Chest compressions and epinephrine during resuscitation of infants born at the border of viability: Yes, no or maybe?

Neonatology, in large part due to its population of babies born at the edge of viability, is rife with bioethical issues. This unique population is at high risk of mortality and considerable neurodevelopmental morbidity. One contentious, ongoing debate concerns whether these extremely low birth weight infants born at the border of viability should, if required by the Neonatal Resuscitation Program guidelines, receive chest compressions and epinephrine as part of their delivery room resuscitation. The present article, through a case presentation and discussion based on the ethical framework of principlism, provides readers with a thoughtful approach to the controversial issue of the provision of chest compressions and epinephrine as part of resuscitation for extremely low birth weight infants born at the border of viability. La néonatologie, en grande partie à cause de sa population de bébés nés à la limite de la viabilité, regorge d’enjeux bioéthiques. Cette population unique est très vulnérable à la mortalité et à une morbidité neurodéveloppementale considérable. Une question litigieuse et continue consiste à se demander si ces nourrissons d’extrême petit poids de naissance nés à la limite de la viabilité devraient, si les lignes directrices du Programme de réanimation néonatale l’indiquent, recevoir des compressions thoraciques et de l’adrénaline dans le cadre de leur réanimation en salle d’accouchement. Au moyen d’une présentation de cas et d’un exposé fondé sur la structure éthique du principlisme, le présent article offre au lecteur une démarche réfléchie à l’égard de la question controversée d’administrer des compressions thoraciques et de l’adrénaline dans le cadre de la réanimation de nourrissons d’extrême petit poids de naissance nés à la limite de la viabilité

Cavity Nonlinear Optics at Low Photon Numbers from Collective Atomic Motion

We report on Kerr nonlinearity and dispersive optical bistability of a Fabry-Perot optical resonator due to the displacement of ultracold atoms trapped within. In the driven resonator, such collective motion is induced by optical forces acting upon up to $10^5$ $^{87}$Rb atoms prepared in the lowest band of a one-dimensional intracavity optical lattice. The longevity of atomic motional coherence allows for strongly nonlinear optics at extremely low cavity photon numbers, as demonstrated by the observation of both branches of optical bistability at photon numbers below unity.Comment: 4 pages, 3 figures. Modifed following reviewer comment

Ab initio molecular dynamics calculations of ion hydration free energies

We apply ab initio molecular dynamics (AIMD) methods in conjunction with the thermodynamic integration or "lambda-path" technique to compute the intrinsic hydration free energies of Li+, Cl-, and Ag+ ions. Using the Perdew-Burke-Ernzerhof functional, adapting methods developed for classical force field applications, and with consistent assumptions about surface potential (phi) contributions, we obtain absolute AIMD hydration free energies (Delta G(hyd)) within a few kcal/mol, or better than 4%, of Tissandier 's [J. Phys. Chem. A 102, 7787 (1998)] experimental values augmented with the SPC/E water model phi predictions. The sums of Li+/Cl- and Ag+/Cl- AIMD Delta G(hyd), which are not affected by surface potentials, are within 2.6% and 1.2 % of experimental values, respectively. We also report the free energy changes associated with the transition metal ion redox reaction Ag++Ni+-> Ag+Ni2+ in water. The predictions for this reaction suggest that existing estimates of Delta G(hyd) for unstable radiolysis intermediates such as Ni+ may need to be extensively revised.Comment: 18 pages, 8 figures. This version is essentially the one published in J. Chem. Phy

Collimated, single-pass atom source from a pulsed alkali metal dispenser for laser-cooling experiments

We have developed an improved scheme for loading atoms into a magneto-optical trap (MOT) from a directed alkali metal dispenser in < 10^-10 torr ultra-high vacuum conditions. A current-driven dispenser was surrounded with a cold absorbing "shroud" held at < 0 C, pumping rubidium atoms not directed into the MOT. This nearly eliminates background alkali atoms and reduces the detrimental rise in pressure normally associated with these devices. The system can be well-described as a current-controlled, rapidly-switched, two-temperature thermal beam, and was used to load a MOT with 3 x 10^8 atoms.Comment: 5 pages, 4 figure

Parenclitic network mapping identifies response to targeted albumin therapy in patients hospitalized with decompensated cirrhosis

BACKGROUND: The efficacy of targeted albumin therapy in the management of decompensatory events in cirrhosis is unclear with different reports showing conflicting results. It is possible that only certain subgroups of patients may benefit from targeted albumin administration. However, extensive conventional subgroup analyses have not yet identified these subgroups. Albumin is an important regulator of physiological networks and may interact with homeostatic mechanism differently in patients according to the integrity of their physiological network. In the present study we aimed to assess the value of network mapping in predicting response to targeted albumin therapy in patients with cirrhosis. METHOD: This is a sub-study of the ATTIRE trial; a multicentre, randomized trial conducted to assess the effect of targeted albumin therapy in cirrhosis. Baseline serum bilirubin, albumin, sodium, creatinine, CRP, and white cell count (WCC), international normalised ratio, heart rate, and blood pressure of 777 patients followed up for 6 months were used for network mapping using parenclitic analysis. Parenclitic network analysis involves measuring the deviation of each individual patient from the existing network of physiological interactions in a reference population. RESULT: Overall network connectivity as well as deviations along WCC-CRP axis predicted 6-month survival independent of age and model for end-stage liver disease (MELD) in the standard care arm. Patients with lower deviation along the WCC-CRP axis showed lower survival in response to targeted albumin administration over 6-month follow-up period. Likewise, patients with higher overall physiological connectivity survived significantly less than the standard care group following targeted albumin infusion. CONCLUSION: The parenclitic network mapping can predict survival of patients with cirrhosis and identify patient subgroups that don't benefit from targeted albumin therapy

