Magnesium sulphate in the treatment of acute asthma: evaluation of current practice in adult emergency departments

Background: A recent meta-analysis showed that intravenous and nebulised magnesium sulphate have similar levels of evidence to support their use in the treatment of acute asthma in adults. This consisted of weak evidence of effect on respiratory function and hospital admissions, with wide confidence intervals ranging from no effect to significant positive effects. Current BTS/SIGN guidelines suggest an equivocal role for intravenous magnesium sulphate and no role for nebulised magnesium sulphate. A study was performed to assess what emergency physicians currently do in their management of acute asthma. Method: A postal survey was undertaken of all adult emergency departments within the UK. A structured question naire was sent to all clinical leads in emergency medicine about their current usage of both intravenous and nebulised magnesium sulphate in the treatment of acute asthma. Results: 180 of the 251 emergency departments in the UK responded (72%). Magnesium sulphate was used in 93%, mostly because it was expected to relieve breathlessness (70%) or reduce HDU/ITU admissions (51%). It was predominantly given to those patients with acute severe asthma (84%) and life-threatening exacerbations (87%), with most stating they would give the drug if there was no response to repeated nebulisers (68%). In comparison, nebulised magnesium sulphate was only used in two emergency departments (1%). The main reason for not administering the drug via a nebuliser was insufficient evidence (51%). Conclusions: Intravenous magnesium sulphate is widely used for acute asthma, usually for patients with severe or life-threatening asthma who have not responded to initial treatment. Nebulised magnesium sulphate, by contrast, is hardly used at all. The use of intravenous magnesium sulphate is more extensive than current guidelines or available evidence would appear to support

The balance sheet of agriculture, 1954

Agriculture - Economic aspects

A report on the population structure of adult salmon and sea trout in the River Lune using scale samples - with reference to historical data.

During 1993, a comprehensive data set of scale readings, length and weight measurements was established for migratory salmonids on the River Lune. This information was collected using three methods of fish capture: 1. The Lune estuary commercial nets. 2. River Lune Forge weir fish trap. 3. River Lune rod catch scale returns. Additional information was contributed by the Kent, Leven and Duddon rod and commercial fisheries. The data shows that the salmon stock in 1993 was dominated by two year old smolts. This varies from year to year. The sea trout population displays a normal population curve in terms of numbers of fish in each age and weight class. The growth rate of salmon and sea trout is very similar even though salmon have the benefit of high sea feeding

The balance sheet of agriculture, 1957

Agriculture ; Agricultural productivity

One-loop renormalisation of N=1/2 supersymmetric gauge theory

We show that N=1/2 supersymmetric gauge theory is renormalisable at one loop, but only after gauge invariance is restored in a non-trivial fashion.Comment: 11 pages, including 3 figures. Plain TeX. Uses Harvmac and epsf. Minor changes and reference adde

Rapid acidification of mode and intermediate waters in the southwestern Atlantic Ocean

Observations along the southwestern Atlantic WOCE A17 line made during the Dutch GEOTRACES-NL programme (2010–2011) were compared with historical data from 1994 to quantify the changes in the anthropogenic component of the total pool of dissolved inorganic carbon (?Cant). Application of the extended multi-linear regression (eMLR) method shows that the ?Cant from 1994 to 2011 has largely remained confined to the upper 1000 dbar. The greatest changes occur in the upper 200 dbar in the Subantarctic Zone (SAZ), where a maximum increase of 37 µmol kg-1 is found. South Atlantic Central Water (SACW) experienced the highest rate of increase in Cant, at 0.99 ± 0.14 µmol kg-1 yr-1, resulting in a maximum rate of decrease in pH of 0.0016 yr-1. The highest rates of acidification relative to ?Cant, however, were found in Subantarctic Mode Water (SAMW) and Antarctic Intermediate Water (AAIW). The low buffering capacity of SAMW and AAIW combined with their relatively high rates of Cant, increase of 0.53 ± 0.11 and 0.36 ± 0.06 µmol kg-1 yr-1, respectively, has lead to rapid acidification in the SAZ, and will continue to do so whilst simultaneously reducing the chemical buffering capacity of this significant CO2 sink

Spatial random downscaling of rainfall signals in Andean heterogeneous terrain.

