Ontario children have outgrown the broselow tape

Objective: The Broselow Pediatric Emergency Tape (Armstrong Medical Industries, Inc., Lincolnshire, IL) (BT) is a well-established length-based tool for estimation of body weight for children during resuscitation. In view of pandemic childhood obesity, the BT may no longer accurately estimate weight. We therefore studied the BT in children from Ontario in a large recent patient cohort. Methods: Actual height and weight were obtained from an urban and a rural setting. Children were prospectively recruited between April 2007 and July 2008 from the emergency department and outpatient clinics at the London Health Science Centre. Rural children from junior kindergarten to grade 4 were also recruited in the spring of 2008 from the Avon Maitland District School Board. Data for preschool children were obtained from three daycare centres and the electronic medical record from the Maitland Valley Medical Centre. The predicted weight from the BT was compared to the actual weight using Spearman rank correlation; agreement and percent error (PE) were also calculated. Results: A total of 6,361 children (46.2% female) were included in the study. The median age was 3.9 years (interquartile range [IQR] 1.56-7.67 years), weight was 17.2 kg (IQR 11.6-25.4 kg), and height was 103.5 cm (IQR 82-124.4 cm). Although the BT weight estimate correlated with the actual weight (r = 0.95577, p \u3c 0.0001), the BT underestimated the actual weight by 1.62 kg (7.1% ± 16.9% SD, 95% CI -26.0-40.2). The BT had an ≥ 10% PE 43.7% of the time. Conclusions: Although the BT remains an effective method for estimating pediatric weight, it was not accurate and tended to underestimate the weight of Ontario children. Until more accurate measurement tools for emergency departments are developed, physicians should be aware of this discrepancy. © Canadian Association of Emergency Physicians 2010

Mechanical Robustness of Graphene on Flexible Transparent Substrates

This study reports on a facile and widely applicable method of transferring chemical vapor deposited (CVD) graphene uniformly onto optically transparent and mechanically flexible substrates using commercially available, low-cost ultraviolet adhesive (UVA) and hot-press lamination (HPL). We report on the adhesion potential between the graphene and the substrate, and we compare these findings with those of the more commonly used cast polymer handler transfer processes. Graphene transferred with the two proposed methods showed lower surface energy and displayed a higher degree of adhesion (UVA: 4.40 ± 1.09 N/m, HPL: 0.60 ± 0.26 N/m) compared to equivalent CVD-graphene transferred using conventional poly(methyl methacrylate) (PMMA: 0.44 ± 0.06 N/m). The mechanical robustness of the transferred graphene was investigated by measuring the differential resistance as a function of bend angle and repeated bend–relax cycles across a range of bend radii. At a bend angle of 100° and a 2.5 mm bend radius, for both transfer techniques, the normalized resistance of graphene transferred on polyethylene terephthalate (PET) was around 80 times less than that of indium–tin oxide on PET. After 104 bend cycles, the resistance of the transferred graphene on PET using UVA and HPL was found to be, on average, around 25.5 and 8.1% higher than that of PMMA-transferred graphene, indicating that UVA- and HPL-transferred graphene are more strongly adhered compared to PMMA-transferred graphene. The robustness, in terms of maintained electrical performance upon mechanical fatigue, of the transferred graphene was around 60 times improved over ITO/PET upon many thousands of repeated bending stress cycles. On the basis of present production methods, the development of the next-generation of highly conformal, diverse form factor electronics, exploiting the emerging family of two-dimensional materials, necessitates the development of simple, low-cost, and mechanically robust transfer processes; the developed UVA and HPL approaches show significant potential and allow for large-area-compatible, near-room temperature transfer of graphene onto a diverse range of polymeric supports

ECOSSE: Estimating Carbon in Organic Soils - Sequestration and Emissions: Final Report

