Ephedrine requirements are reduced during spinal anaesthesia for caesarean section in preeclampsia

Part of the Portfolio Thesis by Geoffrey H. Sharwood-Smith: The inferior vena caval compression theory of hypotension in obstetric spinal anaesthesia: studies in normal and preeclamptic pregnancy, a literature review and revision of fundamental concepts, available at http://hdl.handle.net/10023/1815Background: Despite controversy over the haemodynamically safest blockade for caesarean section in women with severe preeclampsia, an increasing number of anaesthetists now opt for spinal anaesthesia. In a previous study we found that spinal compared to epidural anaesthesia offered an equally safe but more effective option for these patients. The current study was designed to compare the hypotension induced by spinal anaesthesia, as measured by ephedrine requirement, between 20 normotensive and 20 severely preeclamptic but haemodynamically stabilised women. Method: Standardised spinal anaesthesia was instituted and ephedrine was given in boluses of 6 mg if the systolic pressure fell >20% from the baseline, or if the patient exhibited symptoms of hypotension. Results: The mean ephedrine requirement of the normotensive group (27.9 ± 11.6 mg) was significantly greater (P < 0.01) than that of the preeclamptic group (16.4 ± 15.0 mg). Conclusion: This suggests that the hypotension induced by spinal anaesthesia in women with severe but haemodynamically stabilised preeclampsia, is less than that of normotensive patients.Publisher PD

Meta Analysis in Model Implementation: Choice Sets and the Valuation of Air Quality Improvements

We document the sensitivity of welfare estimates derived from discrete choice models to assumptions about the choice set. Such assumptions can affect welfare estimates through both the estimated parameters of the model and, conditional on the parameters, the substitution among alternatives. Our analysis involves estimates of the benefits of air quality improvements in Los Angeles based on discrete choices of neighborhood and housing. We further illustrate the use of meta analysis to document and summarize voluminous information derived from repeated sensitivity analyses.Meta analysis, random utility model, choice set, air quality, housing

Responses of a bacterial pathogen to phosphorus limitation of its aquatic invertebrate host

Host nutrition is thought to affect the establishment, persistence, and severity of pathogenic infections. Nutrient-deficient foods possibly benefit pathogens by constraining host immune function or benefit hosts by limiting parasite growth and reproduction. However, the effects of poor elemental food quality on a host's susceptibility to infection and disease have received little study. Here we show that the bacterial microparasite Pasteuria ramosa is affected by the elemental nutrition of its aquatic invertebrate host, Daphnia magna. We found that high food carbon : phosphorus (C: P) ratios significantly reduced infection rates of Pasteuria in Daphnia and led to lower within-host pathogen multiplication. In addition, greater virulent effects of bacterial infection on host reproduction were found in Daphnia-consuming P-deficient food. Poor Daphnia elemental nutrition thus reduced the growth and reproduction of its bacterial parasite, Pasteuria. The effects of poor host nutrition on the pathogen were further evidenced by Pasteuria's greater inhibition of reproduction in P-limited Daphnia. Our results provide strong evidence that elemental food quality can significantly influence the incidence and intensity of infectious disease in invertebrate hosts

Nurse telephone triage in out of hours primary care: a pilot study

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Kondo insulators in the periodic Anderson model: a local moment approach

The symmetric periodic Anderson model is well known to capture the essential physics of Kondo insulator materials. Within the framework of dynamical mean-field theory, we develop a local moment approach to its single-particle dynamics in the paramagnetic phase. The approach is intrinsically non-perturbative, encompasses all energy scales and interaction strengths, and satisfies the low-energy dictates of Fermi liquid theory. It captures in particular the strong coupling behaviour and exponentially small quasiparticle scales characteristic of the Kondo lattice regime, as well as simple perturbative behaviour in weak coupling. Particular emphasis is naturally given to strong coupling dynamics, where the resultant clean separation of energy scales enables the scaling behaviour of single-particle spectra to be obtained.Comment: 15 pages, 10 postscript figures, accepted for publication in EPJ B; HyperTex disable

General Equilibrium Benefit Transfers for Spatial Externalities: Revisiting EPA's Prospective Analysis

Environmental policy analyses increasingly require the evaluation of benefits from large changes in spatially differentiated public goods. Such changes are likely to induce general equilibrium effects through changes in household expenditures and local migration, yet current practice "transfers" constant marginal values for even the largest changes. Moreover, it ignores important distributional effects of policy. This paper demonstrates that recently developed locational equilibrium models can provide transferable general equilibrium benefit measures. Our results suggest that taking account of the potential for adjustment and household heterogeneity is important. Applying benefits estimated from this method to the effect of the Clean Air Act amendments in Los Angeles, we find that the estimated annual general equilibrium benefits in 2000 and 2010 are dramatically different by income group and location. The gains range from $33 to about$2,400 per household. These differences arise from variations in the air quality conditions, income, and the effects of general equilibrium price adjustment.air quality, clean air act, non-market valuation, Tiebout model

The Stellar Parameters and Evolutionary State of the Primary in the d'-Symbiotic System StH\alpha190

We report on a high-resolution, spectroscopic stellar parameter and abundance analysis of a d' symbiotic star: the yellow component of StH\alpha190. This star has recently been discovered, and confirmed here, to be a rapidly rotating (vsini=100 km/s) subgiant, or giant, that exhibits radial-velocity variations of probably at least 40 km/s, indicating the presence of a companion (a white dwarf star). It is found that the cool stellar component has Teff=5300K and log g=3.0. The iron and calcium abundances are close to solar, however, barium is overabundant, relative to Fe and Ca, by about +0.5 dex. The barium enhancement reflects mass-transfer of s-process enriched material when the current white dwarf was an asymptotic giant branch (AGB) star. The past and future evolution of this binary system depends critically on its current orbital period, which is not yet known. Concerted and frequent radial-velocity measurements are needed to provide crucial physical constraints to this d' symbiotic system.Comment: 9 pages, 1 table, 3 figures. In press to Astrophysical Journal Letter

Tuning edge state localization in graphene nanoribbons by in-plane bending

The electronic properties of graphene are influenced by both geometric confinement and strain. We study the electronic structure of in-plane bent graphene nanoribbons, systems where confinement and strain are combined. To understand its electronic properties, we develop a tight-binding model that has a small computational cost and is based on exponentially decaying hopping and overlap parameters. Using this model, we show that the edge states in zigzag graphene nanoribbons are sensitive to bending and develop an effective dispersion that can be described by a one-dimensional atomic chain model. Because the velocity of the electrons at the edge is proportional to the slope of the dispersion, the edge states become gradually delocalized upon increasing the strength of bending.Comment: 11 pages, 8 figure

Exact Results for Three-Body Correlations in a Degenerate One-Dimensional Bose Gas

Motivated by recent experiments we derive an exact expression for the correlation function entering the three-body recombination rate for a one-dimensional gas of interacting bosons. The answer, given in terms of two thermodynamic parameters of the Lieb-Liniger model, is valid for all values of the dimensionless coupling $\gamma$ and contains the previously known results for the Bogoliubov and Tonks-Girardeau regimes as limiting cases. We also investigate finite-size effects by calculating the correlation function for small systems of 3, 4, 5 and 6 particles.Comment: 4 pages, 2 figure