Investigation in haemodynamic stability during intermittent haemodialysis in the critically ill

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An investigation into the effects of commencing haemodialysis in the critically ill

<b>Introduction:</b> We have aimed to describe haemodynamic changes when haemodialysis is instituted in the critically ill. 3 hypotheses are tested: 1)The initial session is associated with cardiovascular instability, 2)The initial session is associated with more cardiovascular instability compared to subsequent sessions, and 3)Looking at unstable sessions alone, there will be a greater proportion of potentially harmful changes in the initial sessions compared to subsequent ones. <b>Methods:</b> Data was collected for 209 patients, identifying 1605 dialysis sessions. Analysis was performed on hourly records, classifying sessions as stable/unstable by a cutoff of >+/-20% change in baseline physiology (HR/MAP). Data from 3 hours prior, and 4 hours after dialysis was included, and average and minimum values derived. 3 time comparisons were made (pre-HD:during, during HD:post, pre-HD:post). Initial sessions were analysed separately from subsequent sessions to derive 2 groups. If a session was identified as being unstable, then the nature of instability was examined by recording whether changes crossed defined physiological ranges. The changes seen in unstable sessions could be described as to their effects: being harmful/potentially harmful, or beneficial/potentially beneficial. <b>Results:</b> Discarding incomplete data, 181 initial and 1382 subsequent sessions were analysed. A session was deemed to be stable if there was no significant change (>+/-20%) in the time-averaged or minimum MAP/HR across time comparisons. By this definition 85/181 initial sessions were unstable (47%, 95% CI SEM 39.8-54.2). Therefore Hypothesis 1 is accepted. This compares to 44% of subsequent sessions (95% CI 41.1-46.3). Comparing these proportions and their respective CI gives a 95% CI for the standard error of the difference of -4% to 10%. Therefore Hypothesis 2 is rejected. In initial sessions there were 92/1020 harmful changes. This gives a proportion of 9.0% (95% CI SEM 7.4-10.9). In the subsequent sessions there were 712/7248 harmful changes. This gives a proportion of 9.8% (95% CI SEM 9.1-10.5). Comparing the two unpaired proportions gives a difference of -0.08% with a 95% CI of the SE of the difference of -2.5 to +1.2. Hypothesis 3 is rejected. Fisher’s exact test gives a result of p=0.68, reinforcing the lack of significant variance. <b>Conclusions:</b> Our results reject the claims that using haemodialysis is an inherently unstable choice of therapy. Although proportionally more of the initial sessions are classed as unstable, the majority of MAP and HR changes are beneficial in nature

The relation between magnetic and material arms in models for spiral galaxies

Context. Observations of polarized radio emission show that large-scale (regular) magnetic fields in spiral galaxies are not axisymmetric, but generally stronger in interarm regions. In some nearby galaxies such as NGC 6946 they are organized in narrow magnetic arms situated between the material spiral arms. Aims. The phenomenon of magnetic arms and their relation to the optical spiral arms (the material arms) call for an explanation in the framework of galactic dynamo theory. Several possibilities have been suggested but are not completely satisfactory; here we attempt a consistent investigation. Methods. We use a 2D mean-field dynamo model in the no-z approximation and add injections of small-scale magnetic field, taken to result from supernova explosions, to represent the effects of dynamo action on smaller scales. This injection of small scale field is situated along the spiral arms, where star-formation mostly occurs. Results. A straightforward explanation of magnetic arms as a result of modulation of the dynamo mechanism by material arms struggles to produce pronounced magnetic arms, at least with realistic parameters, without introducing new effects such as a time lag between Coriolis force and {\alpha}-effect. In contrast, by taking into account explicitly the small-scale magnetic field that is injected into the arms by the action of the star forming regions that are concentrated there, we can obtain dynamo models with magnetic structures of various forms that can be compared with magnetic arms. (abbrev). Conclusions. We conclude that magnetic arms can be considered as coherent magnetic structures generated by large-scale dynamo action, and associated with spatially modulated small-scale magnetic fluctuations, caused by enhanced star formation rates within the material arms.Comment: 13 pages, 8 figures, accepted for publication to A&

Fabrication of thick structures by sputtering

Deposit, 5500-gram of Cu-0.15 wt % Zr alloy, sputtered onto copper cylinder to average thickness of 12.29 mm. Structure was achieved with high-rate sputter deposition for about 100 hours total sputtering time. Material had twice the strength of unsputtered material at temperatures to 723 K and equivalent strength at nearly 873 K

