Separation of natural from laboratory-grown diamond using time-gated luminescence imaging

A technique that expands on the surface luminescence imaging used in the DiamondView instrument has been developed at De Beers Group Technology, Maidenhead, UK. This provides an additional level of imaging information by way of separating prompt and delayed surface luminescence. The technique has the added benefit of quickly and easily distinguishing colorless or near-colorless natural diamond from laboratory-grown diamond. It can be applied when the identification of natural diamond is required in the study of single stones, multiples in batches, set jewelry, or in a fully automated process. The prompt and delayed luminescence characteristics of natural diamond are compared with a range of chemical vapor deposition (CVD) and high-pressure, high-temperature (HPHT) synthetic diamonds. Of significant interest are some of the less common CVD synthetic samples that have been observed in recent years. This article will summarize the luminescence observed in different diamond types, discuss its spectral characteristics, and serve as a useful reference when interpreting such luminescence images

Blue delayed luminescence emission in neutral nitrogen vacancy containing chemical vapor deposition synthetic diamond

Herein, the authors investigate the temperature‐dependent properties of delayed luminescence in an as‐grown nitrogen‐containing chemical vapor deposition synthetic diamond gemstone when excited above its bandgap. At room temperature, this gemstone exhibits delayed luminescence from nitrogen‐vacancy centers at 575 nm. However, at 77 K, the first recorded instance of a long‐lived delayed blue luminescence centered at ≈465 nm, accompanied by spectral peaks at 419, 455, and 499 nm is reported. By analyzing spectral and temporal data at different temperatures, it can be speculated on potential photophysical transitions. This discovery documents the initial observation of this delayed luminescence emission, contributing to the collective understanding of synthetic diamonds

Restrictive or Liberal Red-Cell Transfusion for Cardiac Surgery.

BACKGROUND The effect of a restrictive versus liberal red-cell transfusion strategy on clinical outcomes in patients undergoing cardiac surgery remains unclear. METHODS In this multicenter, open-label, noninferiority trial, we randomly assigned 5243 adults undergoing cardiac surgery who had a European System for Cardiac Operative Risk Evaluation (EuroSCORE) I of 6 or more (on a scale from 0 to 47, with higher scores indicating a higher risk of death after cardiac surgery) to a restrictive red-cell transfusion threshold (transfuse if hemoglobin level was <7.5 g per deciliter, starting from induction of anesthesia) or a liberal red-cell transfusion threshold (transfuse if hemoglobin level was <9.5 g per deciliter in the operating room or intensive care unit [ICU] or was <8.5 g per deciliter in the non-ICU ward). The primary composite outcome was death from any cause, myocardial infarction, stroke, or new-onset renal failure with dialysis by hospital discharge or by day 28, whichever came first. Secondary outcomes included red-cell transfusion and other clinical outcomes. RESULTS The primary outcome occurred in 11.4% of the patients in the restrictive-threshold group, as compared with 12.5% of those in the liberal-threshold group (absolute risk difference, -1.11 percentage points; 95% confidence interval [CI], -2.93 to 0.72; odds ratio, 0.90; 95% CI, 0.76 to 1.07; P<0.001 for noninferiority). Mortality was 3.0% in the restrictive-threshold group and 3.6% in the liberal-threshold group (odds ratio, 0.85; 95% CI, 0.62 to 1.16). Red-cell transfusion occurred in 52.3% of the patients in the restrictive-threshold group, as compared with 72.6% of those in the liberal-threshold group (odds ratio, 0.41; 95% CI, 0.37 to 0.47). There were no significant between-group differences with regard to the other secondary outcomes. CONCLUSIONS In patients undergoing cardiac surgery who were at moderate-to-high risk for death, a restrictive strategy regarding red-cell transfusion was noninferior to a liberal strategy with respect to the composite outcome of death from any cause, myocardial infarction, stroke, or new-onset renal failure with dialysis, with less blood transfused. (Funded by the Canadian Institutes of Health Research and others; TRICS III ClinicalTrials.gov number, NCT02042898 .)

The violent frontline: space, ethnicity and confronting the state in Edwardian Spitalfields and 1980s Brixton

This article discusses in comparative terms the relationship between space, ethnic identity, subaltern status and anti-state violence in twentieth century London. It does so by comparing two examples in which the control of the state, as represented by the Metropolitan Police, was challenged by minority groups through physical force. It will examine the Spitalfields riots of 1906, which began as strike action by predominantly Jewish bakers and escalated into a general confrontation between the local population and the police, and the Brixton riots of 1981, a response to endemic police harassment of mainly Caribbean youth and long-term economic discrimination in that area of South London. It will begin by dissecting the association of physical metropolitan space with the diasporic ‘other’ in the Edwardian East End and post-consensus South London, and how this ‘othering’ was influenced both by the state and the anti-migrant far right. It will then interrogate the difficult relationship between the Metropolitan Police and Jewish and Caribbean working class communities, and how this deteriorating relationship exploded into in extreme violence in 1906 and 1981. The article will conclude by assessing how the relationships between space, identity and violence influenced long-term national and communal narratives of Jewish and Caribbean interactions with the British state

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Excitation of fluorescence decay using a 265 nm pulsed light-emitting diode: Evidence for aqueous phenylalanine rotamers

The authors describe the characteristics and application of a 265 nm AlGaN light-emitting diode (LED) operated at 1 MHz repetition rate, 1.2 ns pulse duration, 1.32 mu W average power, 2.3 mW peak power, and similar to 12 nm bandwidth. The LED enables the fluorescence decay of weakly emitting phenylalanine to be measured routinely, even in dilute solution. For pH of 6-9.2, the authors find evidence for a biexponential rather than monoexponential decay, providing direct evidence for the presence of phenylalanine rotamers with a photophysics closer to the other two fluorescent amino acids tryrosine and tryptophan than has previously been reported. (c) 2006 American Institute of Physics

Effect of ph on aqueous phenylalanine studied using a 265-nm pulsed light-emitting diode

Recently, we described the characteristics and application of a 265-nm AlGaN light-emitting diode (LED) operated at 1-MHz repetition rate, 1.2-ns pulse duration, 1.32-μW average power, 2.3-mW peak power, and approximately 12-nm bandwidth. The LED enables the fluorescence decay of weakly emitting phenylalanine to be measured routinely in the condensed phase, even in dilute solution. For a pH range of 1-11, we find evidence for a biexponential rather than a monoexponential decay, whereas at pH 13, only a monoexponential decay is present. These results provide direct evidence for the dominance of two phenylalanine rotamers in solution with a photophysics closer to the other two fluorescent amino acids, tyrosine and tryptophan, than has previously been reported. Although phenylalanine fluorescence is difficult to detect in most proteins because of its low quantum yield and resonance energy transfer from phenylalanine to tyrosine and tryptophan, the convenience of the 265-nm LED may well take protein photophysics in new directions, for example, by making use of this resonance energy transfer or by observing phenylalanine fluorescence directly in specific proteins where resonance energy transfer is inefficient

Base pair mismatch identification with DNA nanoswitch and long lifetime acridine fluorophore

Detection of single base pair mutations in an unlabelled nucleic acid target sequence is demonstrated using the time-resolved measurement of the Förster Resonance Energy Transfer (FRET) between a long lifetime acridine-based fluorophore and a non-fluorescent quencher molecule covalently bound to a DNA Holliday junction-based nanoswitch