Local cooling for relieving pain from perineal trauma sustained during childbirth

Background: Perineal trauma is common during childbirth and may be painful. Contemporary maternity practice includes offering women numerous forms of pain relief, including the local application of cooling treatments. Objectives: To evaluate the effectiveness and side effects of localised cooling treatments compared with no treatment, other forms of cooling treatments and non-cooling treatments. Search strategy: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (January 2007), CINAHL (1982 to January 2007) and contacted experts in the field. Selection criteria: Published and unpublished randomised and quasi-randomised trials (RCTs) that compared localised cooling treatment applied to the perineum with no treatment or other treatments applied to relieve pain related to perineal trauma sustained during childbirth. Data collection and analysis: At least two independent authors performed data extraction for each study. Analyses were performed on an intention-to-treat basis where data allowed. We sought additional information from the authors of three trials. Main results: Seven published RCTs were included, comparing local cooling treatments (ice packs, cold gel pads or cold/iced baths) with no treatment, hamamelis water (witch hazel), pulsed electromagnetic energy (PET), hydrocortisone/pramoxine foam [Epifoam] or warm baths. The RCTs reported on a total of 859 women. Ice packs provided improved pain relief 24 to 72 hours after birth compared with no treatment (risk ratio (RR) 0.61, 95% confidence interval (CI) 0.41 to 0.91). Women preferred the utility of the gel pads compared with ice packs or no treatment, although no differences in pain relief were detected between the treatments. None of our comparisons of treatments resulted in differences detected in perineal oedema or bruising. Women reported more pain (RR 5.60, 95% CI 2.35 to 13.33) and used more additional analgesia (RR 4.00, 95% CI 1.44 to 11.13) following the application of ice packs compared with PET. Authors' conclusions: There is only limited evidence to support the effectiveness of local cooling treatments (ice packs, cold gel pads, cold/iced baths) applied to the perineum following childbirth to relieve pain

Fixed Price Approximability of the Optimal Gain From Trade

Bilateral trade is a fundamental economic scenario comprising a strategically acting buyer and seller, each holding valuations for the item, drawn from publicly known distributions. A mechanism is supposed to facilitate trade between these agents, if such trade is beneficial. It was recently shown that the only mechanisms that are simultaneously DSIC, SBB, and ex-post IR, are fixed price mechanisms, i.e., mechanisms that are parametrised by a price p, and trade occurs if and only if the valuation of the buyer is at least p and the valuation of the seller is at most p. The gain from trade is the increase in welfare that results from applying a mechanism; here we study the gain from trade achievable by fixed price mechanisms. We explore this question for both the bilateral trade setting, and a double auction setting where there are multiple buyers and sellers. We first identify a fixed price mechanism that achieves a gain from trade of at least 2/r times the optimum, where r is the probability that the seller's valuation does not exceed the buyer's valuation. This extends a previous result by McAfee. Subsequently, we improve this approximation factor in an asymptotic sense, by showing that a more sophisticated rule for setting the fixed price results in an expected gain from trade within a factor O(log(1/r)) of the optimal gain from trade. This is asymptotically the best approximation factor possible. Lastly, we extend our study of fixed price mechanisms to the double auction setting defined by a set of multiple i.i.d. unit demand buyers, and i.i.d. unit supply sellers. We present a fixed price mechanism that achieves a gain from trade that achieves for all epsilon > 0 a gain from trade of at least (1-epsilon) times the expected optimal gain from trade with probability 1 - 2/e^{#T epsilon^2 /2}, where #T is the expected number of trades resulting from the double auction

Direction-dependent secondary bonds and their stepwise melting in a uracil-based molecular crystal studied by infrared spectroscopy and theoretical modeling