Background Climate change, caused by greenhouse gas ( GHG) emissions, is one of the most serious threats facing our planet, and is of concern at both UK and devolved administration levels. Accurate predictions for the effects of changes in climate and land use on GHG emissions are vital for informing land use policy. Models which are currently used to predict differences in soil carbon (C) and nitrogen (N) caused by these changes, have been derived from those based on mineral soils or deep peat. None of these models is entirely satisfactory for describing what happens to organic soils following land-use change. Reports of Scottish GHG emissions have revealed that approximately 15% of Scotland's total emissions come from land use changes on Scotland's high carbon soils; the figure is much lower for Wales. It is therefore important to reduce the major uncertainty in assessing the carbon store and flux from land use change on organic soils, especially those which are too shallow to be deep peats but still contain a large reserve of C. In order to predict the response of organic soils to external change we need to develop a model that reflects more accurately the conditions of these soils. The development of a model for organic soils will help to provide more accurate values of net change to soil C and N in response to changes in land use and climate and may be used to inform reporting to UKGHG inventories. Whilst a few models have been developed to describe deep peat formation and turnover, none have so far been developed suitable for examining the impacts of land-use and climate change on the types of organic soils often subject to land-use change in Scotland and Wales. Organic soils subject to land-use change are often (but not exclusively) characterised by a shallower organic horizon than deep peats (e.g. organo-mineral soils such as peaty podzols and peaty gleys). The main aim of the model developed in this project was to simulate the impacts of land-use and climate change in these types of soils. The model is, a) be driven by commonly available meteorological data and soil descriptions, b) able to simulate and predict C and N turnover in organic soils, c) able to predict the impacts of land-use change and climate change on C and N stores in organic soils in Scotland and Wales. In addition to developing the model, we have undertaken a number of other modelling exercises, literature searches, desk studies, data base exercises, and experimentation to answer a range of other questions associated with the responses of organic soils in Scotland and Wales to climate and land-use change. Aims of the ECOSSE project The aims of the study were: To develop a new model of C and N dynamics that reflects conditions in organic soils in Scotland and Wales and predicts their likely responses to external factors To identify the extent of soils that can be considered organic in Scotland and Wales and provide an estimate of the carbon contained within them To predict the contribution of CO 2, nitrous oxide and methane emissions from organic soils in Scotland and Wales, and provide advice on how changes in land use and climate will affect the C and N balance In order to fulfil these aims, the project was broken down into modules based on these objectives and the report uses that structure. The first aim is covered by module 2, the second aim by module 1, and the third aim by modules 3 to 8. Many of the modules are inter-linked. Objectives of the ECOSSE project The main objectives of the project were to: Describe the distribution of organic soils in Scotland and Wales and provide an estimate of the C contained in them Develop a model to simulate C and N cycling in organic soils and provide predictions as to how they will respond to land-use, management and climate change using elements of existing peat, mineral and forest soil models Provide predictive statements on the effects of land-use and climate change on organic soils and the relationships to GHG emissions, including CO 2, nitrous oxide and methane. Provide predictions on the effects of land use change and climate change on the release of Dissolved Organic Matter from organic soils Provide estimates of C loss from scenarios of accelerated erosion of organic soils Suggest best options for mitigating C and N loss from organic soils Provide guidelines on the likely effects of changing land-use from grazing or semi-natural vegetation to forestry on C and N in organic soils Use the land-use change data derived from the Countryside Surveys of Scotland and Wales to provide predictive estimates for changes to C and N balance in organic soils over time

Mechanical Robustness of Graphene on Flexible Transparent Substrates.

This study reports on a facile and widely applicable method of transferring chemical vapor deposited (CVD) graphene uniformly onto optically transparent and mechanically flexible substrates using commercially available, low-cost ultraviolet adhesive (UVA) and hot-press lamination (HPL). We report on the adhesion potential between the graphene and the substrate, and we compare these findings with those of the more commonly used cast polymer handler transfer processes. Graphene transferred with the two proposed methods showed lower surface energy and displayed a higher degree of adhesion (UVA: 4.40 ± 1.09 N/m, HPL: 0.60 ± 0.26 N/m) compared to equivalent CVD-graphene transferred using conventional poly(methyl methacrylate) (PMMA: 0.44 ± 0.06 N/m). The mechanical robustness of the transferred graphene was investigated by measuring the differential resistance as a function of bend angle and repeated bend-relax cycles across a range of bend radii. At a bend angle of 100° and a 2.5 mm bend radius, for both transfer techniques, the normalized resistance of graphene transferred on polyethylene terephthalate (PET) was around 80 times less than that of indium-tin oxide on PET. After 10(4) bend cycles, the resistance of the transferred graphene on PET using UVA and HPL was found to be, on average, around 25.5 and 8.1% higher than that of PMMA-transferred graphene, indicating that UVA- and HPL-transferred graphene are more strongly adhered compared to PMMA-transferred graphene. The robustness, in terms of maintained electrical performance upon mechanical fatigue, of the transferred graphene was around 60 times improved over ITO/PET upon many thousands of repeated bending stress cycles. On the basis of present production methods, the development of the next-generation of highly conformal, diverse form factor electronics, exploiting the emerging family of two-dimensional materials, necessitates the development of simple, low-cost, and mechanically robust transfer processes; the developed UVA and HPL approaches show significant potential and allow for large-area-compatible, near-room temperature transfer of graphene onto a diverse range of polymeric supports.Oppenheimer Research Fellowship, Royal Society, Engineering and Physical Sciences Research Council (Impact Acceleration Account grant), Innovate UK (Advanced Materials Feasibility Study award

