Phenylephrine Versus Ephedrine: Safest Vasopressor for the Neonate During Caesarean Section

One of the most common side effects of spinal anesthesia is the development of hypotension. Data collected has determined that 80% of parturients that undergo spinal anesthesia for this mode of delivery experience hypotension (Chestnut et al., 2014). Hypotension, if sustained and severe, can lead to fetal hypoxia, neonatal depression or injury, and decreased uteroplacental perfusion. Hypotension can also cause severe health issues for the parturient including apnea, altered level of consciousness, cardiac arrest, and pulmonary aspiration. This systematic review of the literature was conducted to determine whether the administration of phenylephrine or ephedrine was safer for the neonate to administer to a hypotensive parturient during cesarean delivery while undergoing a spinal anesthetic. Inclusion criteria included parturients that were classified as an American Society of Anesthesiologists physical status score of II that experienced hypotension after undergoing spinal anesthesia for elective cesarean section. Exclusion criteria included any parturient classified as an ASA physical status score \u3e 2, any cesarean section classified as emergent, or those parturients that received an epidural as the method of anesthesia for elective cesarean section. A systematic review of the literature was performed and the results of randomized control trials and other studies were analyzed that measured neonatal outcomes following the administration of ephedrine and phenylephrine to the hypotensive parturient. The results of these studies were disseminated and the conclusions reached were implemented into a white paper change proposal

Spectroscopic ellipsometry as a sensitive monitor of materials contamination

Spectroscopic ellipsometry is demonstrated to be extremely sensitive to contamination layers in the thickness range from 0.1 nm to 10 microns. In the present experiments we deposit either a thin lubricating oil (WD-40) or mineral oil continuously onto Ir, Cu, Al, Au, and V substrates from a bubbler, and monitor its thickness growth from sub-nanometer to tens of nanometers as a function of time. Re-evaporation of contaminant oils is also monitored in real-time by ellipsometry

One place doesn't fit all: improving the effectiveness of sustainability standards by accounting for place

Includes bibliographical references (pages 8-10).The growing interest in incentivizing sustainable agricultural practices is supported by a large network of voluntary production standards, which aim to offer farmers and ranchers increased value for their product in support of reduced environmental impact. To be effective with producers and consumers alike, these standards must be both credible and broadly recognizable, and thus are typically highly generalizable. However, the environmental impact of agriculture is strongly place-based and varies considerably due to complex biophysical, socio-cultural, and management-based factors, even within a given sector in a particular region. We suggest that this contradiction between the placeless generality of standards and the placed-ness of agriculture renders many sustainability standards ineffective. In this policy and practice review, we examine this contradiction through the lens of beef production, with a focus on an ongoing regional food purchasing effort in Denver, Colorado, USA. We review the idea of place in the context of agricultural sustainability, drawing on life cycle analysis and diverse literature to find that recognition of place-specific circumstances is essential to understanding environmental impact and improving outcomes. We then examine the case of the Good Food Purchasing Program (GFPP), a broad set of food-purchasing standards currently being implemented for institutional purchasing in Denver. The GFPP was created through a lengthy stakeholder-inclusive process for use in Los Angeles, California, USA, and has since been applied to many cities across the country. The difference between Los Angeles' process and that of applying the result of Los Angeles' process to Denver is instructive, and emblematic of the flaws of generalizable sustainability standards themselves. We then describe the essential elements of a place-based approach to agricultural sustainability standards, pointing toward a democratic, process-based, and outcome-oriented strategy that results in standards that enable rather than hinder the creativity of both producers and consumers. Though prescription is anathema to our approach, we close by offering a starting point for the development of standards for beef production in Colorado that respect the work of people in place

Light and Life: Exotic Photosynthesis in Binary Star Systems

The potential for hosting photosynthetic life on Earth-like planets within binary/multiple stellar systems was evaluated by modelling the levels of photosynthetically active radiation (PAR) such planets receive. Combinations of M and G stars in: (i) close-binary systems; (ii) wide-binary systems and (iii) three-star systems were investigated and a range of stable radiation environments found to be possible. These environmental conditions allow for the possibility of familiar, but also more exotic forms of photosynthetic life, such as infrared photosynthesisers and organisms specialised for specific spectral niches.Comment: Accepted for publication in: Astrobiolog

