Lower alpha frequency of intraoperative frontal EEG is associated with postoperative delirium: A secondary propensity-matched analysis.

BACKGROUND Postoperative delirium (POD) is a serious complication of surgery, especially in the elderly patient population. It has been proposed that decreasing the amount of anesthetics by titrating to an EEG index will lower POD rate, but clear evidence is missing. A strong age-dependent negative correlation has been reported between the peak oscillatory frequency of alpha waves and end-tidal anesthetic concentration, with older patients generating slower alpha frequencies. We hypothesized, that slower alpha oscillations are associated with a higher rate of POD. METHOD Retrospective analysis of patients` data from a prospective observational study in cardiac surgical patients approved by the Bernese Ethics committee. Frontal EEG was recorded during Isoflurane effect-site concentrations of 0.7 to 0.8 and peak alpha frequency was measured at highest power between 6 and 17 Hz. Delirium was assessed by chart review. Demographic and clinical characteristics were compared between POD and non-POD groups. Selection bias was addressed using nearest neighbor propensity score matching (PSM) for best balance. This incorporated 18 variables, whereas patients with missing variable information or without an alpha oscillation were excluded. RESULT Of the 1072 patients in the original study, 828 were included, 73 with POD, 755 without. PSM allowed 328 patients into the final analysis, 67 with, 261 without POD. Before PSM, 8 variables were significantly different between POD and non-POD groups, none thereafter. Mean peak alpha frequency was significantly lower in the POD in contrast to non-POD group before and after matching (7.9 vs 8.9 Hz, 7.9 vs 8.8 Hz respectively, SD 1.3, p < 0.001). CONCLUSION Intraoperative slower frontal peak alpha frequency is independently associated with POD after cardiac surgery and may be a simple intraoperative neurophysiological marker of a vulnerable brain for POD. Further studies are needed to investigate if there is a causal link between alpha frequency and POD

How to humiliate and shame: A reporter's guide to the power of the mugshot

This is an Author's Accepted Manuscript of an article published in Social Semiotics, 24(1), 56-87, 2014, copyright Taylor & Francis, available online at: http://www.tandfonline.com/The judicial photograph – the “mugshot” – is a ubiquitous and instantly recognisable form, appearing in the news media, on the internet, on book covers, law enforcement noticeboards and in many other mediums. This essay attempts to situate the mugshot in a historical and theoretical context to explain the explicit and implicit meaning of the genre as it has developed, focussing in particular on their use in the UK media in late modernity. The analysis is based on the author's reflexive practice as a journalist covering crime in the national news media for 30 years and who has used mugshots to illustrate stories for their explicit and specific content. The author argues that the visual limitations of the standardised “head and shoulders” format of the mugshot make it a robust subject for analysing the changing meaning of images over time. With little variation in the image format, arguments for certain accreted layers of signification are easier to make. Within a few years of the first appearance of the mugshot form in the mid-19th century, it was adopted and adapted as a research tool by scientists and criminologists. While the positivist scientists claimed empirical objectivity we can now see that mugshots played a part in the construction of subjective notions of “the other”, “the lesser” or “sub-human” on the grounds of class, race and religion. These dehumanising ideas later informed the theorists and bureaucrats of National Socialist ideology from the 1920s to 1940s. The author concludes that once again the mugshot has become, in certain parts of the media, a signifier widely used to exclude or deride certain groups. In late modernity, the part of the media that most use mugshots – the tabloid press and increasingly tabloid TV – is part of a neo-liberal process that, in a conscious commercial appeal to the paying audience, seeks to separate rather than unify wider society

Das quantifizierte EEG im elektroenzephalogrammbasierten Monitoring während Allgemeinanästhesie