A novel approach to sharing all available information from funded health research: the NIHR Journals Library

Abstract Background Relevant information on health research must be made publicly available in an accurate, timely and accessible manner if evidence is to inform practice and benefit patient care. Failure to publish research information represents a significant waste of research funds. However, recent studies have demonstrated that non-publication and selective or biased reporting remains a significant problem. The role of online publications in rectifying these issues by providing open access to study information is increasingly recognised. Objective This paper details a novel approach to publishing research information developed by the National Institute for Health Research (NIHR), a major funder of health research in the United Kingdom. The NIHR has enhanced its Journals Library (www.journalslibrary.nihr.ac.uk), providing an online repository of information from research funded through five programmes. We describe how the NIHR Journals Library provides a ‘thread’ of relevant information for each study, including protocols, participant information sheets, data linkages, final reports, publications and diverse knowledge products. We also discuss the Library as a ‘living’ resource, one that is updated as each study progresses from inception to completion. Finally, we consider the implications of the Library for the NIHR, other journals and research teams submitting information. Conclusion Openly publishing information from funded research in the NIHR Journals Library serves as a model of knowledge sharing, maximising return on investment and enhancing the usability and replicability of research findings for different evidence-user communities. The Library also supports wider ‘research on research’ ambitions, enabling users to interrogate the repository of NIHR-funded studies, enhancing the understanding of research commissioning, design, dissemination and impact. Video abstract: www.youtube.com/watch?v=8H03uxN_iTE

Issues concerning web-based business reporting: an analysis of the views of interested parties

Rapid developments in information and communications technology have led organisations in many countries to consider the impact of the Internet on the delivery and dissemination of business information. This paper reports the findings of a UK study into the views of various user groups, preparers and auditors regarding specific proposals for change and newly emerging practices. Over 500 individuals from six groups responded to a questionnaire study, representing an overall response rate of 33%. Views were elicited regarding: (i) the desirability of different kinds of additional information that could be provided electronically, (ii) the usefulness of different navigation and search aids, and (iii) the portability of information under different formats.It is found that users favour many of the expansions of scope made possible by the web. A range of navigation aids, search aids and file formats are found by all groups to be at least fairly useful, especially global navigation aids. Preferences regarding file formats vary across the groups. Paired group comparisons show that, while expert and non-expert users hold similar views in relation to many issues, users' and preparers' views differ considerably. Auditors' views generally fall in between those of users and preparers. Cyert and Ijiri's (1974) framework is used to rationalise the observed conflicts and congruences of interest, underpinning clear pointers for policy-makers

The Low-Velocity, Rapidly Fading Type Ia Supernova 2002es

SN 2002es is a peculiar subluminous Type Ia supernova (SN Ia) with a combination of observed characteristics never before seen in a SN Ia. At maximum light, SN 2002es shares spectroscopic properties with the underluminous SN 1991bg subclass of SNe Ia, but with substantially lower expansion velocities (~6000 km/s) more typical of the SN 2002cx subclass. Photometrically, SN 2002es differs from both SN 1991bg-like and SN 2002cx-like supernovae. Although at maximum light it is subluminous (M_B=-17.78 mag), SN 2002es has a relatively broad light curve (Dm15(B)=1.28 +/- 0.04 mag), making it a significant outlier in the light-curve width vs. luminosity relationship. We estimate a 56Ni mass of 0.17 +/- 0.05 M_sun synthesized in the explosion, relatively low for a SN Ia. One month after maximum light, we find an unexpected plummet in the bolometric luminosity. The late-time decay of the light curves is inconsistent with our estimated 56Ni mass, indicating that either the light curve was not completely powered by 56Ni decay or the ejecta became optically thin to gamma-rays within a month after maximum light. The host galaxy is classified as an S0 galaxy with little to no star formation, indicating the progenitor of SN 2002es is likely from an old stellar population. We also present a less extensive dataset for SN 1999bh, an object which shares similar observed properties. Both objects were found as part of the Lick Observatory Supernova Search, allowing us to estimate that these objects should account for ~2.5% of SNe Ia within a fixed volume. We find that current theoretical models are unable to explain the observed of characteristics of SN 2002es.Comment: 19 pages, 15 figures, Submitted to Ap

