Comparison of a novel real-time SonixGPS needle-tracking ultrasound technique with traditional ultrasound for vascular access in a phantom gel model

ObjectiveUltrasound-guided percutaneous vascular access for endovascular procedures is well established in surgical practice. Despite this, rates of complications from venous and arterial access procedures remain a significant cause of morbidity. We hypothesized that the use of a new technique of vascular access using an ultrasound with a novel needle-guidance positioning system (GPS) would lead to improved success rates of vascular puncture for both in-plane and out-of-plane techniques compared with traditional ultrasound.MethodsA prospective, randomized crossover study of medical students from all years of medical school was conducted using a phantom gel model. Each medical student performed three ultrasound-guided punctures with each of the four modalities (in-plane no GPS, in-plane with GPS, out-of-plane no GPS, out-of-plane with GPS) for a total of 12 attempts. The success or failure was judged by the ability to aspirate a simulated blood solution from the model. The time to successful puncture was also recorded. A poststudy validated NASA Task Load Index workload questionnaire was conducted to assess the student's perceptions of the two different techniques.ResultsA total of 30 students completed the study. There was no significant difference seen in the mean times of vascular access for each of the modalities. Higher success rates for vascular access using the GPS for both the in-plane (94% vs 91%) and the out-of-plane (86% vs 70%) views were observed; however, this was not statistically significant. The students perceived the mental demand (median 12.0 vs 14.00; P = .035) and effort to be lower (mean 11.25 vs 14.00; P = .044) as well as the performance to be higher (mean 15.50 vs 14.00; P = .041) for the GPS vs the traditional ultrasound-guided technique. Students also perceived their ability to access vessels increased with the aid of the GPS (7.00 vs 6.50; P = .007). The majority of students expressed a preference for GPS (26/30, 87%) as opposed to the traditional counterpart.ConclusionsUse of the novel SonixGPS needle-tracking ultrasound system (UltraSonix, Richmond, BC, Canada) was not associated with a higher success rate of vascular puncture compared with the traditional ultrasound-guided technique. Assessment of mental task load significantly favored the use of the ultrasound GPS over the traditional ultrasound technique

Radio data challenge the broadband modelling of GRB160131A afterglow

Context. Gamma-ray burst (GRB) afterglows originate from the interaction between the relativistic ejecta and the surrounding medium. Consequently, their properties depend on several aspects: radiation mechanisms, relativistic shock micro-physics, circumburst environment, and the structure and geometry of the relativistic jet. While the standard afterglow model accounts for the overall spectral and temporal evolution for a number of GRBs, its validity limits emerge when the data set is particularly rich and constraining, especially in the radio band. Aims. We aimed to model the afterglow of the long GRB160131A (redshift $z = 0.972$), for which we collected a rich, broadband, and accurate data set, spanning from $6\times10^{8}$ to $7\times10^{17}$ Hz in frequency, and from 330 s to 160 days post burst in time. Methods. We modelled the spectral and temporal evolution of this GRB afterglow through two approaches: the adoption of empirical functions to model optical/X-rays data set, later assessing their compatibility with the radio domain; the inclusion of the entire multi-frequency data set simultaneously through the Python package named sAGa (Software for AfterGlow Analysis), to come up with an exhaustive and self-consistent description of the micro-physics, geometry, and dynamics of the afterglow. Results. From deep broadband analysis (from radio to X-ray frequencies) of the afterglow light curves, GRB160131A outflow shows evidence of jetted emission. Moreover, we observe dust extinction in the optical spectra, and energy injection in the optical/X-ray data. Radio spectra are characterised by several peaks, that could be due to either interstellar scintillation (ISS) effects or a multi-component structure. Conclusions. The inclusion of radio data in the broadband set of GRB160131A makes a self-consistent modelling hardly attainable within the standard model of GRB afterglows.Comment: 36 pages, 16 figures, 8 tables, accepted by A&A; v2: updated Acknowledgement

Effects of serum proteins on corrosion behavior of ISO 5832–9 alloy modified by titania coatings

