1,161 research outputs found
Thoracic Epidural analgesia versus Rectus Sheath Catheters for open midline incisions in major abdominal surgery within an enhanced recovery programme (TERSC):study protocol for a randomised controlled trial
BACKGROUND: Thoracic epidural analgesia (TEA) is recommended for post-operative pain relief in patients undergoing major abdominal surgery via a midline incision. However, the effectiveness of TEA is variable with high failure rates reported post-operatively. Common side effects such as low blood pressure and motor block can reduce mobility and hinder recovery, and a number of rare but serious complications can also occur following their use.Rectus sheath catheters (RSC) may provide a novel alternative approach to somatic analgesia without the associated adverse effects of TEA. The aim of this study is to compare the efficacy of both techniques in terms of pain relief, patient experience, post-operative functional recovery, safety and cost-effectiveness. METHODS/DESIGN: This is a single-centre randomised controlled non-blinded trial, which also includes a nested qualitative study. Over a two-year period, 132 patients undergoing major abdominal surgery via a midline incision will be randomised to receive either TEA or RSC for post-operative analgesia. The primary outcome measures pain scores on moving from a supine to a sitting position at 24 hours post wound closure, and the patient experience between groups evaluated through in-depth interviews. Secondary outcomes include pain scores at rest and on movement at other time points, opiate consumption, functional recovery, morbidity and cost-effectiveness. DISCUSSION: This will be the first randomised controlled trial comparing thoracic epidurals to ultrasound-guided rectus sheath catheters in adults undergoing elective midline laparotomy. The standardised care provided by an Enhanced Recovery Programme makes this a comparison between two complex pain packages and not simply two analgesic techniques, in order to ascertain if RSC is a viable alternative to TEA. TRIAL REGISTRATION: Current Controlled Trials ISRCTN81223298 (16 January 2014)
Development of a novel tool for assessing coverage of implementation factors in health promotion program resources
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.Katharine B. Richardson Research Award at Children's Mercy Kansas CityNational Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under Award Number F32DK115146Institute of Education Sciences and U.S. Department of Education by grant R305A15027
Self-Organized States in Cellular Automata: Exact Solution
The spatial structure, fluctuations as well as all state probabilities of
self-organized (steady) states of cellular automata can be found (almost)
exactly and {\em explicitly} from their Markovian dynamics. The method is shown
on an example of a natural sand pile model with a gradient threshold.Comment: 4 pages (REVTeX), incl. 2 figures (PostScript
Pattern Transfer of Sub-10 nm Features via Tin-Containing Block Copolymers
Tin-containing block copolymers were investigated as materials for nanolithographic applications. Poly(4-trimethylstannylstyrene-block-styrene) (PSnS-PS) and poly(4-trimethylstannylstyrene-block-4-methoxystyrene) (PSnS-PMOST) synthesized by reversible addition–fragmentation chain transfer polymerization form lamellar domains with periodicities ranging from 18 to 34 nm. Thin film orientation control was achieved by thermal annealing between a neutral surface treatment and a top coat. Incorporation of tin into one block facilitates pattern transfer into SiO_2 via a two-step etch process utilizing oxidative and fluorine-based etch chemistries
Single Top from Technipion Production
We investigate the contribution of technicolor mechanisms to the production
of single top quarks at hadron colliders. Technipions with mass larger than the
top mass will decay predominantly to a top quark plus a bottom antiquark. We
investigate two promising sub-processes: technipion plus W-boson via
gluon-gluon fusion and technipion plus quark production via quark gluon
interaction. The decay chain of technipion to top plus bottom quarks and then
top to W plus bottom yields final states for the two subprocesses with,
respectively, two W's and two bottom quarks and one W, two bottom quarks and a
light quark. We calculate the total cross sections and the
distributions for these technipion production mechanisms at Tevatron and LHC
energies for a range of technipion masses, starting at 200 GeV. We study the
backgrounds to our processes and the kinematic cuts that enhance the signal to
background ratio and we report event rate estimates for the upgraded Tevatron
and the LHC. Only the LHC has the potential to observe these processes.Comment: 9 pages, latex, uses revtex.st
Differential Forms on Log Canonical Spaces
The present paper is concerned with differential forms on log canonical
varieties. It is shown that any p-form defined on the smooth locus of a variety
with canonical or klt singularities extends regularly to any resolution of
singularities. In fact, a much more general theorem for log canonical pairs is
established. The proof relies on vanishing theorems for log canonical varieties
and on methods of the minimal model program. In addition, a theory of
differential forms on dlt pairs is developed. It is shown that many of the
fundamental theorems and techniques known for sheaves of logarithmic
differentials on smooth varieties also hold in the dlt setting.