A pilot Internet "Value of Health" Panel: recruitment, participation and compliance

Objectives To pilot using a panel of members of the public to provide preference data via the Internet Methods A stratified random sample of members of the general public was recruited and familiarised with the standard gamble procedure using an Internet based tool. Health states were perdiodically presented in "sets" corresponding to different conditions, during the study. The following were described: Recruitment (proportion of people approached who were trained); Participation (a) the proportion of people trained who provided any preferences and (b) the proportion of panel members who contributed to each "set" of values; and Compliance (the proportion, per participant, of preference tasks which were completed). The influence of covariates on these outcomes was investigated using univariate and multivariate analyses. Results A panel of 112 people was recruited. 23% of those approached (n = 5,320) responded to the invitation, and 24% of respondents (n = 1,215) were willing to participate (net = 5.5%). However, eventual recruitment rates, following training, were low (2.1% of those approached). Recruitment from areas of high socioeconomic deprivation and among ethnic minority communities was low. Eighteen sets of health state descriptions were considered over 14 months. 74% of panel members carried out at least one valuation task. People from areas of higher socioeconomic deprivation and unmarried people were less likely to participate. An average of 41% of panel members expressed preferences on each set of descriptions. Compliance ranged from 3% to 100%. Conclusion It is feasible to establish a panel of members of the general public to express preferences on a wide range of health state descriptions using the Internet, although differential recruitment and attrition are important challenges. Particular attention to recruitment and retention in areas of high socioeconomic deprivation and among ethnic minority communities is necessary. Nevertheless, the panel approach to preference measurement using the Internet offers the potential to provide specific utility data in a responsive manner for use in economic evaluations and to address some of the outstanding methodological uncertainties in this field

Impact of discussion on preferences elicited in a group setting

BACKGROUND: The completeness of preferences is assumed as one of the axioms of expected utility theory but has been subject to little empirical study. METHODS: Fifteen non-health professionals was recruited and familiarised with the standard gamble technique. The group then met five times over six months and preferences were elicited independently on 41 scenarios. After individual valuation, the group discussed the scenarios, following which preferences could be changed. Changes made were described and summary measures (mean and median) before and after discussion compared using paired t test and Wilcoxon Signed Rank Test. Semi-structured telephone interviews were carried out to explore attitudes to discussing preferences. These were transcribed, read by two investigators and emergent themes described. RESULTS: Sixteen changes (3.6%) were made to preferences by seven (47%) of the fifteen members. The difference between individual preference values before and after discussion ranged from -0.025 to 0.45. The average effect on the group mean was 0.0053. No differences before and after discussion were statistically significant. The group valued discussion highly and suggested it brought four main benefits: reassurance; improved procedural performance; increased group cohesion; satisfying curiosity. CONCLUSION: The hypothesis that preferences are incomplete cannot be rejected for a proportion of respondents. However, brief discussion did not result in substantial number of changes to preferences and these did not have significant impact on summary values for the group, suggesting that incompleteness, if present, may not have an important effect on cost-utility analyses

Catching Element Formation In The Act

Gamma-ray astronomy explores the most energetic photons in nature to address some of the most pressing puzzles in contemporary astrophysics. It encompasses a wide range of objects and phenomena: stars, supernovae, novae, neutron stars, stellar-mass black holes, nucleosynthesis, the interstellar medium, cosmic rays and relativistic-particle acceleration, and the evolution of galaxies. MeV gamma-rays provide a unique probe of nuclear processes in astronomy, directly measuring radioactive decay, nuclear de-excitation, and positron annihilation. The substantial information carried by gamma-ray photons allows us to see deeper into these objects, the bulk of the power is often emitted at gamma-ray energies, and radioactivity provides a natural physical clock that adds unique information. New science will be driven by time-domain population studies at gamma-ray energies. This science is enabled by next-generation gamma-ray instruments with one to two orders of magnitude better sensitivity, larger sky coverage, and faster cadence than all previous gamma-ray instruments. This transformative capability permits: (a) the accurate identification of the gamma-ray emitting objects and correlations with observations taken at other wavelengths and with other messengers; (b) construction of new gamma-ray maps of the Milky Way and other nearby galaxies where extended regions are distinguished from point sources; and (c) considerable serendipitous science of scarce events -- nearby neutron star mergers, for example. Advances in technology push the performance of new gamma-ray instruments to address a wide set of astrophysical questions.Comment: 14 pages including 3 figure