Stainless steel ISO 5832–9 type is often used to perform implants which operate in protein-containing physiological environments. The interaction between proteins and surface of the implant may affect its corrosive properties. The aim of this work was to study the effect of selected serum proteins (albumin and γ-globulins) on the corrosion of ISO 5832–9 alloy (trade name M30NW) which surface was modified by titania coatings. These coatings were obtained by sol– gel method and heated at temperatures of 400 and 800 °C. To evaluate the effect of the proteins, the corrosion tests were performed with and without the addition of proteins with concentration of 1 g L−1 to the physiological saline solution (0.9 % NaCl, pH 7.4) at 37 °C. The tests were carried out within 7 days. The following electrochemical methods were used: open circuit potential, linear polarization resistance, and electrochemical impedance spectroscopy. In addition, surface analysis by optical microscopy and X-ray photoelectron spectroscopy (XPS) method was done at the end of weekly corrosion tests. The results of corrosion tests showed that M30NW alloy both uncoated and modified with titania coatings exhibits a very good corrosion resistance during weekly exposition to corrosion medium. The best corrosion resistance in 0.9 % NaCl solution is shown by alloy samples modified by titania coating annealed at 400 °C. The serumproteins have no significant effect onto corrosion of investigated biomedical steel. The XPS results confirmed the presence of proteins on the alloy surface after 7 days of immersion in proteincontaining solutions.The investigations were supported by the National Science Centre project No. N N507 501339. The authors gratefully acknowledge Dr. Janusz Sobczak and Dr. hab. Wojciech Lisowski from Institute of Physical Chemistry of PAS for XPS surface analyses

Access and utilisation of maternity care for disabled women who experience domestic abuse:a systematic review

BACKGROUND: Although disabled women are significantly more likely to experience domestic abuse during pregnancy than non-disabled women, very little is known about how maternity care access and utilisation is affected by the co-existence of disability and domestic abuse. This systematic review of the literature explored how domestic abuse impacts upon disabled women’s access to maternity services. METHODS: Eleven articles were identified through a search of six electronic databases and data were analysed to identify: the factors that facilitate or compromise access to care; the consequences of inadequate care for pregnant women’s health and wellbeing; and the effectiveness of existing strategies for improvement. RESULTS: Findings indicate that a mental health diagnosis, poor relationships with health professionals and environmental barriers can compromise women’s utilisation of maternity services. Domestic abuse can both compromise, and catalyse, access to services and social support is a positive factor when accessing care. Delayed and inadequate care has adverse effects on women’s physical and psychological health, however further research is required to fully explore the nature and extent of these consequences. Only one study identified strategies currently being used to improve access to services for disabled women experiencing abuse. CONCLUSIONS: Based upon the barriers and facilitators identified within the review, we suggest that future strategies for improvement should focus on: understanding women’s reasons for accessing care; fostering positive relationships; being women-centred; promoting environmental accessibility; and improving the strength of the evidence base

Structural analysis and corrosion studies on an ISO 5832-9 biomedical alloy with TiO2 sol–gel layers

The aim of this study was to demonstrate the relationship between the structural and corrosion properties of an ISO 5832-9 biomedical alloy modified with titanium dioxide (TiO2) layers. These layers were obtained via the sol–gel method by acid-catalyzed hydrolysis of titanium isopropoxide in isopropanol solution. To obtain TiO2 layers with different structural properties, the coated samples were annealed at temperatures of 200, 300, 400, 450, 500, 600 and 800 C for 2 h. For all the prepared samples, accelerated corrosion measurements were performed in Tyrode’s physiological solution using electrochemical methods. The most important corrosion parameters were determined: corrosion potential, polarization resistance, corrosion rate, breakdown and repassivation potentials. Corrosion damage was analyzed using scanning electron microscopy. Structural analysis was carried out for selected TiO2 coatings annealed at 200, 400, 600 and 800 C. In addition, the morphology, chemical composition, crystallinity, thickness and density of the deposited TiO2 layers were determined using suitable electron and X-ray measurement methods. It was shown that the structure and character of interactions between substrate and deposited TiO2 layers depended on annealing temperature. All the obtained TiO2 coatings exhibit anticorrosion properties, but these properties are related to the crystalline structure and character of substrate–layer interaction. From the point of view of corrosion, the best TiO2 sol–gel coatings for stainless steel intended for biomedical applications seem to be those obtained at 400 C.This study was supported by Grant No. N N507 501339 of the National Science Centre. The authors wish to express their thanks to J. Borowski (MEDGAL, Poland) for the Rex 734 alloy

