Volatile anaesthetics and positive pressure ventilation reduce left atrial performance: a transthoracic echocardiographic study in young healthy adults

Background Animal and in vitro studies suggest that volatile anaesthetics affect left atrial (LA) performance. We hypothesized that human LA pump function and dimensions are altered by volatile anaesthetics in vivo. Methods We performed transthoracic echocardiographic (TTE) measurements in 59 healthy subjects (aged 18-48 yr) undergoing minor surgery under general anaesthesia. The unpremedicated patients were randomly assigned to anaesthesia with sevoflurane, desflurane, or isoflurane. TTE examinations were performed at baseline and after induction of anaesthesia and upon placement of a laryngeal mask during spontaneous breathing. After changing to intermittent positive pressure ventilation (IPPV), an additional TTE was performed. The study focused on the velocity-time integral of late peak transmitral inflow velocity (AVTI) and maximum LA volume. Results We found no evidence for relevant differences in the effects of the three volatile anaesthetics. AVTI decreased significantly from 4.1 (1.2) cm at baseline to 3.2 (1.1) cm during spontaneous breathing of 1 minimum alveolar concentration of volatile anaesthetics. AVTI decreased further to 2.8 (1.0) cm after changing to IPPV. The maximum LA volume was 45.4 (18.6) cm3 at baseline and remained unchanged during spontaneous breathing but decreased to 34.5 (16.7) cm3 during IPPV. Other parameters of LA pump function and dimensions decreased similarly. Conclusions Volatile anaesthetics reduced active LA pump function in humans in vivo. Addition of IPPV decreased LA dimensions and further reduced LA pump function. Effects in vivo were less pronounced than previously found in in vitro and animal studies. Further studies are warranted to evaluate the clinical implications of these findings. Clinical trial registration NCT002445

The Benefits and Limitations of a Clinician Lead Sexual Education Program in Wisconsin Public Schools

Background: Abstinence-based sexual education is the primary method of sexual education in public schools.4 The majority of public schools use teachers who may or not have proper training to teach the course. Comprehensive sexual education taught by clinicians could potentially decrease sexual risky behavior in the youth population. Purpose: Identify potential benefits or limitations to a clinician-led sexual education program in Wisconsin public schools. Methods: Articles 2017 or newer were reviewed utilizing search engines such as PubMed, Google Scholar, and NIH. A Google Forum with 18 questions was sent out to 420 Wisconsin public school administrators. It was open for 7 days and yielded 49 responses. Ten of the responses were graphed and analyzed for data. Conclusions: Due to the unequal sample size, the data cannot be properly analyzed to have a concrete conclusion.13 Throughout the literature review it was found that teachers who had taken a course in teaching sexual education, yielded better outcomes with their students

How does the perception of a welfare magnet influence support for immigration and redistribution? Evidence from Switzerland

It is a long-standing debate whether countries act as welfare magnets and attract immigrants who free-ride on their social programs. Based on data for Switzerland, this study shows with an information experiment that the perception of the welfare magnet is crucial for immigration and redistribution policies. Specifically, roughly 80% of the survey participants believe that Switzerland acts as a welfare magnet. Informing that immigrants contribute more to the old-age and survivors’ insurance than Swiss citizens mitigates this view, resulting in a desire for a significantly lower reduction of the future inflow of immigrants. Conversely, positive evidence on the welfare magnet in Denmark does not further decrease the respondents’ attitude towards immigration, but significantly lowers support for redistribution

Key Elements in a Framework for Land Use Impact Assessment Within LCA (11 pp)

