Avoiding inadvertent epidural injection of drugs intended for non-epidural use

Publisher's copy made available with the permission of the publisher © Australian Society of AnaesthetistsInadvertent administration of non-epidural medications into the epidural space has the potential for serious morbidity and mortality. The aim of this study was to collate reported incidents of this type, describe the potential mechanisms of occurrence and identify possible solutions. We searched medical databases and reviewed reference lists of papers retrieved, covering a period of 35 years, regarding this type of medication incident. The 31 reports of 37 cases found is likely to represent a gross underestimation of the actual number of incidents that occur. 'Syringe swap', 'ampoule error', and epidural/intravenous line confusion were the main sources of error in 36/37 cases (97%). Given that no effective treatment for such errors has been identified, prevention should be the main defence strategy. Despite all the precautions that are currently undertaken, accidents will inevitably occur. We have identified areas for systemwide change that may prevent these types of incidents from occurring in future.http://www.aaic.net.au/Article.asp?D=200213

Incipient Formation of an Electron Lattice in a Weakly Confined Quantum Wire

We study the low-temperature transport properties of 1D quantum wires as the confinement strength V-conf and the carrier density n(1D) are varied using a combination of split gates and a top gate in GaAs/AlGaAs heterostructures. At intermediate V-conf and n(1D), we observe a jump in conductance to 4e(2)/h, suggesting a double wire. On further reducing n(1D), plateau at 2e(2)/h returns. Our results show beginnings of the formation of an electron lattice in an interacting quasi-1D quantum wire. In the presence of an in-plane magnetic field, mixing of spin-aligned levels of the two wires gives rise to more complex states

Data-Driven Analysis of Engagement in Gamified Learning Environments: A Methodology for Real-Time Measurement of MOOCs

Welfare and economic development is directly dependent on the availability of highly skilled and educated individuals in society. In the UK, higher education is accessed by a large percentage of high school graduates (50% in 2017). Still, in Brazil, a limited number of pupils leaving high schools continue their education (up to 20%). Initial pioneering efforts of universities and companies to support pupils from underprivileged backgrounds, to be able to succeed in being accepted by universities include personalised learning solutions. However, initial findings show that typical distance learning problems occur with the pupil population: isolation, demotivation, and lack of engagement. Thus, researchers and companies proposed gamification. However, gamification design is traditionally exclusively based on theory-driven approaches and usually ignore the data itself. This paper takes a different approach, presenting a large-scale study that analysed, statistically and via machine learning (deep and shallow), the first batch of students trained with a Brazilian gamified intelligent learning software (called CamaleOn), to establish, via a grassroots method based on learning analytics, how gamification elements impact on student engagement. The exercise results in a novel proposal for real-time measurement on Massive Open Online Courses (MOOCs), potentially leading to iterative improvements of student support. It also specifically analyses the engagement patterns of an underserved community

On-line case discussion assessment in Ultrasound: The effect on student centred and inter-professional learning

In 2009 an asynchronous on-line case discussion assessment was introduced, to replace an existing traditional case-study assessment, within the Medical Ultrasound Programmes at City University London, to help extend collaborative, interprofessional student-led learning skills. Two clinical modules were used to develop the on-line learning method with associated assessments. Students selected and led a clinical case from their department, uploaded anonymised images and case details with questions, to encourage interaction from other colleagues. Thirty students participated in the on-line case discussions. The assessment was evaluated via informal feedback, end of module feedback and an on-line questionnaire. Some students completed two modules, using the on-line discussion, others were involved in only one module, of which 21 out of 26 students completed end of module feedback for the 1st module and 18 out of 20 students completed feedback from the 2nd module. Twelve students out of 30 completed the on-line questionnaire. Feedback suggested that the on-line case discussions were a good learning tool, providing a wide range of cases for students to participate in or read and learn from each other. All students found the cases interesting, engaging and useful, but time consuming. Despite the small numbers involved, useful feedback was provided to assist further development of the assessment, particularly in relation to the number of cases being assessed and length of availability. On-line case discussions are an innovative, engaging method to encourage self directed, collaborative learning which could be utilised in the health care setting to share interesting cases, promote inter-professional and self-directed learning

Spin-incoherent transport in quantum wires

When a quantum wire is weakly confined, a conductance plateau appears at e(2)/h with decreasing carrier density in zero magnetic field accompanied by a gradual suppression of the 2e(2)/h plateau. Applying an in-plane magnetic field B-parallel to does not alter the value of this quantization; however, the e(2)/h plateau weakens with increasing B-parallel to up to 9 T, and then strengthens on further increasing B-parallel to, which also restores the 2e(2)/h plateau. Our results are consistent with spin-incoherent transport in a one-dimensional wire

Exercise-Associated hyponatremia: 2017 update

Exercise-associated hyponatremia (EAH) was initially described in the 1980s in endurance athletes, and work done since then has conclusively identified that overdrinking beyond thirst and non-osmotic arginine vasopressin release are the most common etiologic factors. In recent years, EAH has been described in a broader variety of athletic events and also has been linked to the development of rhabdomyolysis. The potential role of volume and sodium depletion in a subset of athletes has also been described. This review focuses on the most recent literature in the field of EAH and summarizes key new findings in the epidemiology, pathophysiology, treatment, and prevention of this condition

Extreme sensitivity of the spin-splitting and 0.7 anomaly to confining potential in one-dimensional nanoelectronic devices

Quantum point contacts (QPCs) have shown promise as nanoscale spin-selective components for spintronic applications and are of fundamental interest in the study of electron many-body effects such as the 0.7 x 2e^2/h anomaly. We report on the dependence of the 1D Lande g-factor g* and 0.7 anomaly on electron density and confinement in QPCs with two different top-gate architectures. We obtain g* values up to 2.8 for the lowest 1D subband, significantly exceeding previous in-plane g-factor values in AlGaAs/GaAs QPCs, and approaching that in InGaAs/InP QPCs. We show that g* is highly sensitive to confinement potential, particularly for the lowest 1D subband. This suggests careful management of the QPC's confinement potential may enable the high g* desirable for spintronic applications without resorting to narrow-gap materials such as InAs or InSb. The 0.7 anomaly and zero-bias peak are also highly sensitive to confining potential, explaining the conflicting density dependencies of the 0.7 anomaly in the literature.Comment: 23 pages, 7 figure