Randomized study of closure of the peritoneum at cesarean delivery.

Journal ArticleThis study was conducted to test the hypothesis that nonclosure of the visceral and parietal peritoneum during low transverse cervical cesarean delivery is not associated with increased intraoperative or immediate postoperative complications. One hundred thirteen patients scheduled for low transverse cervical cesarean were randomized to either closure of both the visceral and parietal peritoneum with absorbable suture (N = 59) or no peritoneal closure (N = 54). Patients were cared for in the usual postoperative manner without reference to treatment group. There were no demographic differences between the groups and no differences in method(s) of anesthesia, operative indication(s), or use of peripartum epidural narcotics. The incidence of fever, endometritis, or wound infection was similar between groups. There were no differences in the number of patients requiring parenteral narcotic analgesia or in the number of doses per patient. The number of oral analgesic doses was significantly greater with closure than without (P = .014). The frequency with which postoperative ileus was diagnosed in each group was similar, and there was no difference regarding the day on which patients were advanced to liquid or select diets. Bowel stimulants were administered more frequently to the closure than to non-closure patients (P = .03). The average operating time was shorter for the open group than for the closure group (P less than .005). We conclude that non-closure of the visceral and parietal peritoneum at low transverse cervical cesarean delivery appears to have no adverse effect on immediate postoperative recovery, may decrease postoperative narcotic requirements, allows less complicated return of bowel function, and provides a simplified and shorter surgical procedure

Trade Studies for a Manned High-Power Nuclear Electric Propulsion Vehicle

Nuclear electric propulsion (NEP) vehicles will be needed for future manned missions to Mars and beyond. Candidate vehicles must be identified through trade studies for further detailed design from a large array of possibilities. Genetic algorithms have proven their utility in conceptual design studies by effectively searching a large design space to pinpoint unique optimal designs. This research combines analysis codes for NEP subsystems with genetic algorithm-based optimization. Trade studies for a NEP reference mission to the asteroids were conducted to identify important trends, and to determine the effects of various technologies and subsystems on vehicle performance. It was found that the electric thruster type and thruster performance have a major impact on the achievable system performance, and that significant effort in thruster research and development is merited

Processing and Characterization of Carbon Nanotube Composites

Recent advances in the synthesis of large-scale quantities of carbon nanotubes (CNT) have provided the opportunity to study the mechanical properties of polymer matrix composites using these novel materials as reinforcement. Nanocomp Technologies, Inc. currently supplies large sheets with dimensions up to 122 cm x 244 cm containing both single-wall and few-wall CNTs. The tubes are approximately 1 mm in length with diameters ranging from 8 to 12 nm. In the present study being conducted at NASA Langley Research Center (LaRC), single and multiple layers of CNT sheets were infused or coated with various polymer solutions that included commercial toughened-epoxies and bismaleimides, as well as a LaRC developed polyimide. The resulting CNT composites were tested in tension using a modified version of ASTM D882-12 to determine their strength and modulus values. The effects of solvent treatment and mechanical elongation/alignment of the CNT sheets on the tensile performance of the composite were determined. Thin composites (around 50 wt% CNT) fabricated from acetone condensed and elongated CNT sheets with either a BMI or polyimide resin solution exhibited specific tensile moduli approaching that of toughened epoxy/ IM7 carbon fiber unidirectional composites

Biogeochemical significance of pelagic ecosystem function:An end-cretaceous case study

This work was aided by a Nuffield Summer Studentship granted to MJH, a U.S. Science Support Program (USSSP) Post-Expedition Activity award for IODP Exp. 342 to PMH, a Flint Postdoctoral Fellowship to DEP, a NERC PhD Studentship granted to JWBR, and a URF and Wolfson merit award to DNS.Pelagic ecosystem function is integral to global biogeochemical cycling, and plays a major role in modulating atmospheric CO2 concentrations (pCO2). Uncertainty as to the effects of human activities on marine ecosystem function hinders projection of future atmospheric pCO2. To this end, events in the geological past can provide informative case studies in the response of ecosystem function to environmental and ecological changes. Around the Cretaceous–Palaeogene (K–Pg) boundary, two such events occurred: Deccan large igneous province (LIP) eruptions and massive bolide impact at the Yucatan Peninsula. Both perturbed the environment, but only the impact coincided with marine mass extinction. As such, we use these events to directly contrast the response of marine biogeochemical cycling to environmental perturbation with and without changes in global species richness. We measure this biogeochemical response using records of deep-sea carbonate preservation. We find that Late Cretaceous Deccan volcanism prompted transient deep-sea carbonate dissolution of a larger magnitude and timescale than predicted by geochemical models. Even so, the effect of volcanism on carbonate preservation was slight compared with bolide impact. Empirical records and geochemical models support a pronounced increase in carbonate saturation state for more than 500 000 years following the mass extinction of pelagic carbonate producers at the K–Pg boundary. These examples highlight the importance of pelagic ecosystems in moderating climate and ocean chemistry.PostprintPeer reviewe

Instantons and seven-branes in type IIB superstring theory

Instanton and seven-brane solutions of type IIB supergravity carrying charges in the Ramond-Ramond sector are constructed. The singular seven-brane has a quantized \RR \ \lq magnetic' charge whereas its dual is the instanton, which is non-singular in the string frame and has an associated {\it global} \lq electric' charge. The product of these charges is constrained by a Dirac quantization condition. The instanton has the form of a space-time wormhole in the string frame, and is responsible for the non-conservation of the Noether current.Comment: PHYZZX macros. 13 pages. Final version as it will appear in Phys. Lett. B (typos corrected

