Randomised, controlled trial of alternating pressure mattresses compared with alternating pressure overlays for the prevention of pressure ulcers : PRESSURE (pressure relieving support surfaces) trial

Objective To compare whether differences exist between alternating pressure overlays and alternating pressure mattresses in the development of new pressure ulcers, healing of existing pressure ulcers, and patient acceptability. Design Pragmatic, open, multicentre, randomised controlled trial. Setting 11 hospitals in six NHS trusts. Participants 1972 people admitted to hospital as acute or elective patients. Interventions Participants were randomised to an alternating pressure mattress (n = 982) of- an alternating pressure overlay (n = 990). Main outcome measures The proportion of participants developing a new pressure ulcer of grade 2 or worse; time to development of new pressure ulcers; proportions of participants developing a new ulcer within 30 days; healing of existing pressure ulcers; and patient acceptability Results Intention to treat analysis found no difference in the proportions of participants developing a new pressure ulcer of grade 2 or worse (10.7% overlay patients, 10.3% mattress patients; difference 0.4%, 95% confidence interval - 23% to 3.1%, P = 0.75). More overlay patients requested change owing to dissatisfaction (23.3%) than mattress patients (18.9%, P = 0.02). Conclusion No difference was found between alternating pressure mattresses and alternating pressure overlays in the proportion of people who develop a pressure ulcer

Confirming the Primarily Smooth Structure of the Vega Debris Disk at Millimeter Wavelengths

Clumpy structure in the debris disk around Vega has been previously reported at millimeter wavelengths and attributed to concentrations of dust grains trapped in resonances with an unseen planet. However, recent imaging at similar wavelengths with higher sensitivity has disputed the observed structure. We present three new millimeter wavelength observations that help to resolve the puzzling and contradictory observations. We have observed the Vega system with the Submillimeter Array (SMA) at a wavelength of 880 μm and an angular resolution of 5"; with the Combined Array for Research in Millimeter-wave Astronomy (CARMA) at a wavelength of 1.3 mm and an angular resolution of 5"; and with the Green Bank Telescope (GBT) at a wavelength of 3.3 mm and angular resolution of 10". Despite high sensitivity and short baselines, we do not detect the Vega debris disk in either of the interferometric data sets (SMA and CARMA), which should be sensitive at high significance to clumpy structure based on previously reported observations. We obtain a marginal (3σ) detection of disk emission in the GBT data; the spatial distribution of the emission is not well constrained.We analyze the observations in the context of several different models, demonstrating that the observations are consistent with a smooth, broad, axisymmetric disk with inner radius 20–100 AU and width ≾50 AU. The interferometric data require that at least half of the 860 μm emission detected by previous single-dish observations with the James Clerk Maxwell Telescope be distributed axisymmetrically, ruling out strong contributions from flux concentrations on spatial scales of ≾100 AU. These observations support recent results from the Plateau de Bure Interferometer indicating that previous detections of clumpy structure in the Vega debris disk were spurious

Pressure relieving support surfaces (PRESSURE) trial : cost effectiveness analysis

Objective To assess tire cost effectiveness of alternating pressure mattresses compared with alternating pressure overlays for the prevention of pressure ulcers in patients admitted to hospital. Design Cost effectiveness analysis carried out alongside the pressure relieving support surfaces (PRESSURE) trial; a multicentre UK based pragmatic randomised controlled trial. Setting 11 hospitals in six UK NHS trusts. Participants Intention to treat population comprising 1971 participants. Main outcome measures Kaplan Meier estimates of restricted mean time to development of pressure ulcers and total costs for treatment in hospital. Results Alternating pressure mattresses were associated with lower overall costs (283.6 pound per patient on average, 95% confidence interval -377.59 pound to. 976.79) pound mainly due to reduced length of stay in hospital, and greater benefits (a delay in time to ulceration of 10.64 days on average, - 24.40 to 3.09). The differences in health benefits and total costs for hospital stay between alternating pressure mattresses and alternating pressure overlays were not statistically significant; however, a cost effectiveness acceptability curve indicated that on average alternating pressure mattresses compared with alternating pressure overlays were associated with air 80% probability of being cost saving. Conclusion Alternating pressure mattresses for the prevention of pressure ulcers are more likely to be cost effective and are more acceptable to patients than alternating pressure overlays

The International Deep Planet Survey I. The frequency of wide-orbit massive planets around A-stars

