Comparison of exact and approximate cross-sections in relativistic Coulomb excitation

We present a new method of obtaining time-dependent matrix elements of the electromagnetic pulse produced by a highly-relativistic projectile. These matrix elements are used in a coupled-channel calculation to predict the cross-sections for population of 1- and 2-phonon states of the giant dipole resonance. Comparisons are made with the predictions of the long-wavelength and Born approximations.Comment: 26 pages, LaTex2

Carbamide peroxide gel stability under different temperature conditions: is manipulated formulation an option?

Nowadays the use of gel containing carbamide peroxide (CP) prepared in Pharmacy is a normal practice in the population. However, the quality of this product is questionable concerning its stability. The aim of this study is was to synthesize and to analyze this drug alone or associated to Carbopol gel through analytical methodology compatible with the routine of the Pharmacies. The reaction between urea and hydrogen peroxide was carried out at different resting times: 24 hours (CP 24 powder) and 48 hours (CP48 powder) after the mixture. Both products were associated with Carbopol 940® gel 1.5% (G) generating G24 and G48 samples. The stability of powders (CP24 e CP48) and the formulations (G24 and G48) were evaluated as a function of time (15, 40 and 45 days) and thermal variation (refrigeration: 8 °C±1; thermal shock 32 °C±1 /8 °C±1; stove: 32 °C±1), using a standard titration method. As a result, only under refrigeration the CP24 and CP48 contents remained stable during the period of 45 days. An interesting finding was that G24 and G48 presented greater stability for at least 45-days under refrigeration and thermal shock conditions, and up to 30 days under stove conditions. The results for the G24 and G48 were slightly higher than those obtained for the control. Therefore, we were able to conclude that association with Carbopol 940® Gel 1.5 % provided greater CP stability and that manipulated formulations containing CP may be viable for use in a period of 45 days under refrigeration conditions. The titration proved to be an effective technique for the analysis of CP with or without Carbopol 940® gel 1.5%.Atualmente, a utilização de gel contendo peróxido de carbamida manipulado em Farmácia é uma prática comum na população. No entanto, a qualidade deste produto é questionada, sobretudo no que se refere à estabilidade deste fármaco. O objetivo deste trabalho consiste na avaliação da viabilidade de sintetizar e analisar quantitativamente este fármaco associado ou não a um gel de Carbopol através de metodologia analítica compatível com a rotina das Farmácias. A reação entre a uréia e o peróxido de hidrogênio foi realizada em tempos diferentes de repouso após a mistura, 24 h para sintetizar o pó PC 24 e 48 h para o pó CP 48. Estes pós foram associados a um gel (G) de Carbopol 940® 1,5 %, originando as amostras G24 e G48. A estabilidade dos pós (PC 24 e PC 48) e das formulações (G 24 e G 48) foi avaliada em função do tempo (15, 40 e 45 dias) e da variação térmica (refrigeração: 8 °C±1; choque térmico: 32 °C±1/8 °C±1 e estufa: 32 °C±1), através da técnica de titulometria. Os resultados indicam que unicamente sob refrigeração o CP24 e o CP 48 mantiveram-se estáveis no período de 45 dias. O G24 e o G48 apresentaram estáveis por pelo menos 45 dias nas condições de refrigeração e choque térmico e por 30 dias na condição estufa. Os resultados obtidos para o G24 e G48 foram ligeiramente superiores aos obtidos para o controle. Além disso, é possível concluir que a associação do PC com o gel de Carbopol 940® 1,5 % promoveu um aumento na estabilidade do PC e que as preparações manipuladas contendo PC são viáveis para uso durante um período de 45 sob refrigeração. A titulometria mostrou-se uma técnica eficaz para a análise do PC associado ou não ao gel de Carbopol 940® 1,5%

Outcome in patients perceived as receiving excessive care across different ethical climates: a prospective study in 68 intensive care units in Europe and the USA

Purpose: Whether the quality of the ethical climate in the intensive care unit (ICU) improves the identification of patients receiving excessive care and affects patient outcomes is unknown. Methods: In this prospective observational study, perceptions of excessive care (PECs) by clinicians working in 68 ICUs in Europe and the USA were collected daily during a 28-day period. The quality of the ethical climate in the ICUs was assessed via a validated questionnaire. We compared the combined endpoint (death, not at home or poor quality of life at 1 year) of patients with PECs and the time from PECs until written treatment-limitation decisions (TLDs) and death across the four climates defined via cluster analysis. Results: Of the 4747 eligible clinicians, 2992 (63%) evaluated the ethical climate in their ICU. Of the 321 and 623 patients not admitted for monitoring only in ICUs with a good (n = 12, 18%) and poor (n = 24, 35%) climate, 36 (11%) and 74 (12%), respectively were identified with PECs by at least two clinicians. Of the 35 and 71 identified patients with an available combined endpoint, 100% (95% CI 90.0–1.00) and 85.9% (75.4–92.0) (P = 0.02) attained that endpoint. The risk of death (HR 1.88, 95% CI 1.20–2.92) or receiving a written TLD (HR 2.32, CI 1.11–4.85) in patients with PECs by at least two clinicians was higher in ICUs with a good climate than in those with a poor one. The differences between ICUs with an average climate, with (n = 12, 18%) or without (n = 20, 29%) nursing involvement at the end of life, and ICUs with a poor climate were less obvious but still in favour of the former. Conclusion: Enhancing the quality of the ethical climate in the ICU may improve both the identification of patients receiving excessive care and the decision-making process at the end of life