The metabolism and de-bromination of bromotyrosine in vivo

During inflammation, leukocyte-derived eosinophil peroxidase catalyses the formation of hypobromous acid, which can brominate tyrosine residues in proteins to form bromotyrosine. Since eosinophils are involved in the pathogenesis of allergic reactions, such as asthma, urinary bromotyrosine level has been used for the assessment of children with asthma. However, little is known about the metabolism and disposition of bromotyrosine in vivo. The aim of this study was to identify the major urinary metabolites formed during bromotyrosine metabolism and to develop mass spectrometric methods for their quantitation. Deuterium-labeled bromotyrosine was synthesized by deuterium exchange. [D3]bromotyrosine (500 nmole) was injected intraperitoneally into Sprague-Dawley rats and urine was collected for 24 h in a metabolic cage. 13C-labeled derivatives of bromotyrosine and its major urinary metabolite were synthesized and used as internal standards for quantitation. Following solid phase extraction, urine samples were derivatized to the pentafluorobenzyl ester, and analyzed using isotope dilution gas chromatography and negative-ion chemical ionization mass spectrometry. A novel brominated metabolite, 3-bromo-4-hydroxyphenylacetic acid (bromo-HPA), was identified as the major brominated metabolite of bromotyrosine. Bromo-HPA only accounted for 0.43±0.04% of infused [D3]bromotyrosine and 0.12±0.02% of infused [D3]bromotyrosine was excreted in the urine unchanged. However, ~1.3% (6.66±1.33 nmole) of infused [D3]bromotyrosine was excreted in the urine as the de-brominated metabolite, [D3]4-hydroxyphenylacetic acid, which is also a urinary metabolite of tyrosine in mammals. We also tested whether or not iodotyrosine dehalogenase can catalyse de-bromination of bromotyrosine and showed that iodotyrosine dehalogenase is able to de-brominate free bromotyrosine in vitro. We identified bromo-HPA as the main brominated urinary metabolite of bromotyrosine in rats. However, de-halogenation of bromotyrosine is the major metabolic pathway to eliminate free brominated tyrosine in vivo

CNN Architectures for Large-Scale Audio Classification

Convolutional Neural Networks (CNNs) have proven very effective in image classification and show promise for audio. We use various CNN architectures to classify the soundtracks of a dataset of 70M training videos (5.24 million hours) with 30,871 video-level labels. We examine fully connected Deep Neural Networks (DNNs), AlexNet [1], VGG [2], Inception [3], and ResNet [4]. We investigate varying the size of both training set and label vocabulary, finding that analogs of the CNNs used in image classification do well on our audio classification task, and larger training and label sets help up to a point. A model using embeddings from these classifiers does much better than raw features on the Audio Set [5] Acoustic Event Detection (AED) classification task.Comment: Accepted for publication at ICASSP 2017 Changes: Added definitions of mAP, AUC, and d-prime. Updated mAP/AUC/d-prime numbers for Audio Set based on changes of latest Audio Set revision. Changed wording to fit 4 page limit with new addition

Ex-nihilo II: Examination Syllabi and the Sequencing of Cosmology Education

Cosmology education has become an integral part of modern physics courses. Directed by National Curricula, major UK examination boards have developed syllabi that contain explicit statements about the model of the Big Bang and the strong observational evidence that supports it. This work examines the similarities and differences in these specifications, addresses when cosmology could be taught within a physics course, what should be included in this teaching and in what sequence it should be taught at different levels.Comment: 9 pages. Accepted for publication in a special issue of Physics Educatio

An Investigation of the Ionic Conductivity and Species Crossover of Lithiated Nafion 117 in Nonaqueous Electrolytes

Nonaqueous redox flow batteries are a fast-growing area of research and development motivated by the need to develop low-cost energy storage systems. The identification of a highly conductive, yet selective membrane, is of paramount importance to enabling such a technology. Herein, we report the swelling behavior, ionic conductivity, and species crossover of lithiated Nafion 117 membranes immersed in three nonaqueous electrolytes (PC, PC : EC, and DMSO). Our results show that solvent volume fraction within the membrane has the greatest effect on both conductivity and crossover. An approximate linear relationship between diffusive crossover of neutral redox species (ferrocene) and the ionic conductivity of membrane was observed. As a secondary effect, the charge on redox species modifies crossover rates in accordance with Donnan exclusion. The selectivity of membrane is derived mathematically and compared to experimental results reported here. The relatively low selectivity for lithiated Nafion 117 in nonaqueous conditions suggests that new membranes are required for competitive nonaqueous redox flow batteries to be realized. Potential design rules are suggested for the future membrane engineering work.United States. Dept. of Energy. Office of Basic Energy Sciences. Joint Center for Energy Storage Researc