D-branes in Nongeometric Backgrounds

"T-fold" backgrounds are generically-nongeometric compactifications of string theory, described by T^n fibrations over a base N with transition functions in the perturbative T-duality group. We review Hull's doubled torus formalism, which geometrizes these backgrounds, and use the formalism to constrain the D-brane spectrum (to leading order in g_s and alpha') on T^n fibrations over S^1 with O(n,n;Z) monodromy. We also discuss the (approximate) moduli space of such branes and argue that it is always geometric. For a D-brane located at a point on the base N, the classical ``D-geometry'' is a T^n fibration over a multiple cover of N.Comment: 29 pages; uses harvmac.tex; v2: substantial revision throughou

Extended thromboprophylaxis with betrixaban in acutely ill medical patients

BACKGROUND: Patients with acute medical illnesses are at prolonged risk for venous thrombosis. However, the appropriate duration of thromboprophylaxis remains unknown. METHODS: Patients who were hospitalized for acute medical illnesses were randomly assigned to receive subcutaneous enoxaparin (at a dose of 40 mg once daily) for 10±4 days plus oral betrixaban placebo for 35 to 42 days or subcutaneous enoxaparin placebo for 10±4 days plus oral betrixaban (at a dose of 80 mg once daily) for 35 to 42 days. We performed sequential analyses in three prespecified, progressively inclusive cohorts: patients with an elevated d-dimer level (cohort 1), patients with an elevated d-dimer level or an age of at least 75 years (cohort 2), and all the enrolled patients (overall population cohort). The statistical analysis plan specified that if the between-group difference in any analysis in this sequence was not significant, the other analyses would be considered exploratory. The primary efficacy outcome was a composite of asymptomatic proximal deep-vein thrombosis and symptomatic venous thromboembolism. The principal safety outcome was major bleeding. RESULTS: A total of 7513 patients underwent randomization. In cohort 1, the primary efficacy outcome occurred in 6.9% of patients receiving betrixaban and 8.5% receiving enoxaparin (relative risk in the betrixaban group, 0.81; 95% confidence interval [CI], 0.65 to 1.00; P=0.054). The rates were 5.6% and 7.1%, respectively (relative risk, 0.80; 95% CI, 0.66 to 0.98; P=0.03) in cohort 2 and 5.3% and 7.0% (relative risk, 0.76; 95% CI, 0.63 to 0.92; P=0.006) in the overall population. (The last two analyses were considered to be exploratory owing to the result in cohort 1.) In the overall population, major bleeding occurred in 0.7% of the betrixaban group and 0.6% of the enoxaparin group (relative risk, 1.19; 95% CI, 0.67 to 2.12; P=0.55). CONCLUSIONS: Among acutely ill medical patients with an elevated d-dimer level, there was no significant difference between extended-duration betrixaban and a standard regimen of enoxaparin in the prespecified primary efficacy outcome. However, prespecified exploratory analyses provided evidence suggesting a benefit for betrixaban in the two larger cohorts. (Funded by Portola Pharmaceuticals; APEX ClinicalTrials.gov number, NCT01583218.)

Superstring field theory equivalence: Ramond sector

We prove that the finite gauge transformation of the Ramond sector of the modified cubic superstring field theory is ill-defined due to collisions of picture changing operators. Despite this problem we study to what extent could a bijective classical correspondence between this theory and the (presumably consistent) non-polynomial theory exist. We find that the classical equivalence between these two theories can almost be extended to the Ramond sector: We construct mappings between the string fields (NS and Ramond, including Chan-Paton factors and the various GSO sectors) of the two theories that send solutions to solutions in a way that respects the linearized gauge symmetries in both sides and keeps the action of the solutions invariant. The perturbative spectrum around equivalent solutions is also isomorphic. The problem with the cubic theory implies that the correspondence of the linearized gauge symmetries cannot be extended to a correspondence of the finite gauge symmetries. Hence, our equivalence is only formal, since it relates a consistent theory to an inconsistent one. Nonetheless, we believe that the fact that the equivalence formally works suggests that a consistent modification of the cubic theory exists. We construct a theory that can be considered as a first step towards a consistent RNS cubic theory.Comment: v1: 24 pages. v2: 27 pages, significant modifications of the presentation, new section, typos corrected, references adde

T-folds, doubled geometry, and the SU(2) WZW model

The SU(2) WZW model at large level N can be interpreted semiclassically as string theory on S^3 with N units of Neveu-Schwarz H-flux. While globally geometric, the model nevertheless exhibits an interesting doubled geometry possessing features in common with nongeometric string theory compactifications, for example, nonzero Q-flux. Therefore, it can serve as a fertile testing ground through which to improve our understanding of more exotic compactifications, in a context in which we have a firm understanding of the background from standard techniques. Three frameworks have been used to systematize the study of nongeometric backgrounds: the T-fold construction, Hitchin's generalized geometry, and fully doubled geometry. All of these double the standard description in some way, in order to geometrize the combined metric and Neveu Schwarz B-field data. We present the T-fold and fully doubled descriptions of WZW models, first for SU(2) and then for general group. Applying the formalism of Hull and Reid-Edwards, we indeed recover the physical metric and H-flux of the WZW model from the doubled description. As additional checks, we reproduce the abelian T-duality group and known semiclassical spectrum of D-branes.Comment: 69 pages; uses amslatex; v4 minor revision