Titania-doped tantala/silica coatings for gravitational-wave detection

Reducing thermal noise from optical coatings is crucial to reaching the required sensitivity in next generation interferometric gravitational-wave detectors. Here we show that adding TiO2 to Ta2O5 in Ta2O5/SiO2 coatings reduces the internal friction and in addition present data confirming it reduces thermal noise. We also show that TiO2-doped Ta2O5/SiO2 coatings are close to satisfying the optical absorption requirements of second generation gravitational-wave detectors

Synergistic use of Landsat 8 OLI image and airborne LiDAR data for aboveground biomass estimation in tropical lowland rainforests

Developing a robust and cost-effective method for accurately estimating tropical forest’s carbon pool over large area is a fundamental requirement for the implementation of Reducing Emissions from Deforestation and forest Degradation (REDD+). This study aims at examining the independent and combined use of airborne LiDAR and Landsat 8 Operational Land Imager (OLI) data to accurately estimate the above-ground biomass (AGB) of primary tropical rainforests in Sabah, Malaysia. Thirty field plots were established in three types of lowland rainforests: alluvial, sandstone hill and heath forests that represent a wide range of AGB density and stand structure. We derived the height percentile and laser penetration variables from the airborne LiDAR and calculated the vegetation indices, tasseled cap transformation values, and the texture measures from Landsat 8 OLI data. We found that there are moderate correlations between the AGB and laser penetration variables from airborne LiDAR data (r = −0.411 to −0.790). For Landsat 8 OLI data, the 6 vegetation indices and the 46 texture measures also significantly correlated with the AGB (r = 0.366–0.519). Stepwise multiple regression analysis was performed to establish the estimation models for independent and combined use of airborne LiDAR and Landsat 8 OLI data. The results showed that the model based on a combination of the two remote sensing data achieved the highest accuracy (R2 adj = 0.81, RMSE = 17.36%) whereas the models using Landsat 8 OLI data airborne LiDAR data independently obtained the moderate accuracy (R2 adj = 0.52, RMSE = 24.22% and R2 adj = 0.63, RMSE = 25.25%, respectively). Our study indicated that texture measures from Landsat 8 OLI data provided useful information for AGB estimation and synergistic use of Landsat 8 OLI and airborne LiDAR data could improve the AGB estimation of primary tropical rainforest

Titania-doped tantala/silica coatings for gravitational-wave detection

Reducing thermal noise from optical coatings is crucial to reaching the required sensitivity in next generation interferometric gravitational-waves detectors. Here we show that adding TiO$_2$ to Ta$_2$O$_5$ in Ta$_2$O$_5$/SiO$_2$ coatings reduces the internal friction and in addition present data confirming it reduces thermal noise. We also show that TiO$_2$-doped Ta$_2$O$_5$/SiO$_2$ coatings are close to satisfying the optical absorption requirements of second generation gravitational-wave detectors

Genetic Risk Score for Intracranial Aneurysms:Prediction of Subarachnoid Hemorrhage and Role in Clinical Heterogeneity

BACKGROUND: Recently, common genetic risk factors for intracranial aneurysm (IA) and aneurysmal subarachnoid hemorrhage (ASAH) were found to explain a large amount of disease heritability and therefore have potential to be used for genetic risk prediction. We constructed a genetic risk score to (1) predict ASAH incidence and IA presence (combined set of unruptured IA and ASAH) and (2) assess its association with patient characteristics. METHODS: A genetic risk score incorporating genetic association data for IA and 17 traits related to IA (so-called metaGRS) was created using 1161 IA cases and 407 392 controls from the UK Biobank population study. The metaGRS was validated in combination with risk factors blood pressure, sex, and smoking in 828 IA cases and 68 568 controls from the Nordic HUNT population study. Furthermore, we assessed association between the metaGRS and patient characteristics in a cohort of 5560 IA patients. RESULTS: Per SD increase of metaGRS, the hazard ratio for ASAH incidence was 1.34 (95% CI, 1.20-1.51) and the odds ratio for IA presence 1.09 (95% CI, 1.01-1.18). Upon including the metaGRS on top of clinical risk factors, the concordance index to predict ASAH hazard increased from 0.63 (95% CI, 0.59-0.67) to 0.65 (95% CI, 0.62-0.69), while prediction of IA presence did not improve. The metaGRS was statistically significantly associated with age at ASAH (β=-4.82×10(-3) per year [95% CI, -6.49×10(-3) to -3.14×10(-3)]; P=1.82×10(-8)), and location of IA at the internal carotid artery (odds ratio=0.92 [95% CI, 0.86-0.98]; P=0.0041). CONCLUSIONS: The metaGRS was predictive of ASAH incidence, although with limited added value over clinical risk factors. The metaGRS was not predictive of IA presence. Therefore, we do not recommend using this metaGRS in daily clinical care. Genetic risk does partly explain the clinical heterogeneity of IA warranting prioritization of clinical heterogeneity in future genetic prediction studies of IA and ASAH