Immediate applications include the existence of a pull-back map for reflexive
differentials, generalisations of Bogomolov-Sommese type vanishing results, and
a positive answer to the Lipman-Zariski conjecture for klt spaces.Comment: 72 pages, 6 figures. A shortened version of this paper has appeared
in Publications math\'ematiques de l'IH\'ES. The final publication is
available at http://www.springerlink.co
One-Loop Renormalization of Lorentz-Violating Electrodynamics
We show that the general Lorentz- and CPT-violating extension of quantum
electrodynamics is one-loop renormalizable. The one-loop Lorentz-violating beta
functions are obtained, and the running of the coefficients for Lorentz and CPT
violation is determined. Some implications for theory and experiment are
discussed.Comment: 12 pages, accepted for publication in Physical Review
Clock-Comparison Tests of Lorentz and CPT Symmetry in Space
Clock-comparison experiments conducted in space can provide access to many
unmeasured coefficients for Lorentz and CPT violation. The orbital
configuration of a satellite platform and the relatively large velocities
attainable in a deep-space mission would permit a broad range of tests with
Planck-scale sensitivity.Comment: 4 page
Study on the rare radiative decay in the standard model and multiscale walking technicolor model
Applying the perturbative QCD ( PQCD ) method, we study the decay
in the standard model and multiscale walking
technicolor model. In the SM, we find that the contribution of weak
annihilation is more important than that of the electromagnetic penguin. The
presence of Pseudo-Goldstone-Bosons in the MWTCM leads to a large enhancement
in the rate of , but this model is in conflict with
the branching ratio of ( ) and the CLEO data
on the branching ratio BR ( ). If topcolor is further
introduced, the calculated results in the topcolor assisted MWTCM can be
suppressed and be in agreement with the CLEO data for a certain range of the
parameters.Comment: 16 pages, Latex, no macros, 1 figure(in Latex), hard copy is
available upon request. to appear in Phys. Rev.
Sediment Cores from White Pond, South Carolina, contain a Platinum Anomaly, Pyrogenic Carbon Peak, and Coprophilous Spore Decline at 12.8 ka
A widespread platinum (Pt) anomaly was recently documented in Greenland ice and 11 North American sedimentary sequences at the onset of the Younger Dryas (YD) event (~12,800 cal yr BP), consistent with the YD Impact Hypothesis. We report high-resolution analyses of a 1-meter section of a lake core from White Pond, South Carolina, USA. After developing a Bayesian age-depth model that brackets the late Pleistocene through early Holocene, we analyzed and quantified the following: (1) Pt and palladium (Pd) abundance, (2) geochemistry of 58 elements, (3) coprophilous spores, (4) sedimentary organic matter (OC and sedaDNA), (5) stable isotopes of C (δ13C) and N (δ15N), (6) soot, (7) aciniform carbon, (8) cryptotephra, (9) mercury (Hg), and (10) magnetic susceptibility. We identified large Pt and Pt/Pd anomalies within a 2-cm section dated to the YD onset (12,785 ± 58 cal yr BP). These anomalies precede a decline in coprophilous spores and correlate with an abrupt peak in soot and C/OC ratios, indicative of large-scale regional biomass burning. We also observed a relatively large excursion in δ15N values, indicating rapid climatic and environmental/hydrological changes at the YD onset. Our results are consistent with the YD Impact Hypothesis and impact-related environmental and ecological changes
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