High-Frequency Jet Ventilation During Cryoablation of Small Renal Tumours

AIM: To evaluate the effect of high-frequency jet ventilation (HFJV) in place of standard intermittent positive-pressure ventilation (IPPV) on procedure duration, patient radiation dose, complication rates, and outcomes during CT-guided cryoablation of small renal tumours. MATERIALS AND METHODS: One hundred consecutive CT-guided cryoablation procedures to treat small renal tumours under general anaesthesia were evaluated-50 with standard IPPV and 50 after the introduction of HFJV as standard practice. Anaesthesia and procedural times, ionising radiation dose, complications, and 1-month post-treatment outcomes were collected. RESULTS: HFJV was feasible and safe in all cases. Mean procedure time and total anaesthetic time were shorter with HFJV (p = <0.0001). The number of required CT acquisitions (p = 0.0002) and total procedure patient radiation dose (p = 0.0027) were also lower in the HFJV group compared with the IPPV group. There were a total of four complications of Clavien-Dindo classification 3 or above-three in the IPPV group and one in the HFJV group. At 1-month follow-up, two cases (both in the IPPV group) demonstrated subtotal treatment. Both cases were subsequently successfully retreated with cryoablation. CONCLUSION: By reducing target tumour motion during CT-guided renal cryoablation, HFJV can reduce procedure times and exposure to ionising radiation. HFJV provides an important adjunct to complex image-guided interventions, with potential to improve safety and treatment outcomes

Superfluid 4He dynamics beyond quasiparticle excitations

The dynamics of superfluid 4He at and above the Landau quasiparticle regime is investigated by high precision inelastic neutron scattering measurements of the dynamic structure factor. A highly structured response is observed above the familiar phonon-maxon-roton spectrum, characterized by sharp thresholds for phonon-phonon, maxon-roton and roton-roton coupling processes. The experimental dynamic structure factor is compared to the calculation of the same physical quantity by a Dynamic Many-body theory including three-phonon processes self-consistently. The theory is found to provide a quantitative description of the dynamics of the correlated bosons for energies up to about three times that of the Landau quasiparticles.Comment: 5 pages, 3 figure

Bacterial ventriculoperitoneal shunt infections: changing trends in antimicrobial susceptibility, a 7-year retrospective study from Pakistan

BACKGROUND: Ventriculoperitoneal (VP) shunt infections in adults represent a severe complication and make treatment more challenging. Therefore, drug susceptibility patterns are crucial for therapeutic decisions and infection control in neurosurgical centers. This 7-year retrospective study aimed to identify the bacteria responsible for adult VP shunt infections and determine their drug susceptibility patterns. METHODS: This single-center study was performed from 2015 to 2021 in Lahore, Pakistan, and included CSF cultures from VP shunt infections. Demographic data, causative organisms, and antimicrobial susceptibility testing results were collected. Multivariate analysis of variance (MANOVA) and two-sample t-tests were used to analyze and compare the antibiotic sensitivity trends over the study period. RESULTS: 14,473 isolates recovered from 13,937 CSF samples of VP shunt infections were identified and analyzed for their susceptibility patterns to antimicrobials. The proportion of Gram-negative and Gram-positive bacteria were 11,030 (76%) and 3443 (24)%, respectively. The predominant bacteria were Acinetobacter species (n = 5898, 41%), followed by Pseudomonas species (n = 2368, 16%) and coagulase-negative Staphylococcus (CoNS) (n = 1880, 13%). 100% of Staphylococcus aureus (S.aureus) and CoNS were sensitive to vancomycin and linezolid (n = 2580). However, 52% of S. aureus (719/1,343) were methicillin-resistant Staphylococcus aureus (MRSA). Acinetobacter showed maximum sensitivity to meropenem at 69% (2759/4768). Pseudomonas was 80% (1385/1863 sensitive to piperacillin-tazobactam, Escherichia coli (E. coli) showed 72% to amikacin (748/1055), while Klebsiella spp. was 57% (574/1170) sensitive to piperacillin-tazobactam. The sensitivity of piperacillin-tazobactam and meropenem for Gram-negative bacteria decreased significantly (p < 0.05) over 7 years, with 92.2% and 88.91% sensitive in 2015 and 66.7% and 62.8% sensitive in 2021, respectively. CONCLUSION: The significant decrease in the effectiveness of carbapenem and beta-lactam/beta-lactamase inhibitor combination drugs for the common Gram-negative causative agents of VP shunt infections suggests that alternative antibiotics such as colistin, fosfomycin, ceftazidime/avibactam, ceftolozane/tazobactam, and tigecycline should be considered and in consequence included in testing panels. Additionally, it is recommended to adopt care bundles for the prevention of VP shunt infection

