Randomized controlled trial of patient-controlled sedation for colonoscopy: Entonox vs modified patient-maintained target-controlled propofol

Aim Propofol sedation is often associated with deep sedation and decreased manoeuvrability. Patient-maintained sedation has been used in such patients with minimal side-effects. We aimed to compare novel modified patient-maintained target-controlled infusion (TCI) of propofol with patient-controlled Entonox inhalation for colonoscopy in terms of analgesic efficacy (primary outcome), depth of sedation, manoeuvrability and patient and endoscopist satisfaction (secondary outcomes). Method One hundred patients undergoing elective colonoscopy were randomized to receive either TCI propofol or Entonox. Patients in the propofol group were administered propofol initially to achieve a target concentration of 1.2 μ g/ml and then allowed to self-administer a bolus of propofol (200 μ g/kg/ml) using a patient-controlled analgesia pump with a handset. Entonox group patients inhaled the gas through a mouthpiece until caecum was reached and then as required. Sedation was initially given by an anaesthetist to achieve a score of 4 (Modified Observer's Assessment of Alertness and Sedation Scale), and colonoscopy was then started. Patients completed an anxiety score (Hospital Anxiety and Depression questionnaire), a baseline letter cancellation test and a pain score on a 100-mm visual analogue scale before and after the procedure. All patients completed a satisfaction survey at discharge and 24 h postprocedure. Results The median dose of propofol was 174 mg, and the median number of propofol boluses was four. There was no difference between the two groups in terms of pain recorded (95% confidence interval of the difference -0.809, 5.02) and patient/endoscopist satisfaction. There was no difference between the two groups in either depth of sedation or manoeuvrability. Conclusion Both Entonox and the modified TCI propofol provide equally effective sedation and pain relief, simultaneously allowing patients to be easily manoeuvred during the procedures. © 2010 The Authors. Colorectal Disease © 2010 The Association of Coloproctology of Great Britain and Ireland

Soil, plant, and transport influences on methane in a subalpine forest under high ultraviolet irradiance

Recent studies have demonstrated direct methane emission from plant foliage under aerobic conditions, particularly under high ultraviolet (UV) irradiance. We examined the potential importance of this phenomenon in a high-elevation conifer forest using micrometeorological techniques. Vertical profiles of methane and carbon dioxide in forest air were monitored every 2 h for 6 weeks in summer 2007. Day to day variability in above-canopy CH<sub>4</sub> was high, with observed values in the range 1790 to 1910 nmol mol<sup>−1</sup>. High CH<sub>4</sub> was correlated with high carbon monoxide and related to wind direction, consistent with pollutant transport from an urban area by a well-studied mountain-plain wind system. Soils were moderately dry during the study. Vertical gradients of CH<sub>4</sub> were small but detectable day and night, both near the ground and within the vegetation canopy. Gradients near the ground were consistent with the forest soil being a net CH<sub>4</sub> sink. Using scalar similarity with CO<sub>2</sub>, the magnitude of the summer soil CH<sub>4</sub> sink was estimated at ~1.7 mg CH<sub>4</sub> m<sup>−2</sup> h<sup>−1</sup>, which is similar to other temperate forest upland soils. The high-elevation forest was naturally exposed to high UV irradiance under clear sky conditions, with observed peak UVB irradiance >2 W m<sup>−2</sup>. Gradients and means of CO<sub>2</sub> within the canopy under daytime conditions showed net uptake of CO<sub>2</sub> due to photosynthetic drawdown as expected. No evidence was found for a significant foliar CH<sub>4</sub> source in the vegetation canopy, even under high UV conditions. While the possibility of a weak foliar source cannot be excluded given the observed soil sink, overall this subalpine forest was a net sink for atmospheric methane during the growing season

Empirical 2MASS-WFC3/IR filter transformations from synthetic photometry

Near-infrared bandpasses on spaceborne observatories diverge from their ground-based counterparts as they are free of atmospheric telluric absorption. Available transformations between respective filter systems in the literature rely on theoretical stellar atmospheres, which are known to have difficulties reproducing observed spectral energy distributions of cool giants. We present new transformations between the 2MASS $JHK_S$ and HST WFC3/IR F110W, F125W, & F160W photometric systems based on synthetic photometry of empirical stellar spectra from four spectral libraries. This sample comprises over 1000 individual stars, which together span nearly the full HR diagram and sample stellar populations from the solar neighborhood out to the Magellanic Clouds, covering a broad range of ages, metallicities, and other relevant stellar properties. In addition to global color-dependent transformations, we examine band-to-band differences for cool, luminous giant stars in particular, including multiple types of primary distance indicators.Comment: 24 pages, 15 figures, accepted to A

Hydration of a B-DNA Fragment in the Method of Atom-atom Correlation Functions with the Reference Interaction Site Model Approximation

We propose an efficient numerical algorithm for solving integral equations of the theory of liquids in the Reference Interaction Site Model (RISM) approximation for infinitely dilute solution of macromolecules with a large number of atoms. The algorithm is based on applying the nonstationary iterative methods for solving systems of linear algebraic equations. We calculate the solvent-solute atom-atom correlation functions for a fragment of the B-DNA duplex d(GGGGG).d(CCCCC) in infinitely dilute aqueous solution. The obtained results are compared with available experimental data and results from computer simulations.Comment: 9 pages, RevTeX, 9 pages of ps figures, accepted for publications in JC

