Patient-maintained sedation for oral surgery using a target-controlled infusion of propofol - a pilot study

OBJECTIVE: To assess the safety and efficacy of a new patient-maintained propofol system for conscious sedation in dentistry. DESIGN: Prospective clinical trial SETTING: Department of Sedation, Glasgow Dental Hospital and School, 2001 SUBJECTS AND METHODS: Patients scheduled for oral surgery with conscious sedation. Exclusions included ASA IV -V, inability to use the handset, opioid use and severe respiratory disease. INTERVENTIONS: Patients were given intravenous propofol to a level of 1.0 microg/ml (reducing from 1.5 microg/ml) using a target controlled infusion system, they then controlled their sedation level by double-clicking a handset which on each activation increased the propofol concentration by 0.2 microg/ml. MAIN OUTCOME MEASURES: Oxygen saturation, patient satisfaction, and surgeon satisfaction. RESULTS: Twenty patients were recruited, 16 female and four male. Nineteen patients completed sedation and treatment successfully. Mean lowest oxygen saturation was 94%. No patients were over-sedated. All patients successfully used the system to maintain a level of sedation adequate for their comfort. Patient and surgeon satisfaction were consistently high. CONCLUSIONS: Initial experience with this novel system has confirmed safety, patient satisfaction and surgeon satisfaction

Hercules X-1: Pulsed gamma-rays detected above 150 GeV

The 1.24 second binary pulsar Her X-1, first observed in X-rays in 1971 by UHURU has now been seen as a sporadic gamma ray source from 1 TeV up to at least 500 TeV. In addition, reprocessed optical and infrared pulses are seen from the companion star HZ Herculis. Thus measurements of the Her X-1/HZ Herculis system span 15 decades in energy, rivaling both the Crab pulsar and Cygnus X-3 in this respect for a discrete galactic source

The Causal Structure of Emotions in Aristotle: Hylomorphism, Causal Interaction between Mind and Body, and Intentionality

Recently, a strong hylomorphic reading of Aristotelian emotions has been put forward, one that allegedly eliminates the problem of causal interaction between soul and body. Taking the presentation of emotions in de An. I 1 as a starting point and basic thread, but relying also on the discussion of Rh. II, I will argue that this reading only takes into account two of the four causes of emotions, and that, if all four of them are included into the picture, then a causal interaction of mind and body remains within Aristotelian emotions, independent of how strongly their hylomorphism is understood. Beyond the discussion with this recent reading, the analysis proposed of the fourfold causal structure of emotions is also intended as a hermeneutical starting point for a comprehensive analysis of particular emotions in Aristotle. Through the different causes Aristotle seems to account for many aspects of the complex phenomenon of emotion, including its physiological causes, its mental causes, and its intentional object

Three method factors explaining the low correlations between assessment center dimension ratings and scores on personality inventories

In general, correlations between assessment centre (AC) ratings and personality inventories are low. In this paper, we examine three method factors that may be responsible for these low correlations: differences in (i) rating source (other versus self), (ii) rating domain (general versus specific), and (iii) rating format (multi- versus single item). This study tests whether these three factors diminish correlations between AC exercise ratings and external indicators of similar dimensions. Ratings of personality and performance were combined in an analytical framework following a 2 × 2 × 2 (source, domain, format) completely crossed, within subjects design. Results showed partial support for the influence of each of the three method factors. Implications for future research are discussed. Copyright © 2004 John Wiley & Sons, Ltd

Numerical atomic orbitals for linear scaling

The performance of basis sets made of numerical atomic orbitals is explored in density-functional calculations of solids and molecules. With the aim of optimizing basis quality while maintaining strict localization of the orbitals, as needed for linear-scaling calculations, several schemes have been tried. The best performance is obtained for the basis sets generated according to a new scheme presented here, a flexibilization of previous proposals. The basis sets are tested versus converged plane-wave calculations on a significant variety of systems, including covalent, ionic and metallic. Satisfactory convergence (deviations significantly smaller than the accuracy of the underlying theory) is obtained for reasonably small basis sizes, with a clear improvement over previous schemes. The transferability of the obtained basis sets is tested in several cases and it is found to be satisfactory as well.Comment: 9 pages with 2 encapsulated postscript figures, submitted to Phys. Rev.

Sex and the Cinema: What American Pie Teaches the Young

This paper focuses upon the wildly successful blockbuster American Pie teenpics, especially American Pie 3 – the Wedding. I argue that these films, which are sited so securely within the visual and pedagogical machinery of Hollywood culture, are specifically designed to appeal to teenage male audiences, and to provide lessons in sex and romance. Movies like this are especially important as they are experienced by far more teenagers than, for example, instructional films or other classroom materials; indeed, as Henry Giroux has observed, "teens and youth learn how to define themselves outside of the traditional sites of instruction, such as the home and the school… Learning in the postmodern age is located elsewhere – in popular spheres that shape their identities, through forms of knowledge and desires that appear absent from what is taught in schools" (Giroux, 1997, p.49). In this paper I discuss whether the American Pie series is actually a "new age" effort which, via insubordinate performances of gender, contests the hegemonic field of signification which regulates the production of sex, gender and desire, or whether it is more accurately described as a retrogressive hetero-conservative opus with a veneer of sexual radicalism. In short, I intend to probe whether this filmic vector for sex education is all about the shaping of responsible, caring, vulnerable men, or is it guiding them to become just like their heterosexual, middle-class fathers? And whether, despite its riotous and raunchy advertising, American Pie really dishes up something spicy or something terribly wholesome instead