Breakthrough direct detections of planetary companions orbiting A-type stars confirm the existence of massive planets at relatively large separations, but dedicated surveys are required to estimate the frequency of similar planetary systems. To measure the first estimation of the giant exoplanetary systems frequency at large orbital separation around A-stars, we have conducted a deep-imaging survey of young (8-400 Myr), nearby (19-84 pc) A- and F-stars to search for substellar companions in the 10-300 AU range. The sample of 42 stars combines all A-stars observed in previous AO planet search surveys reported in the literature with new AO observations from VLT/NaCo and Gemini/NIRI. It represents an initial subset of the International Deep Planet Survey (IDPS) sample of stars covering M- to B-stars. The data were obtained with diffraction-limited observations in H- and Ks-band combined with angular differential imaging to suppress the speckle noise of the central stars, resulting in typical 5-sigma detection limits in magnitude difference of 12 mag at 1", 14 mag at 2" and 16 mag at 5" which is sufficient to detect massive planets. A detailed statistical analysis of the survey results is performed using Monte Carlo simulations. Considering the planet detections, we estimate the fraction of A-stars having at least one massive planet (3-14 MJup) in the range 5-320 AU to be inside 5.9-18.8% at 68% confidence, assuming a flat distribution for the mass of the planets. By comparison, the brown dwarf (15-75 MJup) frequency for the sample is 2.0-8.9% at 68% confidence in the range 5-320 AU. Assuming power law distributions for the mass and semimajor axis of the planet population, the AO data are consistent with a declining number of massive planets with increasing orbital radius which is distinct from the rising slope inferred from radial velocity (RV) surveys around evolved A-stars.Comment: 20 pages, 10 figures, 7 tables. Accepted for publication in A&

Vitamin D deficiency in traumatic brain injury and its relationship with severity of injury and quality of life: a prospective, observational study

This single-centre prospective observational study aims to describe the prevalence of vitamin D deficiency (VDD) in the traumatic brain injury (TBI) population and identify any relationship between vitamin D and severity of head injury or quality of life. 124 TBI patients had serum vitamin D (25-OHD) levels measured at the local post-TBI endocrine screening clinic over 20 months. Quality of Life after Brain Injury (QOLIBRI) questionnaires were completed by the patient concurrently. A multivariate regressional analysis was performed, controlling for age, season, ethnicity, time since injury, TBI severity and gender. 34% (n=42) of the cohort were vitamin D deficient (25-OHD <25nmol/L) with a further 23% (n=29) having insufficient levels (25-OHD 25-50nmol/L). Vitamin D was significantly lower in severe TBI compared to mild TBI (n=95, p=0.03, CI 95% -23.60 to -1.21, mean effect size 12.40 nmol/L). There was a trend for self-reported quality of life to be better in patients with optimum vitamin D levels compared to patients with deficient vitamin D levels, controlling for severity of injury (n=81, p=0.05, CI 95% -0.07 to 21.27). This is the first study to identify a significant relationship between vitamin D levels and severity of head injury. Clinicians should actively screen for and treat VDD in head injured patients to reduce the risk of further morbidity such as osteomalacia and cardiovascular disease. Future research should establish the natural history of vitamin D levels following TBI to identify at which stage VDD develops and whether vitamin D replacement could have a beneficial effect on recovery and quality of life

Partially-erupting prominences: a comparison between observations and model-predicted observables

&lt;p&gt;&lt;b&gt;Aims:&lt;/b&gt; We investigate several partially-erupting prominences to study their relationship with other CME-associated phenomena and compare these observations with observables predicted by a model of partially-expelled-flux-ropes (Gibson &#38; Fan 2006a, ApJ, 637, L65; 2006b, J. Geophys. Res., 111, 12103).&lt;/p&gt; &lt;p&gt;&lt;b&gt;Methods:&lt;/b&gt; We studied 6 selected events with partially-erupting prominences using multi-wavelength observations recorded by the Extreme-ultraviolet Imaging Telescope (EIT), Transition Region and Coronal Explorer (TRACE), Mauna Loa Solar Observatory (MLSO), Big Bear Solar Observatory (BBSO), and Soft X-ray Telescope (SXT). The observational features associated with partially-erupting prominences were then compared with the predicted observables from the model.&lt;/p&gt; &lt;p&gt;&lt;b&gt;Results:&lt;/b&gt; The partially-expelled-flux-rope (PEFR) model can explain the partial eruption of these prominences, and in addition predicts a variety of other CME-related observables that provide evidence of internal reconnection during eruption. We find that all of the partially-erupting prominences studied in this paper exhibit indirect evidence of internal reconnection. Moreover, all cases showed evidence of at least one observable unique to the PEFR model, e.g., dimmings external to the source region and/or a soft X-ray cusp overlying a reformed sigmoid.&lt;/p&gt; &lt;p&gt;&lt;b&gt;Conclusions:&lt;/b&gt; The PEFR model provides a plausible mechanism to explain the observed evolution of partially-erupting-prominence-associated CMEs in our study.&lt;/p&gt

Visual and computational analysis of structure-activity relationships in high-throughput screening data

Novel analytic methods are required to assimilate the large volumes of structural and bioassay data generated by combinatorial chemistry and high-throughput screening programmes in the pharmaceutical and agrochemical industries. This paper reviews recent work in visualisation and data mining that can be used to develop structure-activity relationships from such chemical/biological datasets