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

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

A Fault-Tolerant Two-Motor Drive With FCS-MP-Based Flux and Torque Control

Independently controlled multi-motor drives are typically realized by using a common dc link and independent sets of three-phase inverters and motors. In the case of an open-circuit fault in an inverter leg, one motor becomes single-phase. To enable continued controllable operation by eliminating single-phasing, the supply for the motor phase with the faulted inverter leg can be paralleled to a healthy leg of another inverter, using hardware reconfiguration. Hence, the two motors are now supplied from a five-leg inverter, which has inherent voltage and current limitations. Theoretically, violating the voltage limit leads to inverter over-modulation and large torque oscillations. It is shown here that the finite-control-set model predictive control (FCS-MPC), designed to control the machines’ stator flux and torque, can consider the inherent voltage limit dynamically in the control loop. Apart from preserving the independent control of the two machines, the additional constraint consideration significantly widens the operating speed ranges of the machines. In particular, it is shown that whenever the voltage limit is entered, the controller reduces the stator flux level automatically, without requiring external flux reference change. The obtained performance is illustrated using experimental results and is also compared to the conventional two-motor field-oriented control scheme. The control concept is thus fully experimentally verified

A Comparative Study of Synchronous Current Control Schemes Based on FCS-MPC and PI-PWM for a Two-Motor Three-Phase Drive

A two-motor drive, supplied by a five-leg inverter, is considered in this paper. The independent control of machines with full dc-bus voltage utilization is typically achieved using an existing pulsewidth modulation (PWM) technique in conjunction with field-oriented control, based on PI current control. However, model predictive control (MPC), based on a finite number of control inputs [finite-control-set MPC (FCS-MPC)], does not utilize a pulsewidth modulator. This paper introduces three FCS-MPC schemes for synchronous current control in this drive system. The first scheme uses all of the available switching states. The second and third schemes are aimed at reducing the computational burden and utilize a reduced set of voltage vectors and a duty ratio partitioning principle, respectively. Steady-state and transient performances are analyzed and compared both against each other and with respect to the field-oriented control based on PI controllers and PWM. All analyses are experimental and use the same experimental rig and test conditions. Comparison of the predictive schemes leads to the conclusion that the first two schemes have the fastest transient response. The third scheme has a much smaller current ripple while achieving perfect control decoupling between the machines and is of low computational complexity. Nevertheless, at approximately the same switching loss, the PI-PWM control yields the lowest current ripple but with slower electrical transient response. © 1982-2012 IEEE

Exploring the attitudes of students undertaking sports degrees towards online international learning

Abstract Aims: There is an increased focus on the internationalisation of the learning experiences of university students1. One way this can be achieved is through ‘virtual internationalisation’2, which can be promoted through the use of Online International Learning (OIL) programmes. This article on sport pedagogy investigates the attitudes of sport students to such a programme. Methods: This article uses quantitative and qualitative methods. 63 students completed a survey and wrote reflective reports. Data was collected from a survey of 16 targeted questions addressing the attitudes of students towards the programme. Students also wrote reflective reports on their experiences, allowing for qualitative responses to be analysed. Results: 62% of students surveyed found the internationalised module to have been a worthwhile experience in terms of learning new skills and working with a partner from an institution based in another continent. 65% suggested that they learned skills on the internationalised module they would use again in education and in future employment. Students from European Union countries gave high rates of positive feedback. 100% reported that the module was a worthwhile experience, compared to 60% of UK students and 38% of international students from outside the European Union. Conclusion: 62% of students surveyed stated that they learned new skills, and there was a perceived value to the programme in terms of enhancing employment prospects. Virtual mobilities projects offer a possible method for tutors to give students international experiences, which is important as sport is now a globalised industry

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

Avapritinib versus regorafenib in locally advanced unresectable or metastatic GI stromal tumor: A randomized, open-label phase III study

PURPOSE Primary or secondary mutations in KIT or platelet-derived growth factor receptor alpha (PDGFRA) underlie tyrosine kinase inhibitor resistance in most GI stromal tumors (GISTs). Avapritinib selectively and potently inhibits KIT- and PDGFRA-mutant kinases. In the phase I NAVIGATOR study (NCT02508532), avapritinib showed clinical activity against PDGFRA D842V–mutant and later-line KIT-mutant GIST. VOYAGER (NCT03465722), a phase III study, evaluated efficacy and safety of avapritinib versus regorafenib as third-line or later treatment in patients with unresectable or metastatic GIST. PATIENTS AND METHODS VOYAGER randomly assigned patients 1:1 to avapritinib 300 mg once daily (4 weeks continuously) or regorafenib 160 mg once daily (3 weeks on and 1 week off). Primary end point was progression-free survival (PFS) by central radiology per RECIST version 1.1 modified for GIST. Secondary end points included objective response rate, overall survival, safety, disease control rate, and duration of response. Regorafenib to avapritinib crossover was permitted upon centrally confirmed disease progression. RESULTS Four hundred seventy-six patients were randomly assigned (avapritinib, n 5 240; regorafenib, n 5 236). Median PFS was not statistically different between avapritinib and regorafenib (hazard ratio, 1.25; 95% CI, 0.99 to 1.57; 4.2 v 5.6 months; P 5 .055). Overall survival data were immature at cutoff. Objective response rates were 17.1% and 7.2%, with durations of responses of 7.6 and 9.4 months for avapritinib and regorafenib; disease control rates were 41.7% (95% CI, 35.4 to 48.2) and 46.2% (95% CI, 39.7 to 52.8). Treatment-related adverse events (any grade, grade $ 3) were similar for avapritinib (92.5% and 55.2%) and regorafenib (96.2% and 57.7%). CONCLUSION Primary end point was not met. There was no significant difference in median PFS between avapritinib and regorafenib in patients with molecularly unselected, late-line GIST

Temperature Dependence of Spin-Split Peaks in Transverse Electron Focusing

We present experimental results of transverse electron-focusing measurements performed using n-type GaAs. In the presence of a small transverse magnetic field (B⊥), electrons are focused from the injector to detector leading to focusing peaks periodic in B⊥. We show that the odd-focusing peaks exhibit a split, where each sub-peak represents a population of a particular spin branch emanating from the injector. The temperature dependence reveals that the peak splitting is well defined at low temperature whereas it smears out at high temperature indicating the exchange-driven spin polarisation in the injector is dominant at low temperatures