Freehand and Video-Rate All-Optical Ultrasound Imaging

All-optical ultrasound (AOUS) imaging, which uses light to both generate and detect ultrasound, is an emerging alternative to conventional electronic ultrasound imaging. To date, AOUS imaging has been performed using paradigms that either resulted in long acquisition times or employed bench-top imaging systems that were impractical for clinical use. In this work, we present a novel AOUS imaging paradigm where scanning optics are used to rapidly synthesise an imaging aperture. This paradigm enabled the first AOUS system with a flexible, handheld imaging probe, which represents a critical step towards clinical translation. This probe, which provides video-rate imaging and a real-time display, is demonstrated with phantoms and in vivo human tissue

Rubidium in Metal-Deficient Disk and Halo Stars

We report the first extensive study of stellar Rb abundances. High-resolution spectra have been used to determine, or set upper limits on, the abundances of this heavy element and the associated elements Y, Zr, and Ba in 44 dwarfs and giants with metallicities spanning the range -2.0 <[Fe/H] < 0.0. In metal-deficient stars Rb is systematically overabundant relative to Fe; we find an average [Rb/Fe] of +0.21 for the 32 stars with [Fe/H] < -0.5 and measured Rb. This behavior contrasts with that of Y, Zr, and Ba, which, with the exception of three new CH stars (HD 23439A and B and BD +5 3640), are consistently slightly deficient relative to Fe in the same stars; excluding the three CH stars, we find the stars with [Fe/H] < -0.5 have average [Y/Fe], [Zr/Fe], and [Ba/Fe] of --0.19 (24 stars), --0.12 (28 stars), and --0.06 (29 stars), respectively. The different behavior of Rb on the one hand and Y, Zr, and Ba on the other can be attributed in part to the fact that in the Sun and in these stars Rb has a large r-process component while Y, Zr, and Ba are mostly s-process elements with only small r-process components. In addition, the Rb s-process abundance is dependent on the neutron density at the s-processing site. Published observations of Rb in s-process enriched red giants indicate a higher neutron density in the metal-poor giants. These observations imply a higher s-process abundance for Rb in metal-poor stars. The calculated combination of the Rb r-process abundance, as estimated for the stellar Eu abundances, and the s-process abundance as estimated for red giants accounts satisfactorily for the observed run of [Rb/Fe] with [Fe/H].Comment: 23 pages, 5 tables, 7 figure

The Discovery of Stellar Oscillations in the Planet Hosting Giant Star Beta Geminorum

We present the results of a long time series of precise stellar radial velocity measurements of the planet hosting K giant star Beta Geminorum. A total of 20 hours of observations spanning three nights were obtained and the radial velocity variations show the presence of solar-like stellar oscillations. Our period analysis yields six significant pulsation modes that have frequencies in the range of 30 - 150 microHz. The dominant mode is at a frequency of 86.9 microHz and has an amplitude of 5.3 m/s. These values are consistent with stellar oscillations for a giant star with a stellar mass of approximately 2 solar masses. This stellar mass implies a companion minimum mass of 2.6 Jupiter masses. Beta Gem is the first planet hosting giant star in which multi-periodic stellar oscillations have been detected. The study of stellar oscillations in planet hosting giant stars may provide an independent, and more accurate determination of the stellar mass.Comment: 12 pages preprint, 2 figures, accepted by ApJ Letter

Effects of asenapine on depressive symptoms in patients with bipolar I disorder experiencing acute manic or mixed episodes: a post hoc analysis of two 3-week clinical trials

<p>Abstract</p> <p>Background</p> <p>Asenapine demonstrated superiority over placebo for mania in bipolar I disorder patients experiencing acute current manic or mixed episodes in 2 randomized, placebo-and olanzapine-controlled trials. We report the results of exploratory pooled post hoc analyses from these trials evaluating asenapine's effects on depressive symptoms in patients from these trials with significant baseline depressive symptoms.</p> <p>Methods</p> <p>In the original trials (A7501004 [NCT00159744], A7501005 [NCT00159796]), 977 patients were randomized to flexible-dose sublingual asenapine (10 mg twice daily on day 1; 5 or 10 mg twice daily thereafter), placebo, or oral olanzapine 5-20 mg once daily for 3 weeks. Three populations were defined using baseline depressive symptoms: (1) Montgomery-Asberg Depression Rating Scale (MADRS) total score ≥20 (n = 132); (2) Clinical Global Impression for Bipolar Disorder-Depression (CGI-BP-D) scale severity score ≥4 (n = 170); (3) diagnosis of mixed episodes (n = 302) by investigative site screening. For each population, asenapine and olanzapine were independently compared with placebo using least squares mean change from baseline on depressive symptom measures.</p> <p>Results</p> <p>Decreases in MADRS total score were statistically greater with asenapine versus placebo at days 7 and 21 in all populations; differences between olanzapine and placebo were not significant. Decreases in CGI-BP-D score were significantly greater with asenapine versus placebo at day 7 in all categories and day 21 in population 1; CGI-BP-D score reductions were significantly greater with olanzapine versus placebo at day 21 in population 1 and day 7 in populations 2 and 3.</p> <p>Conclusions</p> <p>These post hoc analyses show that asenapine reduced depressive symptoms in bipolar I disorder patients experiencing acute manic or mixed episodes with clinically relevant depressive symptoms at baseline; olanzapine results appeared to be less consistent. Controlled studies of asenapine in patients with acute bipolar depression are necessary to confirm the generalizability of these findings.</p