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Neurological manifestations of COVID-19 in adults and children

Different neurological manifestations of coronavirus disease 2019 (COVID-19) in adults and children and their impact have not been well characterized. We aimed to determine the prevalence of neurological manifestations and in-hospital complications among hospitalized COVID-19 patients and ascertain differences between adults and children. We conducted a prospective multicentre observational study using the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) cohort across 1507 sites worldwide from 30 January 2020 to 25 May 2021. Analyses of neurological manifestations and neurological complications considered unadjusted prevalence estimates for predefined patient subgroups, and adjusted estimates as a function of patient age and time of hospitalization using generalized linear models. Overall, 161 239 patients (158 267 adults; 2972 children) hospitalized with COVID-19 and assessed for neurological manifestations and complications were included. In adults and children, the most frequent neurological manifestations at admission were fatigue (adults: 37.4%; children: 20.4%), altered consciousness (20.9%; 6.8%), myalgia (16.9%; 7.6%), dysgeusia (7.4%; 1.9%), anosmia (6.0%; 2.2%) and seizure (1.1%; 5.2%). In adults, the most frequent in-hospital neurological complications were stroke (1.5%), seizure (1%) and CNS infection (0.2%). Each occurred more frequently in intensive care unit (ICU) than in non-ICU patients. In children, seizure was the only neurological complication to occur more frequently in ICU versus non-ICU (7.1% versus 2.3%, P < 0.001). Stroke prevalence increased with increasing age, while CNS infection and seizure steadily decreased with age. There was a dramatic decrease in stroke over time during the pandemic. Hypertension, chronic neurological disease and the use of extracorporeal membrane oxygenation were associated with increased risk of stroke. Altered consciousness was associated with CNS infection, seizure and stroke. All in-hospital neurological complications were associated with increased odds of death. The likelihood of death rose with increasing age, especially after 25 years of age. In conclusion, adults and children have different neurological manifestations and in-hospital complications associated with COVID-19. Stroke risk increased with increasing age, while CNS infection and seizure risk decreased with age

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

An Application of Non-Parametric Method and Simple Linear Regression in Rainfall Partitioning in Tropical Lowland Forest of Sepilok Forest Reserve, Sabah

This study was conducted in the alluvial forest and heath forest in the lowland tropical forest of Sepilok Forest Reserve, Sabah, Malaysia. The main objective was to assess how forest structure regulates rainfall partitioning in both forests. Field monitoring involved a series of forest inventory work to determine the forest stand characteristics. Mann Whitney U test was performed to compare physical characteristics between the two forests. Meanwhile rainfall partitioning was quantified by measuring the throughfall (Tf) for a period of 12 months in ten (15 x 15 m) Tf plots and a simple linear regression was conducted to obtain a regression model to estimate Tf. In terms of stand structure characteristics, data in the alluvial forest indicates wider variation. Percentage of Tf as of gross rainfall (Pg) is higher in the heath forest than in alluvial forest with the value of 89.5 % and 76.8 %, respectively. Representative trees were selected for stemflow (Sf) estimation at each forest type. The estimated Sf is 0.2 % in alluvial forest and 0.5 % in heath forest. In this study, tree diameter at breast height (Dbh) and height as well as aboveground biomass were identified to have some influence in Tf and Sf production. Keywords: rainfall partitioning; gross rainfall; throughfall; stemflow; Mann Whitney U; simple linear regression</jats:p

An application of non-parametric method and simple linear regression in rainfall partitioning in tropical lowland forest of Sepilok Forest Reserve, Sabah

This study was conducted in the alluvial forest and heath forest in the lowland tropical forest of Sepilok Forest Reserve, Sabah, Malaysia. The main objective was to assess how forest structure regulates rainfall partitioning in both forests. Field monitoring involved a series of forest inventory work to determine the forest stand characteristics. Mann Whitney U test was performed to compare physical characteristics between the two forests. Meanwhile rainfall partitioning was quantified by measuring the throughfall (Tf) for a period of 12 months in ten (15 x 15 m) Tf plots and a simple linear regression was conducted to obtain a regression model to estimate Tf. In terms of stand structure characteristics, data in the alluvial forest indicates wider variation. Percentage of Tf as of gross rainfall (Pg) is higher in the heath forest than in alluvial forest with the value of 89.5 % and 76.8 %, respectively. Representative trees were selected for stemflow (Sf) estimation at each forest type. The estimated Sf is 0.2 % in alluvial forest and 0.5 % in heath forest. In this study, tree diameter at breast height (Dbh) and height as well as aboveground biomass were identified to have some influence in Tf and Sf production