Three types of supramolecular interactions are identified in the three crystallographic directions in crystals of 1,4-bis[(1-hexylurac-6-yl)ethynyl]benzene, a uracil-based molecule with a linear backbone. These three interactions, characterized by their strongest component, are: intermolecular double H-bonds along the molecular axis, London dispersion interaction of hexyl chains connecting these linear assemblies, and $\pi$--$\pi$ stacking of the aromatic rings perpendicular to the molecular planes. On heating, two transitions happen, disordering of hexyl chains at 473 K, followed by H-bond melting at 534 K. The nature of the bonds and transitions was established by matrix-isolation and temperature-dependent infrared spectroscopy and supported by theoretical computations

Specific staining of human chromosomes in Chinese hamster x man hybrid cell lines demonstrates interphase chromosome territories

In spite of Carl Rabl's (1885) and Theodor Boveri's (1909) early hypothesis that chromosomes occupy discrete territories or domains within the interphase nucleus, evidence in favor pf this hypothesis has been limited and indirect so far in higher plants and animals. The alternative possibility that the chromatin fiber of single chromosomes might be extended throughout the major part of even the whole interphase nucleus has been considered for many years. In the latter case, chromosomes would only exist as discrete chromatin bodies during mitosis but not during interphase. Both possibilities are compatible with Boveri's well established paradigm of chromosome individuality. Here we show that an active human X chromosome contained as the only human chromosome in a Chinese hamster x man hybrid cell line can be visualized both in metaphse plates and in interphase nuclei after in situ hybridization with either 3H- or biotin-labeled human genomic DNA. We demonstrate that this chromosome is organized as a distinct chromatin body throughout interphase. In addition, evidence for the territorial organization of human chromosomes is also presented for another hybrid cell line containing several autosomes and the human X chromosome. These findings are discussed in the context of our present knowledge of the organization and topography of interphase chromosomes. General applications of a strategy aimed at specific staining of individual chromosomes in experimental and clinical cytogenetics are briefly considered

Harnack inequality for fractional sub-Laplacians in Carnot groups

In this paper we prove an invariant Harnack inequality on Carnot-Carath\'eodory balls for fractional powers of sub-Laplacians in Carnot groups. The proof relies on an "abstract" formulation of a technique recently introduced by Caffarelli and Silvestre. In addition, we write explicitly the Poisson kernel for a class of degenerate subelliptic equations in product-type Carnot groups

Evidence for surprise minimization over value maximization in choice behavior

Classical economic models are predicated on the idea that the ultimate aim of choice is to maximize utility or reward. In contrast, an alternative perspective highlights the fact that adaptive behavior requires agents' to model their environment and minimize surprise about the states they frequent. We propose that choice behavior can be more accurately accounted for by surprise minimization compared to reward or utility maximization alone. Minimizing surprise makes a prediction at variance with expected utility models; namely, that in addition to attaining valuable states, agents attempt to maximize the entropy over outcomes and thus 'keep their options open'. We tested this prediction using a simple binary choice paradigm and show that human decision-making is better explained by surprise minimization compared to utility maximization. Furthermore, we replicated this entropy-seeking behavior in a control task with no explicit utilities. These findings highlight a limitation of purely economic motivations in explaining choice behavior and instead emphasize the importance of belief-based motivations

Determining the electrochemical transport parameters of sodium-ions in hard carbon composite electrodes

Sodium-ion batteries offer advantages over conventional Li-ion batteries, including cost and safety. However, much less is known about their operation and performance properties, particularly at the anode. The electron and ion transport in the active materials and composite electrode significantly impact battery performance. Understanding the changes in transport properties as a function of state-of-charge and state-of-health is essential for effective electrode design and performance assessment. In this work, the resistivity and diffusivity of sodium transport in hard carbon composite electrodes are studied at different states-of-health, using Galvanostatic Intermittent Titration Technique (GITT), Electrochemical Impedance Spectroscopy (EIS), and Electrochemical Potential Spectroscopy (EPS) in a stable 3-electrode test cell configuration. The reference electrode eliminated some voltage errors arising from the overpotentials on the counter electrode. The resistance contributions from the surface electrolyte interface, electrolyte transport in the electrode pores, and the charge transfer resistance are extrapolated from the impedance measurements and the diffusion coefficient from the GITT and EPS. The different techniques indicate similar trends in the diffusion coefficient during sodiation, desodiation, and ageing, although different orders of magnitude were observed between the EPS and GITT data. The accuracy of the parameters calculated using the different electrochemical techniques is discussed in detail