The unpolarized macronova associated with the gravitational wave event GW 170817

The merger of two dense stellar remnants including at least one neutron star (NS) is predicted to produce gravitational waves (GWs) and short duration gamma ray bursts (GRBs). In the process, neutron-rich material is ejected from the system and heavy elements are synthesized by r-process nucleosynthesis. The radioactive decay of these heavy elements produces additional transient radiation termed "kilonova" or "macronova". We report the detection of linear optical polarization P = (0.50 +/- 0.07)% at 1.46 days after detection of the GWs from GW170817, a double neutron star merger associated with an optical macronova counterpart and a short GRB. The optical emission from a macronova is expected to be characterized by a blue, rapidly decaying, component and a red, more slowly evolving, component due to material rich of heavy elements, the lanthanides. The polarization measurement was made when the macronova was still in its blue phase, during which there is an important contribution from a lanthanide-free outflow. The low degree of polarization is consistent with intrinsically unpolarized emission scattered by Galactic dust, suggesting a symmetric geometry of the emitting region and low inclination of the merger system. Stringent upper limits to the polarization degree from 2.45 - 9.48 days post-burst are consistent with the lanthanides-rich macronova interpretation.Comment: 18 pages, 1 figure, 2 tables, Nature Astronomy, in pres

GRB 091024A and the Nature of Ultra-Long Gamma-Ray Bursts

We present a broadband study of gamma-ray burst (GRB) 091024A within the context of other ultra-long-duration GRBs. An unusually long burst detected by Konus-Wind (KW), Swift, and Fermi, GRB 091024A has prompt emission episodes covering ~1300 s, accompanied by bright and highly structured optical emission captured by various rapid-response facilities, including the 2 m autonomous robotic Faulkes North and Liverpool Telescopes, KAIT, S-LOTIS, and the Sonoita Research Observatory. We also observed the burst with 8 and 10 m class telescopes and determine the redshift to be z = 1.0924 ± 0.0004. We find no correlation between the optical and γ-ray peaks and interpret the optical light curve as being of external origin, caused by the reverse and forward shock of a highly magnetized jet (RB ≈ 100-200). Low-level emission is detected throughout the near-background quiescent period between the first two emission episodes of the KW data, suggesting continued central-engine activity; we discuss the implications of this ongoing emission and its impact on the afterglow evolution and predictions. We summarize the varied sample of historical GRBs with exceptionally long durations in gamma-rays (gsim1000 s) and discuss the likelihood of these events being from a separate population; we suggest ultra-long GRBs represent the tail of the duration distribution of the long GRB population

Colour variations in the GRB 120327A afterglow

Aims. We present a comprehensive temporal and spectral analysis of the long Swift GRB 120327A afterglow data to investigate possible causes of the observed early-time colour variations.Methods. We collected data from various instruments and telescopes in X-ray, ultraviolet, optical, and near-infrared bands, and determined the shapes of the afterglow early-time light curves. We studied the overall temporal behaviour and the spectral energy distributions from early to late times.Results. The ultraviolet, optical, and near-infrared light curves can be modelled with a single power-law component between 200 and 2 × 104 s after the burst event. The X-ray light curve shows a canonical steep-shallow-steep behaviour that is typical of long gamma-ray bursts. At early times a colour variation is observed in the ultraviolet/optical bands, while at very late times a hint of a re-brightening is visible. The observed early-time colour change can be explained as a variation in the intrinsic optical spectral index, rather than an evolution of the optical extinction