A Hybrid Achromatic Metalens

Metamaterials and metasurfaces are widely used to manipulate electromagnetic waves over a broad range of wavelengths. Several recent efforts have focused on metalenses, ultra-thin optical elements that focus light using subwavelength structures. Compared to their refractive counterparts, metalenses offer reduced size and weight, improved manufacturability, and new functionality such as polarization control. However, metalenses that correct chromatic aberration also suffer from markedly reduced focusing efficiency. Here we introduce a Hybrid Achromatic Metalens (HAML), that overcomes this trade-off and offers improved focusing efficiency over a broad wavelength range from 1000 - 1800 nm. Fabricated HAMLs demonstrated diffraction limited performance for numerical apertures (NA) of 0.27, 0.11, and 0.06 with average focusing efficiencies $> 60\%$ and maximum efficiencies ~ $80\%$. HAMLs can be designed by combining recursive ray-tracing and simulated phase libraries rather than computational intensive global search algorithms. Moreover, HAMLs can be fabricated in low-refractive index materials using multi-photon lithography for customization or using molding for mass production.Comment: 20 pages, 7 figure

Structural health monitoring (SHM) for composite structure undergoing tensile and thermal testing

Application of ultrasonic guided waves generated by piezoelectric smart transducers has become one of the widely-used techniques in structural health monitoring. This technique has led to significant improvements and profound effects in the field of aircraft reliability and safety. Lamb wave propagation on composite plate-like structure undergoing mechanical testing is investigated in the paper. Smart PZT actuator/sensor is bonded on the carbon-fiber and glassfiber epoxy composites, which are subjected to tensile and thermal stress tests. The acquired results indicate the changes in scattering waves in composites materials due to the applied thermal and tensile force. Wavelet analysis was incorporated in this research work in order to distinguish different structural status

Incidence and sociodemographic characteristics of eczema diagnosis in children: a cohort study

Letter to the Editor

Variation in gas chromatography (GC) analysis in setting up laboratory protocols for waste to energy novel fixed bed reactor setups

Gas Chromatography coupled with Mass Spectrometry (GC/MS) has been applied in various analytical chemistry works. However, to fine tune a system that can serve the purposes of pyrolysis oil identification has proven to be a laborious effort, especially when considering the fact that no standard protocol exists for such analysis. In addition, obtained products were yielded from a newly commissioned unit with a unique and novel design. In this study, a US patent office claimed reactor [SULTAN-1, Pyrolysis Reactor System for the Conversion and Analysis of Organic Solid Waste, Patent application number: 15,487,351] that degrades polyolefinc virgin and waste materials to obtain petroleum refinery and petrochemical feedstock, has been commissioned. The reactor produces three distinct physical states of matter products accumulated as testing specimens, i.e. solids, gaseous and oil. The samples analysed in this work were of the gas and oil produced by pyrolysis of end of life tyre (ELTs) shavings that required to have a special recipe to work with in the laboratory. Various MS cords were utilised and experimental setups to fine tune the process, and special emphasis was given on the gas samples variation in this communication. To reach the desired analysis results with high repeatability, a plethora of experiences of lab personnel and laboratory-based experimental work was accumulated. Laboratory protocols were also setup for this work. These will be detailed along the process execution which yielded a standard laboratory best practice analytical method as part of the State of Kuwait newly initiated Government Initiative project

Structural and magnetic changes in CoAlZr thin films upon post annealing

We present a study of the effect of annealing amorphous ferromagnetic thin films of Co0.85(Al0.7Zr0.3)0.15, post deposition. The annealing was done in vacuum with no applied magnetic field. We find that already at a relatively low annealing temperature of 130 ◦C there is crystallite formation that introduces both structural and magnetic inhomogeneity. This does not affect the saturation magnetization strongly, but strongly affects the switching behavior and the overall effective anisotropy of the films. Further, there is a dramatic increase in magnetization damping. Thus, the annealing has a profound effect on both static and dynamic magnetic properties of the material. This is important to keep in mind for potential applications using these materials.Icelandic Research Fund Grants No. 228951, 218029 and 217843.Peer Reviewe

Obstetric anal sphincter injury: a systematic review of information available on the internet.

OBJECTIVE: There is no systematic evaluation of online health information pertaining to obstetric anal sphincter injury. Therefore, we evaluated the accuracy, credibility, reliability, and readability of online information concerning obstetric anal sphincter injury. MATERIALS AND METHODS: Multiple search engines were searched. The first 30 webpages were identified for each keyword and considered eligible if they provided information regarding obstetric anal sphincter injury. Eligible webpages were assessed by two independent researchers for accuracy (prioritised criteria based upon the RCOG Third and Fourth Degree Tear guideline); credibility; reliability; and readability. RESULTS: Fifty-eight webpages were included. Seventeen webpages (30%) had obtained Health On the Net certification, or Information Standard approval and performed better than those without such approvals (p = 0.039). The best overall performing website was http://www.pat.nhs.uk (score of 146.7). A single webpage (1%) fulfilled the entire criteria for accuracy with a score of 18: www.tamesidehospital.nhs.uk . Twenty-nine webpages (50%) were assessed as credible (scores ≥7). A single webpage achieved a maximum credibility score of 10: www.meht.nhs.uk . Over a third (21 out of 58) were rated as poor or very poor. The highest scoring webpage was http://www.royalsurrey.nhs.uk (score 62). No webpage met the recommended Flesch Reading Ease Score above 70. The intra-class coefficient between researchers was 0.98 (95% CI 0.96-0.99) and 0.94 (95% CI 0.89-0.96) for accuracy and reliability assessments. CONCLUSION: Online information concerning obstetric anal sphincter injury often uses language that is inappropriate for a lay audience and lacks sufficient accuracy, credibility, and reliability