Spatiotemporal Distribution Of Ionospheric Irregularities Over India During St. Patrick‘s Day Storm

178-189The irregularities formed over the equatorial ionospheric region over the Indian sector have been studied for the first time for the day of the most intense geomagnetic storm of solar cycle-24, which occurred on 17.03.2015, using Rate of TEC Index (ROTI) as the index for the study. These values have been derived using the measurements done with the TEC network receivers of the Indian SBAS system, GAGAN. Spatial and temporal variations of ROTI have been observed and compared to the same parameters on a quiet day with occurrence of nominal scintillation. The latitudinal symmetry of the irregularities for a given local time was evident. It has been found that the ionospheric irregularities formed over this region get immensely enhanced due to the storm in terms of its intensity and spatial extent, as well. The temporal spread of the irregularities has been observed and the statistical variations of the occurrences were compared with respect to those on quiet days. The results have provided few interesting observations including an understanding of the profundity and extensiveness of the irregularities and of the possibilities of consequent scintillation for the navigation signal over Indian region during space weather induced intense geomagnetic disturbances

Non-pharmacological interventions to improve sleep quality and quantity for hospitalized adult patients—co-produced study with surgical patient partners:systematic review

Background: Hospitalized patients experience sleep disruption with consequential physiological and psychological effects. Surgical patients are particularly at risk due to surgical stress and postoperative pain. This systematic review aimed to identify non-pharmacological interventions for improving sleep and exploring their effects on sleep-related and clinical outcomes. Methods: A systematic literature search was performed in accordance with PRISMA guidelines and was preregistered on the Open Science Framework (doi: 10.17605/OSF.IO/EA6BN) and last updated in November 2023. Studies that evaluated non-pharmacological interventions for hospitalized, adult patients were included. Thematic content analysis was performed to identify hypothesized mechanisms of action and modes of administration, in collaboration with a patient partner. Risk of bias assessment was performed using the Cochrane Risk Of Bias (ROB) or Risk Of Bias In Non-Randomized Studies – of Interventions (ROBINS-I) tools. Results: A total of 59 eligible studies and data from 14 035 patients were included; 28 (47.5%) were randomized trials and 26 included surgical patients (10 trials). Thirteen unique non-pharmacological interventions were identified, 17 sleep measures and 7 linked health-related outcomes. Thematic analysis revealed two major themes for improving sleep in hospital inpatients: enhancing the sleep environment and utilizing relaxation and mindfulness techniques. Two methods of administration, self-administered and carer-administered, were identified. Environmental interventions, such as physical aids, and relaxation interventions, including aromatherapy, showed benefits to sleep measures. There was a lack of standardized sleep measurement and an overall moderate to high risk of bias across all studies. Conclusions: This systematic review has identified several sleep interventions that are likely to benefit adult surgical patients, but there remains a lack of high-quality evidence to support their routine implementation

Sonographic appearances and percutaneous management of primary tuberculous liver abscess

Primary tuberculous liver abscesses are rare. We report on 3 patients who presented with a nonresolving abscess in the liver. Clinical presentation and sonographic findings in each case were nonspecific. A diagnosis of tuberculosis was established with microbiologic examination of pus in 2 cases and examination of an excised abscess wall in 1 case. Needle aspiration (1 patient) and short-term (72 hours) catheter drainage (1 patient) were unsuccessful, and surgical excision was required in these patients. In the third patient, continuous catheter drainage over 18 days resulted in cure, indicating that long-term catheter drainage with antituberculous chemotherapy may be a viable alternative to surgery in the management of primary tuberculous liver abscess

Mechanical graphite transport in fault zones and the formation of graphite veins

This paper describes a vein-shaped graphite occurrence in which, for the first time, the geological, mineralogical and isotopic evidence support its formation by physical remobilization of previously formed syngenetic graphite. The deposit studied is located in the Spanish Central System and it occurs along the contact between a hydrothermal Ag-bearing quartz vein and a graphite-bearing quartzite layer. The characteristics of this occurrence differ from those of fluid-deposited vein-type graphite mineralization in that: (1) graphite flakes are oriented parallel to the vein walls; (2) graphite crystallinity is slightly lower than in the syngenetic precursor (graphite disseminated in the quartzite); and (3) the isotopic signatures of both types of graphite are identical and correspond to biogenic carbon. In addition, the P-T conditions of the hydrothermal Ag-bearing quartz veins in the study area (P <1 kbar, and T up to 360ëC) contrast with the high degree of structural order of graphite in the vein. Therefore, physical remobilization of graphite can be regarded as a suitable alternative mechanism to account for some cases of vein-shaped graphite deposits. Such a mechanism would require a previous concentration of disseminated syngenetic graphite promoted, in this case, by the retrograde solubility of quartz. This process would generate monomineralic graphite aggregates enhancing its lubricant properties and permitting graphite to move in the solid state along distances in the range of up to several metres

Forecasting waiting lists for elective procedures and surgery in England:a modelling study

This is an independent report on NHS waiting lists for elective procedures in England. It is the first analysis to focus specifically on procedures rather than the overall waiting list which includes outpatients and medical treatments. We report that in addition to the 1 million people waiting for elective procedures on the NHS waiting list in England, there are also 3.3 million people on the 'hidden' waiting list. We have presented specialty-level breakdowns and have identified 20 key procedures that represent 70% of the waiting list. We project waiting lists through to 2030.To cite data presented in this report, please reference: Nepogodiev D, Acharya R, Chaudhry D, et al. Forecasting waiting lists for elective procedures and surgery in England: a modelling study. medRxiv. 2022:2022.06.20.22276651

A Bayesian Analysis of a Randomized Clinical Trial Comparing Antimetabolite Therapies for Non-Infectious Uveitis

PurposeTo conduct a Bayesian analysis of a randomized clinical trial (RCT) for non-infectious uveitis using expert opinion as a subjective prior belief.MethodsA RCT was conducted to determine which antimetabolite, methotrexate or mycophenolate mofetil, is more effective as an initial corticosteroid-sparing agent for the treatment of intermediate, posterior, and pan-uveitis. Before the release of trial results, expert opinion on the relative effectiveness of these two medications was collected via online survey. Members of the American Uveitis Society executive committee were invited to provide an estimate for the relative decrease in efficacy with a 95% credible interval (CrI). A prior probability distribution was created from experts' estimates. A Bayesian analysis was performed using the constructed expert prior probability distribution and the trial's primary outcome.ResultsA total of 11 of the 12 invited uveitis specialists provided estimates. Eight of 11 experts (73%) believed mycophenolate mofetil is more effective. The group prior belief was that the odds of treatment success for patients taking mycophenolate mofetil were 1.4-fold the odds of those taking methotrexate (95% CrI 0.03-45.0). The odds of treatment success with mycophenolate mofetil compared to methotrexate was 0.4 from the RCT (95% confidence interval 0.1-1.2) and 0.7 (95% CrI 0.2-1.7) from the Bayesian analysis.ConclusionsA Bayesian analysis combining expert belief with the trial's result did not indicate preference for one drug. However, the wide credible interval leaves open the possibility of a substantial treatment effect. This suggests clinical equipoise necessary to allow a larger, more definitive RCT