Levetiracetam versus phenytoin for second-line treatment of paediatric convulsive status epilepticus (EcLiPSE): a multicentre, open-label, randomised trial

Background Phenytoin is the recommended second-line intravenous anticonvulsant for treatment of paediatric convulsive status epilepticus in the UK; however, some evidence suggests that levetiracetam could be an effective and safer alternative. This trial compared the efficacy and safety of phenytoin and levetiracetam for second-line management of paediatric convulsive status epilepticus.Methods This open-label, randomised clinical trial was undertaken at 30 UK emergency departments at secondary and tertiary care centres. Participants aged 6 months to under 18 years, with convulsive status epilepticus requiring second-line treatment, were randomly assigned (1:1) using a computer-generated randomisation schedule to receive levetiracetam (40 mg/kg over 5 min) or phenytoin (20 mg/kg over at least 20 min), stratified by centre. The primary outcome was time from randomisation to cessation of convulsive status epilepticus, analysed in the modified intention-to-treat population (excluding those who did not require second-line treatment after randomisation and those who did not provide consent). This trial is registered with ISRCTN, number ISRCTN22567894.Findings Between July 17, 2015, and April 7, 2018, 1432 patients were assessed for eligibility. After exclusion of ineligible patients, 404 patients were randomly assigned. After exclusion of those who did not require second-line treatment and those who did not consent, 286 randomised participants were treated and had available data: 152 allocated to levetiracetam, and 134 to phenytoin. Convulsive status epilepticus was terminated in 106 (70%) children in the levetiracetam group and in 86 (64%) in the phenytoin group. Median time from randomisation to cessation of convulsive status epilepticus was 35 min (IQR 20 to not assessable) in the levetiracetam group and 45 min (24 to not assessable) in the phenytoin group (hazard ratio 1·20, 95% CI 0·91–1·60; p=0·20). One participant who received levetiracetam followed by phenytoin died as a result of catastrophic cerebral oedema unrelated to either treatment. One participant who received phenytoin had serious adverse reactions related to study treatment (hypotension considered to be immediately life-threatening [a serious adverse reaction] and increased focal seizures and decreased consciousness considered to be medically significant [a suspected unexpected serious adverse reaction]). Interpretation Although levetiracetam was not significantly superior to phenytoin, the results, together with previously reported safety profiles and comparative ease of administration of levetiracetam, suggest it could be an appropriate alternative to phenytoin as the first-choice, second-line anticonvulsant in the treatment of paediatric convulsive status epilepticus

The effects of cow genetic group on the density of raw whole milk

peer reviewedThe density of milk is dependent upon various factors including temperature, processing conditions, and animal breed. This study evaluated the effect of different cow genetic groups, Jersey, elite Holstein Friesians (EHF), and national average Holstein Friesians (NAHF) on the compositional and physicochemical properties of milk. Approximately 1,040 representative (morning and evening) milk samples (~115 per month during 9 mo) were collected once every 2 wk. Milk composition was determined with a Bentley Dairyspec instrument. Data were analysed with a mixed linear model that included the fixed effects of sampling month, genetic group, interaction between month and genetic group and the random effects of cow to account for repeated measures on the same animal. Milk density was determined using three different analytical approaches – a portable and a standard desktop density meter and 100 cm3 calibrated glass pycnometers. Milk density was analysed with the same mixed model as for milk composition but including the analytical method as a fixed effect. Jersey cows had the greatest mean for fat content (5.69 ± 0.13%), followed by EHF (4.81 ± 0.16%) and NAHF (4.30 ± 0.15%). Milk density was significantly higher (1.0313 g/cm³ ± 0.00026, P < 0.05) for the milk of Jersey breed when compared to the EHF (1.0304 ± 0.00026 g/cm³) and NAHF (1.0303 ± 0.00024 g/cm³) genetic groups. The results from this study can be used by farmers and dairy processors alike to enhance accuracy when calculating the quantity and value of milk solids depending upon the genetic merit of the animal/herd, and may also improve milk payment systems through relating milk solids content and density

Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine

[This corrects the article DOI: 10.1186/s13054-016-1208-6.]