Canopy nitrogen, carbon assimilation, and albedo in temperate and boreal forests: Functional relations and potential climate feedbacks

The availability of nitrogen represents a key constraint on carbon cycling in terrestrial ecosystems, and it is largely in this capacity that the role of N in the Earth\u27s climate system has been considered. Despite this, few studies have included continuous variation in plant N status as a driver of broad-scale carbon cycle analyses. This is partly because of uncertainties in how leaf-level physiological relationships scale to whole ecosystems and because methods for regional to continental detection of plant N concentrations have yet to be developed. Here, we show that ecosystem CO2 uptake capacity in temperate and boreal forests scales directly with whole-canopy N concentrations, mirroring a leaf-level trend that has been observed for woody plants worldwide. We further show that both CO2 uptake capacity and canopy N concentration are strongly and positively correlated with shortwave surface albedo. These results suggest that N plays an additional, and overlooked, role in the climate system via its influence on vegetation reflectivity and shortwave surface energy exchange. We also demonstrate that much of the spatial variation in canopy N can be detected by using broad-band satellite sensors, offering a means through which these findings can be applied toward improved application of coupled carbon cycle–climate models

The Frequency of Mid-Infrared Excess Sources in Galactic Surveys

We have identified 230 Tycho-2 Spectral Catalog stars that exhibit 8 micron mid-infrared extraphotospheric excesses in the MidCourse Space Experiment (MSX) and Spitzer Space Telescope Galactic Legacy MidPlane Survey Extraordinaire (GLIMPSE) surveys. Of these, 183 are either OB stars earlier than B8 in which the excess plausibly arises from a thermal bremsstrahlung component or evolved stars in which the excess may be explained by an atmospheric dust component. The remaining 47 stars have spectral classifications B8 or later and appear to be main sequence or late pre-main-sequence objects harboring circumstellar disks. Six of the 47 stars exhibit multiple signatures characteristic of pre-main-sequence circumstellar disks, including emission lines, near-infrared K-band excesses, and X-ray emission. Approximately one-third of the remaining 41 sources have emission lines suggesting relative youth. Of the 25 GLIMPSE stars with SST data at >24 microns, 20 also show an excess at 24 microns. Three additional objects have 24 micron upper limits consistent with possible excesses, and two objects have photospheric measurements at 24 microns. Six MSX sources had a measurement at wavelengths >8 microns. We modeled the excesses in 26 stars having two or more measurements in excess of the expected photospheres as single-component blackbodies. We determine probable disk temperatures and fractional infrared luminosities in the range 191 < T < 787 and 3.9x10^-4 < L_IR/L_* < 2.7x10^-1. We estimate a lower limit on the fraction of Tycho-2 Spectral Catalog main-sequence stars having mid-IR, but not near-IR, excesses to be 1.0+-0.3%.Comment: Accepted to Ap

Enhancing cell and gene therapy manufacture through the application of advanced fluorescent optical sensors (Review)

Cell and gene therapies (CGTs) are examples of future therapeutics that can be used to cure or alleviate the symptoms of disease, by repairing damaged tissue or reprogramming defective genetic information. However, despite the recent advancements in clinical trial outcomes, the path to widescale adoption of CGTs remains challenging, such that the emergence of a “blockbuster” therapy has so far proved elusive. Manufacturing solutions for these therapies require the application of scalable and replicable cell manufacturing techniques, which differ markedly from the existing pharmaceutical incumbent. Attempts to adopt this pharmaceutical model for CGT manufacture have largely proved unsuccessful. The most significant challenges facing CGT manufacturing are process analytical testing and quality control. These procedures would greatly benefit from improved sensory technologies that allow direct measurement of critical quality attributes, such as pH, oxygen, lactate and glucose. In turn, this would make manufacturing more robust, replicable and standardized. In this review, the present-day state and prospects of CGT manufacturing are discussed. In particular, the authors highlight the role of fluorescent optical sensors, focusing on their strengths and weaknesses, for CGT manufacture. The review concludes by discussing how the integration of CGT manufacture and fluorescent optical sensors could augment future bioprocessing approaches

Persistent reduced ecosystem respiration after insect disturbance in high elevation forests

Amid a worldwide increase in tree mortality, mountain pine beetles (Dendroctonus ponderosae Hopkins) have led to the death of billions of trees from Mexico to Alaska since 2000. This is predicted to have important carbon, water and energy balance feedbacks on the Earth system. Counter to current projections, we show that on a decadal scale, tree mortality causes no increase in ecosystem respiration from scales of several square metres up to an 84 km2 valley. Rather, we found comparable declines in both gross primary productivity and respiration suggesting little change in net flux, with a transitory recovery of respiration 6–7 years after mortality associated with increased incorporation of leaf litter C into soil organic matter, followed by further decline in years 8–10. The mechanism of the impact of tree mortality caused by these biotic disturbances is consistent with reduced input rather than increased output of carbon