Experimental quantum tomography of photonic qudits via mutually unbiased basis

We present the experimental quantum tomography of 7- and 8-dimensional quantum systems based on projective measurements in the mutually unbiased basis (MUB-QT). One of the advantages of MUB-QT is that it requires projections from a minimal number of bases to be performed. In our scheme, the higher dimensional quantum systems are encoded using the propagation modes of single photons, and we take advantage of the capabilities of amplitude- and phase-modulation of programmable spatial light modulators to implement the MUB-QT.Comment: Published versio

Impacts of phosphorus concentration and light intensity on river periphyton biomass and community structure

Periphyton growth rate has been identified as the key process that leads to river eutrophication. Effort has focused on reducing phosphorus concentrations to control periphyton biomass, but other factors, such as light, are also important. Within-stream flume mesocosms were deployed in the River Lambourn, UK, to investigate how light intensity and phosphorus concentrations affect periphyton biomass and community structure. Soluble reactive phosphorus (SRP) concentrations were tripled in some flumes, and decreased in others by dosing of FeCl3. Increasing SRP concentrations from the ambient concentration of 49 µg L-1 to 155 µg L-1 had no effect on biomass, but community composition (by flow cytometry) shifted from diatom to cyanobacterial dominance. Reducing light levels (equivalent to riparian tree shading) decreased biomass by 40 %, showing that the biofilms were light limited at SRP concentration ≥ 49 µg L-1. Periphyton were phosphorus / light co-limited when SRP concentrations were reduced to 33 µg L-1. Further reductions in SRP concentration (23 µg L-1) resulted in phosphorus limitation of periphyton biomass and increased dominance of diatoms and chlorophytes within the biofilm. Reducing light intensity through providing riparian tree shading could be an important management tool to reduce periphyton biomass and improve ecological status

Patterns of analgesic use, pain and self-efficacy: a cross-sectional study of patients attending a hospital rheumatology clinic

Background: Many people attending rheumatology clinics use analgesics and non-steroidal anti-inflammatories for persistent musculoskeletal pain. Guidelines for pain management recommend regular and pre-emptive use of analgesics to reduce the impact of pain. Clinical experience indicates that analgesics are often not used in this way. Studies exploring use of analgesics in arthritis have historically measured adherence to such medication. Here we examine patterns of analgesic use and their relationships to pain, self-efficacy and demographic factors. Methods: Consecutive patients were approached in a hospital rheumatology out-patient clinic. Pattern of analgesic use was assessed by response to statements such as 'I always take my tablets every day.' Pain and self-efficacy (SE) were measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Arthritis Self-Efficacy Scale (ASES). Influence of factors on pain level and regularity of analgesic use were investigated using linear regression. Differences in pain between those agreeing and disagreeing with statements regarding analgesic use were assessed using t-tests. Results: 218 patients (85% of attendees) completed the study. Six (2.8%) patients reported no current pain, 26 (12.3%) slight, 100 (47.4%) moderate, 62 (29.4%) severe and 17 (8.1%) extreme pain. In multiple linear regression self efficacy and regularity of analgesic use were significant (p < 0.01) with lower self efficacy and more regular use of analgesics associated with more pain. Low SE was associated with greater pain: 40 (41.7%) people with low SE reported severe pain versus 22 (18.3%) people with high SE, p < 0.001. Patients in greater pain were significantly more likely to take analgesics regularly; 13 (77%) of those in extreme pain reported always taking their analgesics every day, versus 9 (35%) in slight pain. Many patients, including 46% of those in severe pain, adjusted analgesic use to current pain level. In simple linear regression, pain was the only variable significantly associated with regularity of analgesic use: higher levels of pain corresponded to more regular analgesic use (p = 0.003). Conclusion: Our study confirms that there is a strong inverse relationship between self-efficacy and pain severity. Analgesics are often used irregularly by people with arthritis, including some reporting severe pain