Differences in biological traits composition of benthic assemblages between unimpacted habitats

There is an implicit requirement under contemporary policy drivers to understand the characteristics of benthic communities under anthropogenically-unimpacted scenarios. We used a trait-based approach on a large dataset from across the European shelf to determine how functional characteristics of unimpacted benthic assemblages vary between different sedimentary habitats. Assemblages in deep, muddy environments unaffected by anthropogenic disturbance show increased proportions of downward conveyors and surface deposit-feeders, while burrowing, diffusive mixing, scavenging and predation traits assume greater numerical proportions in shallower habitats. Deep, coarser sediments are numerically more dominated by sessile, upward conveyors and suspension feeders. In contrast, unimpacted assemblages of coarse sediments in shallower regions are proportionally dominated by the diffusive mixers, burrowers, scavengers and predators. Finally, assemblages of gravelly sediments exhibit a relatively greater numerical dominance of non-bioturbators and asexual reproducers. These findings may be used to form the basis of ranking habitats along a functional sensitivity gradient

Abacavir, zidovudine, or stavudine as paediatric tablets for African HIV-infected children (CHAPAS-3): an open-label, parallel-group, randomised controlled trial

BACKGROUND: WHO 2013 guidelines recommend universal treatment for HIV-infected children younger than 5 years. No paediatric trials have compared nucleoside reverse-transcriptase inhibitors (NRTIs) in first-line antiretroviral therapy (ART) in Africa, where most HIV-infected children live. We aimed to compare stavudine, zidovudine, or abacavir as dual or triple fixed-dose-combination paediatric tablets with lamivudine and nevirapine or efavirenz. METHODS: In this open-label, parallel-group, randomised trial (CHAPAS-3), we enrolled children from one centre in Zambia and three in Uganda who were previously untreated (ART naive) or on stavudine for more than 2 years with viral load less than 50 copies per mL (ART experienced). Computer-generated randomisation tables were incorporated securely within the database. The primary endpoint was grade 2-4 clinical or grade 3/4 laboratory adverse events. Analysis was intention to treat. This trial is registered with the ISRCTN Registry number, 69078957. FINDINGS: Between Nov 8, 2010, and Dec 28, 2011, 480 children were randomised: 156 to stavudine, 159 to zidovudine, and 165 to abacavir. After two were excluded due to randomisation error, 156 children were analysed in the stavudine group, 158 in the zidovudine group, and 164 in the abacavir group, and followed for median 2·3 years (5% lost to follow-up). 365 (76%) were ART naive (median age 2·6 years vs 6·2 years in ART experienced). 917 grade 2-4 clinical or grade 3/4 laboratory adverse events (835 clinical [634 grade 2]; 40 laboratory) occurred in 104 (67%) children on stavudine, 103 (65%) on zidovudine, and 105 (64%), on abacavir (p=0·63; zidovudine vs stavudine: hazard ratio [HR] 0·99 [95% CI 0·75-1·29]; abacavir vs stavudine: HR 0·88 [0·67-1·15]). At 48 weeks, 98 (85%), 81 (80%) and 95 (81%) ART-naive children in the stavudine, zidovudine, and abacavir groups, respectively, had viral load less than 400 copies per mL (p=0·58); most ART-experienced children maintained suppression (p=1·00). INTERPRETATION: All NRTIs had low toxicity and good clinical, immunological, and virological responses. Clinical and subclinical lipodystrophy was not noted in those younger than 5 years and anaemia was no more frequent with zidovudine than with the other drugs. Absence of hypersensitivity reactions, superior resistance profile and once-daily dosing favours abacavir for African children, supporting WHO 2013 guidelines. FUNDING: European Developing Countries Clinical Trials Partnership

Low temperature ellipsometry of NaV2O5

The dielectric function of alpha'NaV2O5 was measured with electric field along the a and b axes in the photon energy range 0.8-4.5 eV for temperatures down to 4K. We observe a pronounced decrease of the intensity of the 1 eV peak upon increasing temperature with an activation energy of about 25meV, indicating that a finite fraction of the rungs becomes occupied with two electrons while others are emptied as temperature increases. No appreciable shifts of peaks were found s in the valence state of individual V atoms at the phase transition is very small. A remarkable inflection of this temperature dependence at the phase transition at 34 K indicates that charge ordering is associated with the low temperature phase.Comment: Revisions in style and order of presentation. One new figure. In press in Physical Review B. REVTeX, 4 pages with 4 postscript figure