Background, Aim and Scope: Land use by agriculture, forestry, mining, house-building or industry leads to substantial impacts, particularly on biodiversity and on soil quality as a supplier of life support functions. Unfortunately there is no widely accepted assessment method so far for land use impacts. This paper presents an attempt, within the UNEP-SETAC Life Cycle Initiative, to provide a framework for the Life Cycle Impact Assessment (LCIA) of land use. Materials and Methods: This framework builds from previous documents, particularly the SETAC book on LCIA (Lindeijer et al. 2002), developing essential issues such as the reference for occupation impacts; the impact pathways to be included in the analysis; the units of measure in the impact mechanism (land use interventions to impacts); the ways to deal with impacts in the future; and bio-geographical differentiation. Results: The paper describes the selected impact pathways, linking the land use elementary flows (occupation; transformation) and parameters (intensity) registered in the inventory (LCI) to the midpoint impact indicators and to the relevant damage categories (natural environment and natural resources). An impact occurs when the land properties are modified (transformation) and also when the current man-made properties are maintained (occupation). Discussion: The size of impact is the difference between the effect on land quality from the studied case of land use and a suitable reference land use on the same area (dynamic reference situation). The impact depends not only on the type of land use (including coverage and intensity) but is also heavily influenced by the bio-geographical conditions of the area. The time lag between the land use intervention and the impact may be large; thus land use impacts should be calculated over a reasonable time period after the actual land use finishes, at least until a new steady state in land quality is reached. Conclusions: Guidance is provided on the definition of the dynamic reference situation and on methods and time frame to assess the impacts occurring after the actual land use. Including the occupation impacts acknowledges that humans are not the sole users of land. Recommendations and Perspectives: The main damages affected by land use that should be considered by any method to assess land use impacts in LCIA are: biodiversity (existence value); biotic production potential (including soil fertility and use value of biodiversity); ecological soil quality (including life support functions of soil other than biotic production potential). Bio-geographical differentiation is required for land use impacts, because the same intervention may have different consequences depending on the sensitivity and inherent land quality of the environment where it occurs. For the moment, an indication of how such task could be done and likely bio-geographical parameters to be considered are suggested. The recommendation of indicators for the suggested impact categories is a matter of future researc

A type-driven approach for sensitivity checking with branching

Differential Privacy (DP) is a promising approach to allow privacy preserving statistics over large datasets of sensitive data. It works by adding random noise to the result of the analytics. Understanding the sensitivity of a query is key to add the right amount of noise capable of protecting privacy of individuals in the dataset. The domain-specific language Spar[1] implements a programming language that uses the type system to automatically track the sensitivity of queries in Haskell. Queries can be constructed from basic operations in an EDSL. The operations’ impact on sensitivity need to be well-known and made explicit at type-level. Spar lacks branching operations. In general branching is a discontinuous operation, so the sensitivity of the whole branch might not be bounded. Due to this reason, most languages that track sensitivity do not provide branching as a basic operation. We introduce a modular and type-driven branching operation that checks for continuity at compile-time. It is implemented in Template Haskell and thus operates on the syntax of the condition and bodies of the branches. To demonstrate our approach, we provide basic examples common in literature. Additionally, we also provide the implementation of more sophisticated operations such as Mergesort. We develop requirements under which the use of our branching operator is sound

Dehydrogenation of Hexamethyl-Dewar-benzene to its Tetramethyl-o-dimethylene Derivative: Synthesis and Cycloreversion of 1,2,3,4-Tetramethyl-5,6-bismethylenebicyclo[2.2.0]hex-2-ene

The allylic bromination of hexamethyl-Dewar-benzene (1) followed by dehydrobromination yields tetramethyl-Dewar-«xylylene» (3). The cycloreversion of 3 to the reactive monocyclic isomer 4 proceeds smoothly upon irradiation or heating above 60 °C

Influence of Ablation on Differential Arc Resistance

The influence of ablation on the du/di behavior of an arc in a model gas circuit breaker was examined. Specifically the transition from a state without ablation in the nozzle towards states with ablation was of interest, since prior work indicated that for high currents the voltage becomes constant or du/di gets even positive if ablation is present. Measurements with different blow pressures and rectangular DC currents of varying amplitude were compared, using PMMA-nozzles and dry air as blowing gas. Ablation was measured by weighing the nozzle, scanning the cross section, and using a coordinate measuring machine. The results agreed well, and confirmed that higher pressure shifts the du/di curve towards more favorable values.ISSN:2336-263

Competing conceptions of a “Swiss” national identity and their effect on attitudes towards the “foreign other”

Treball Final del Màster Universitari en Estudis Internacionals de Pau, Conflictes i Desenvolupament (Pla de 2013). Codi: SBG119. Curs acadèmic 2014-201