the time-of-flight secondary ion mass spectrometry (ToF-SIMS) data can be used to provide relative quantification of the concentration of an attached fluoroionophore. We also show the first use of ToF-SIMS imaging and depth profiling of the Pb content within a glass substrate to provide information on the coverage provided by the coating and the relative thickness of an organic coating. Combined, these techniques provide a comprehensive picture of the coated glass surface that facilitates fibre sensor development.Herbert T. C. Foo, Heike Ebendorff-Heidepriem, Christopher J. Sumby, Tanya M. Monr

Possible singlet to triplet pairing transition in NaxCoO2 H2O

We present precise measurements of the upper critical field (Hc2) in the recently discovered cobalt oxide superconductor. We have found that the critical field has an unusual temperature dependence; namely, there is an abrupt change of the slope of Hc2(T) in a weak field regime. In order to explain this result we have derived and solved Gor'kov equations on a triangular lattice. Our experimental results may be interpreted in terms of the field-induced transition from singlet to triplet superconductivity.Comment: 6 pages, 5 figures, revte

Inhibitory activity and organic acid concentrations of metabolite combinations produced by various strains of Lactobacillus plantarum

Metabolite combinations produced by Lacrtobacillus plantarum strains were studied by inhibitory activity test using Pediococcus acidilactici as indicator microorganism. The pH and cell population of L. plantarum strains were also determined. L. plantarum RG14 strain has significant (P < 0.05) lower pH but higher cell count than the other four L. plantarum strains. Inhibitory activity of metabolite combination was stronger than single strain metabolite. However, there was significantly higher (P < 0.05) inhibitory activity in Com 2 (TL1, RG11 and RI11 strains), Com 5 (TL1, RG14 and RS5 strains) and Com 7 (RG11, RG14 and RI11 strains) than other 7 metabolite combinations, which was attributed to the present of bacteriocin inhibitory compound. Lactic and acetic acids were also present in high amount in metabolite combinations. Therefore, metabolites produced by L. plantarum strains containing mainly organic acids and bacteriocin possess vast potential as feed additives for animals.Key words: Lactobacillus plantarum, metabolite combination, inhibitory activity, lactic acid, acetic aci

What Types of Feedback do Undergraduate Chemistry Students Give Each Other? A Case Study from Singapore

This study was part of a larger project to improve learning of undergraduate chemistry in Singapore through the use of self-authored three-tier multiple-choice questions (3TMCQs) and the giving/receiving of peer feedback. Specifically, we examined the quality of written feedback based on the classification by Hattie and Timperley (2007) that year 2 to 4 learners (N=31) gave each other on responses in their 3TMCQs (N=466 administered). It was found that the most common type of voluntary feedback given by test-makers was task (& self), followed by process (& self), self alone, and lastly regulation (& self) levels over seven chemistry courses. In addition, question type (based on revised Bloom’s Taxonomy) had a marginal effect on the quality of feedback received; instead, items answered incorrectly garnered higher quality feedback and were four times more important than the cognitive level of questions. Feedback quality given by more experienced students was also no better than those given by less experienced ones. While there is growing evidence supporting the self-authoring of questions and giving/receiving peer feedback to enhance learning at undergraduate levels, further research is warranted into the types of peer feedback that learners may receive when attempting different question formats

Chemical Instability of the Cobalt Oxyhydrate Superconductor under Ambient Conditions

The layered sodium cobalt oxyhydrate superconductor Na0.3CoO2*1.4H2O is shown through X-ray diffraction and thermogravimetric studies to be one of a series of hydrated phases of Na0.3CoO2. Further, it is shown that the material is exceptionally sensitive to both temperature and humidity near ambient conditions, easily dehydrating to a non-superconducting lower hydrate. The observation of this stable lower hydrate with c=13.8 angstroms implies that the superconductivity turns on in this system between CoO2 layer spacings of 6.9 and 9.9 angstroms at nominally constant chemical doping.Comment: 10 pages and 4 figure