Remotely sensed data are often used as proxies for indirect precipitation measures over data-scarce and complex-terrain areas such as the Peruvian Andes. Although this information might be appropriate for some research requirements, the extent at which local sites could be related to such information is very limited because of the resolution of the available satellite data. Downscaling techniques are used to bridge the gap between what climate modelers (global and regional) are able to provide and what decision-makers require (local). Precipitation downscaling improves the poor local representation of satellite data and helps end-users acquire more accurate estimates of water availability. Thus, a multifractal downscaling technique complemented by a heterogeneity filter was applied to TRMM (Tropical Rainfall Measuring Mission) 3B42 gridded data (spatial resolution ~ 28 km) from the Peruvian Andean high plateau or Altiplano to generate downscaled rainfall fields that are relevant at an agricultural scale (spatial resolution ~ 1 km)

Blood feeding in juvenile Paragnathia formica (Isopoda: Gnathiidae): biochemical characterization of trypsin inhibitors, detection of anticoagulants, and molecular identification of fish hosts

SUMMARYThe 3 post-marsupial juvenile stages of the gnathiid isopod, Paragnathia formica, are haematophagous ectoparasites of fishes that may, in heavy infestations, cause host mortality. Protein digestion in fed stage 3 juveniles is accomplished by cysteine proteinases, but what bioactive compounds attenuate host haemostatic, inflammatory and immunological responses during feeding is unknown. Trypsin inhibitory activity and anticoagulant activity were detected in crude extracts of unfed P. formica stage 1 juveniles; fractionation of stage 1 crude extracts by ion exchange chromatography resulted in 3 preparations each displaying these bioactivities. Further characterization revealed anti-thrombin activity in 2 of these preparations, whilst the third displayed the strongest anticoagulant activity that targeted a factor of the intrinsic coagulation pathway. Three trypsin inhibitors (18 kDa, 21 kDa, and 22 kDa) were also detected using reverse zymography. In parallel, homogenates of fed stage 2 and 3 juveniles were used to identify their fish hosts by amplifying the 16S mitochondrial rDNA and 18S genomic rDNA vertebrate gene regions. Blood from at least 4 fish families had been ingested by separate individuals during feeding. This study demonstrates that trypsin inhibitors and anticoagulants are present in P. formica juveniles which could suppress host haemostatic, inflammatory and immunological responses during feeding, and that juveniles are not host specific

Ab initio calculation of the neutron-proton mass difference

The existence and stability of atoms rely on the fact that neutrons are more massive than protons. The measured mass difference is only 0.14\% of the average of the two masses. A slightly smaller or larger value would have led to a dramatically different universe. Here, we show that this difference results from the competition between electromagnetic and mass isospin breaking effects. We performed lattice quantum-chromodynamics and quantum-electrodynamics computations with four nondegenerate Wilson fermion flavors and computed the neutron-proton mass-splitting with an accuracy of $300$ kilo-electron volts, which is greater than $0$ by $5$ standard deviations. We also determine the splittings in the $\Sigma$, $\Xi$, $D$ and $\Xi_{cc}$ isospin multiplets, exceeding in some cases the precision of experimental measurements.Comment: 57 pages, 15 figures, 6 tables, revised versio

Mass Loss Due to Sputtering and Thermal Processes in Meteoroid Ablation

Conventional meteoroid theory assumes that the dominant mode of ablation is by evaporation following intense heating during atmospheric flight. In this paper we consider the question of whether sputtering may provide an alternative disintegration process of some importance.For meteoroids in the mass range from 10^-3 to 10^-13 kg and covering a meteor velocity range from 11 to 71 km/s, we numerically modeled both thermal ablation and sputtering ablation during atmospheric flight. We considered three meteoroid models believed to be representative of asteroidal (3300 kg m^-3 mass density), cometary (1000 kg m^-3) and porous cometary (300 kg m^-3) meteoroid structures. Atmospheric profiles which considered the molecular compositions at different heights were used in the sputtering calculations. We find that while in many cases (particularly at low velocities and for relatively large meteoroid masses) sputtering contributes only a small amount of mass loss during atmospheric flight, in some cases sputtering is very important. For example, a 10^-10 kg porous meteoroid at 40 km/s will lose nearly 51% of its mass by sputtering, while a 10^-13 kg asteroidal meteoroid at 60 km/s will lose nearly 83% of its mass by sputtering. We argue that sputtering may explain the light production observed at very great heights in some Leonid meteors. The impact of this work will be most dramatic for very small meteoroids such as those observed with large aperture radars.Comment: in pdf form, 48 pgs incl figures and table