The electroencephalogram (EEG) is increasingly being used in the clinical routine of anesthesia in German-speaking countries. In over 90% of patients the frontal EEG changes somewhat predictably in response to administration of the normally used anesthetic agents (propofol and volatile gasses). An adequate depth of anesthesia and appropriate concentrations of anesthetics in the brain generate mostly frontal oscillations between 8 and 12 Hz as well as slow delta waves between 0.5 and 4 Hz. The frontal EEG channel is well-suited for avoidance of insufficient depth of anesthesia and excessive administration of anesthetics. This article explains the clinical interpretation of the most important EEG patterns and the biophysical background. Also discussed are important limitations and pitfalls for the clinical routine, which the anesthetist should know in order to utilize the EEG as an admittedly incomplete but clinically extremely important parameter for the level of consciousness.Das Elektroenzephalogramm (EEG) findet im klinischen Alltag der Anästhesie des deutschsprachigen Raumes zunehmend Anwendung. Bei über 90 % der Patienten ändert sich das frontale EEG als Reaktion auf die Gabe der gebräuchlichen Narkotika (Propofol und volatile Narkosegase) in typischer Weise. Eine adäquate Narkosetiefe und angemessene Konzentrationen der Anästhetika im Gehirn erzeugen meist frontale Oszillationen zwischen 8 und 12 Hz (α-Oszillationen) sowie langsame δ‑Wellen zwischen 0,5 und 4 Hz. Die frontale EEG-Ableitung eignet sich gut zur Vermeidung einer unzureichenden Narkosetiefe bzw. einer Überdosierung von Anästhetika. Im Folgenden werden die klinische Interpretation der wichtigsten EEG-Muster und ihr biophysikalischer Hintergrund erläutert. Ebenso werden wichtige Limitationen und „Fallstricke“ für den klinischen Alltag diskutiert, die der Anästhesist kennen sollte, um das EEG als zwar unvollständigen, aber klinisch äußerst wichtigen Parameter des Bewusstseinslevels zu nutzen

Effect of Grain Size and Shape on Undrained Behaviour of Sands

The stress–strain and stress path characteristics of sands are influenced by their grain size, shape, and packing. Morphological characteristics and size of particles play important role on the undrained shear strength of sands. Often, effects of these parameters are complex and cannot be easily distinguished. This study advances the knowledge of the role of particle size and shape on the undrained shear strength of sands. To eliminate the consequence of morphological characteristics, two sands with different particle sizes but similar angularity, and another sand with different roundness were selected for the study. These morphological characteristics for all three sands were determined from the analysis of scanning electron microscope images. F131 sand with higher median grain size and lower shape factors (rᵣ and rₛ) had highest undrained peak shear strength and phase transformation value. Undrained strength (qₚₜ) and effective principal stress (P′ₚₜ) in phase transformation point had direct relationship with grain median grain size (D₅₀) and inversely effect of shape factor (rᵣ and rₛ). F131 and F161 sands represented highest peak and ultimate steady-state strengths, respectively. Flow potential appeared to be directly proportional with (rᵣ and rₛ) and inversely with D₅₀. The peak index decreased with increasing shape factors (rᵣ and rₛ)

Ring-Exchange Interaction Effects on Magnons in Dirac Magnet CoTiO3_3

In magnetically ordered materials with localized electrons, the fundamental magnetic interactions are due to exchange of electrons [1-3]. Typically, only the interaction between pairs of electrons' spins is considered to explain the nature of the ground state and its excitations, whereas three-, four-, and six-spin interactions are ignored. When these higher order processes occur in a loop they are called cyclic or ring exchange. The ring-exchange interaction is required to explain low temperature behavior in bulk and thin films of solid $^3$He [4-8]. It also plays a crucial role in the quantum magnet La$_2$CuO$_4$ [9,10]. Here, we use a combination of time domain THz (TDTS) and magneto-Raman spectroscopies to measure the low energy magnetic excitations in CoTiO$_3$, a proposed Dirac topological magnon material [11,12] where the origin of the energy gap in the magnon spectrum at the Brillouin zone center remains unclear. We measured the magnetic field dependence of the energies of the two lowest energy magnons and determine that the gap opens due to the ring-exchange interaction between the six spins in a hexagon. This interaction also explains the selection rules of the THz magnon absorption. Finally, we clarify that topological surface magnons are not expected in CoTiO$_3$. Our study demonstrates the power of combining TDTS and Raman spectroscopies with theory to identify the microscopic origins of the magnetic excitations in quantum magnets.Comment: 7 pages, 4 figures in main text, 26 pages and 11 figures in supplemen