Towards A Mean-Field Formulation Of The Babcock-Leighton Type Solar Dynamo. I. Alpha Coefficient Versus Durney's Double Ring Approach

We develop a model of the solar dynamo in which, on the one hand, we follow the Babcock-Leighton approach to include surface processes like the production of poloidal field from the decay of active regions, and, on the other hand, we attempt to develop a mean field theory that can be studied in quantitative detail. One of the main challenges in developing such models is to treat the buoyant rise of toroidal field and the production of poloidal field from it near the surface. We build up a dynamo model with two contrasting methods of treating buoyancy. In one method, we incorporate the generation of the poloidal field near the solar surface by Durney's procedure of double ring eruption. In the second method, the poloidal field generation is treated by a positive alpha-effect concentrated near the solar surface, coupled with an algorithm for handling buoyancy. The two methods are found to give qualitatively similar results.Comment: 32 pages, 27 figures, uses aastex.cls and epsfig.st

Phase-Insensitive Scattering of Terahertz Radiation

The nonlinear interaction between Near-Infrared (NIR) and Terahertz pulses is principally investigated as a means for the detection of radiation in the hardly accessible THz spectral region. Most studies have targeted second-order nonlinear processes, given their higher efficiencies, and only a limited number have addressed third-order nonlinear interactions, mainly investigating four-wave mixing in air for broadband THz detection. We have studied the nonlinear interaction between THz and NIR pulses in solid-state media (specifically diamond), and we show how the former can be frequency-shifted up to UV frequencies by the scattering from the nonlinear polarisation induced by the latter. Such UV emission differs from the well-known electric-field-induced second harmonic (EFISH) one, as it is generated via a phase-insensitive scattering, rather than a sum- or difference-frequency four-wave-mixing process

Exposure to the complement C5b-9 complex sensitizes 661W photoreceptor cells to both apoptosis and necroptosis.

The loss of photoreceptors is the defining characteristic of many retinal degenerative diseases, but the mechanisms that regulate photoreceptor cell death are not fully understood. Here we have used the 661W cone photoreceptor cell line to ask whether exposure to the terminal complement complex C5b-9 induces cell death and/or modulates the sensitivity of these cells to other cellular stressors. 661W cone photoreceptors were exposed to complete normal human serum following antibody blockade of CD59. Apoptosis induction was assessed morphologically, by flow cytometry, and on western blotting by probing for cleaved PARP and activated caspase-3. Necroptosis was assessed by flow cytometry and Sirtuin 2 inhibition using 2-cyano-3-[5-(2,5-dichlorophenyl)-2-furyl]-N-5-quinolinylacrylamide (AGK2). The sensitivity of 661W cells to ionomycin, staurosporine, peroxide and chelerythrine was also investigated, with or without prior formation of C5b-9. 661W cells underwent apoptotic cell death following exposure to C5b-9, as judged by poly(ADP-ribose) polymerase 1 cleavage and activation of caspase-3. We also observed apoptotic cell death in response to staurosporine, but 661W cells were resistant to both ionomycin and peroxide. Interestingly, C5b-9 significantly increased 661W sensitivity to staurosporine-induced apoptosis and necroptosis. These studies show that low levels of C5b-9 on 661W cells can induce apoptosis, and that C5b-9 specifically sensitizes 661W cells to certain apoptotic and necroptotic pathways. Our observations provide new insight into the potential role of the complement system in photoreceptor loss, with implications for the molecular aetiology of retinal disease

Numerical investigation of friction in inflaton equations of motion

The equation of motion for the expectation value of a scalar quantum field does not have the local form that is commonly assumed in studies of inflationary cosmology. We have recently argued that the true, temporally non-local equation of motion does not possess a time-derivative expansion and that the conversion of inflaton energy into particles is not, in principle, described by the friction term estimated from linear response theory. Here, we use numerical methods to investigate whether this obstacle to deriving a local equation of motion is purely formal, or of some quantitative importance. Using a simple scalar-field model, we find that, although the non-equilibrium evolution can exhibit significant damping, this damping is not well described by the local equation of motion obtained from linear response theory. It is possible that linear response theory does not apply to the situation we study only because thermalization turns out to be slow, but we argue that that the large discrepancies we observe indicate a failure of the local approximation at a more fundamental level.Comment: 13 pages, 7 figure