Differentiation between Parkinson disease and other forms of Parkinsonism using support vector machine analysis of susceptibility-weighted imaging (SWI): initial results

Objectives: To diagnose Parkinson disease (PD) at the individual level using pattern recognition of brain susceptibility-weighted imaging (SWI). Methods: We analysed brain SWI in 36 consecutive patients with Parkinsonism suggestive of PD who had (1) SWI at 3T, (2) brain 123I-ioflupane SPECT and (3) extensive neurological testing including follow-up (16 PD, 67.4 ± 6.2years, 11 female; 20 OTHER, a heterogeneous group of atypical Parkinsonism syndromes 65.2 ± 12.5years, 6 female). Analysis included group-level comparison of SWI values and individual-level support vector machine (SVM) analysis. Results: At the group level, simple visual analysis yielded no differences between groups. However, the group-level analyses demonstrated increased SWI in the bilateral thalamus and left substantia nigra in PD patients versus other Parkinsonism. The inverse comparison yielded no supra-threshold clusters. At the individual level, SVM correctly classified PD patients with an accuracy above 86%. Conclusions: SVM pattern recognition of SWI data provides accurate discrimination of PD among patients with various forms of Parkinsonism at an individual level, despite the absence of visually detectable alterations. This pilot study warrants further confirmation in a larger cohort of PD patients and with different MR machines and MR parameters. Key Points: • Magnetic resonance imaging data offers new insights into Parkinson's disease • Visual susceptibility-weighted imaging (SWI) analysis could not discriminate idiopathic from atypical PD • However, support vector machine (SVM) analysis provided highly accurate detection of idiopathic PD • SVM analysis may contribute to the clinical diagnosis of individual PD patients • Such information can be readily obtained from routine MR dat

The signalling channel of Central Bank interventions:modelling the Yen/US dollar exchange rate

This paper presents a theoretical framework analysing the signalling channel of exchange rate interventions as an informational trigger. We develop an implicit target zone framework with learning in order to model the signalling channel. The theoretical premise of the model is that interventions convey signals that communicate information about the exchange rate objectives of the central bank. The model is used to analyse the impact of Japanese FX interventions during the period 1999--2011 on the yen/US dollar dynamics

Imaging and Dynamics of Light Atoms and Molecules on Graphene

Observing the individual building blocks of matter is one of the primary goals of microscopy. The invention of the scanning tunneling microscope [1] revolutionized experimental surface science in that atomic-scale features on a solid-state surface could finally be readily imaged. However, scanning tunneling microscopy has limited applicability due to restrictions, for example, in sample conductivity, cleanliness, and data aquisition rate. An older microscopy technique, that of transmission electron microscopy (TEM) [2, 3] has benefited tremendously in recent years from subtle instrumentation advances, and individual heavy (high atomic number) atoms can now be detected by TEM [4 - 7] even when embedded within a semiconductor material [8, 9]. However, detecting an individual low atomic number atom, for example carbon or even hydrogen, is still extremely challenging, if not impossible, via conventional TEM due to the very low contrast of light elements [2, 3, 10 - 12]. Here we demonstrate a means to observe, by conventional transmision electron microscopy, even the smallest atoms and molecules: On a clean single-layer graphene membrane, adsorbates such as atomic hydrogen and carbon can be seen as if they were suspended in free space. We directly image such individual adatoms, along with carbon chains and vacancies, and investigate their dynamics in real time. These techniques open a way to reveal dynamics of more complex chemical reactions or identify the atomic-scale structure of unknown adsorbates. In addition, the study of atomic scale defects in graphene may provide insights for nanoelectronic applications of this interesting material.Comment: 9 pages manuscript and figures, 9 pages supplementary informatio