Evolution of Microscopic Localization in Graphene in a Magnetic Field from Scattering Resonances to Quantum Dots

Graphene is a unique two-dimensional material with rich new physics and great promise for applications in electronic devices. Physical phenomena such as the half-integer quantum Hall effect and high carrier mobility are critically dependent on interactions with impurities/substrates and localization of Dirac fermions in realistic devices. We microscopically study these interactions using scanning tunneling spectroscopy (STS) of exfoliated graphene on a SiO2 substrate in an applied magnetic field. The magnetic field strongly affects the electronic behavior of the graphene; the states condense into welldefined Landau levels with a dramatic change in the character of localization. In zero magnetic field, we detect weakly localized states created by the substrate induced disorder potential. In strong magnetic field, the two-dimensional electron gas breaks into a network of interacting quantum dots formed at the potential hills and valleys of the disorder potential. Our results demonstrate how graphene properties are perturbed by the disorder potential; a finding that is essential for both the physics and applications of graphene.Comment: to be published in Nature Physic

Some economic problems of the Illinois River Valley

Papers presented before the Economics Section of the Illinois State Academy of Science, Peoria, Illinois, May 8, 1931.Includes bibliographical references

A laboratory study of anisotropic geomaterials incorporating recent micromechanical understanding

This paper presents an experimental investigation revisiting the anisotropic stress–strain–strength behaviour of geomaterials in drained monotonic shear using hollow cylinder apparatus. The test programme has been designed to cover the effect of material anisotropy, preshearing, material density and intermediate principal stress on the behaviour of Leighton Buzzard sand. Experiments have also been performed on glass beads to understand the effect of particle shape. This paper explains phenomenological observations based on recently acquired understanding in micromechanics, with attention focused on strength anisotropy and deformation non-coaxiality, i.e. non-coincidence between the principal stress direction and the principal strain rate direction. The test results demonstrate that the effects of initial anisotropy produced during sample preparation are significant. The stress–strain–strength behaviour of the specimen shows strong dependence on the principal stress direction. Preloading history, material density and particle shape are also found to be influential. In particular, it was found that non-coaxiality is more significant in presheared specimens. The observations on the strength anisotropy and deformation non-coaxiality were explained based on the stress–force–fabric relationship. It was observed that intermediate principal stress parameter b(b = (σ2 − σ3)/(σ1 − σ3)) has a significant effect on the non-coaxiality of sand. The lower the b-value, the higher the degree of non-coaxiality is induced. Visual inspection of shear band formed at the end of HCA testing has also been presented. The inclinations of the shear bands at different loading directions can be predicted well by taking account of the relative direction of the mobilized planes to the bedding plane

Locating Photography

The specter of global dissemination haunted photography from its very beginning. This chapter explains two aspects of photography's “globalization”: its use as a “western” technique to document an increasingly colonized world and its dissemination around the world and its adoption by local practitioners. In rural and small‐town central India, the studio retains a central place in most people's encounters with photography. Martín Chambi would retain a lifelong adherence to the purity of the photographic image but other indigenista photographers, such as Juan Manuel Figueroa Aznar, would increasingly use paint alongside photography. A World System Photography, seen in networks that fold locally articulated practices into trajectories that fuse technics, history, and culture, can help people think in new ways about the “location” of photography. Locations have to be re‐imagined as “Terra Infirma”, unstable and complex positions which may have more of the quality of linking sections of a network than of territories