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

Orientation filtering by growth-velocity competition in zone-melting recrystallization of silicon on SiO_2

We describe a method of controlling the in-plane directions of grains in (100)-textured silicon films produced by zone-melting recrystallization over amorphous SiO2. Grains having in-plane orientation within a narrow range are able to grow through an orientation filter consisting of a pattern of crystallization barriers, while grains having other orientations are occluded. The results of experiments using an orientation filter, and the parameters which optimize filter performance, are reported

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

Integrated out-of-hours care arrangements in England: observational study of progress towards single call access via NHS Direct and impact on the wider health system

Objectives: To assess the extent of service integration achieved within general practice cooperatives and NHS Direct sites participating in the Department of Health’s national “Exemplar Programme” for single call access to out-of-hours care via NHS Direct. To assess the impact of integrated out-of-hours care arrangements upon general practice cooperatives and the wider health system (use of emergency departments, 999 ambulance services, and minor injuries units). Design: Observational before and after study of demand, activity, and trends in the use of other health services. Setting: Thirty four English general practice cooperatives with NHS Direct partners (“exemplars”) of which four acted as “case exemplars”. Also 10 control cooperatives for comparison. Main Outcome Measures: Extent of integration achieved (defined as the proportion of hours and the proportion of general practice patients covered by integrated arrangements), patterns of general practice cooperative demand and activity and trends in use of the wider health system in the first year. Results: Of 31 distinct exemplars 21 (68%) integrated all out-of-hours call management by March 2004. Nine (29%) established single call access for all patients. In the only case exemplar where direct comparison was possible, cooperative nurse telephone triage before integration completed a higher proportion of calls with telephone advice than did NHS Direct afterwards (39% v 30%; p<0.0001). The proportion of calls completed by NHS Direct telephone advice at other sites was lower. There is evidence for transfer of demand from case exemplars to 999 ambulance services. A downturn in overall demand for care seen in two case exemplars was also seen in control sites. Conclusion: The new model of out-of-hours care was implemented in a variety of settings across England by new partnerships between general practice cooperatives and NHS Direct. Single call access was not widely implemented and most patients needed to make at least two telephone calls to contact the service. In the first year, integration may have produced some reduction in total demand, but this may have been accompanied by shifts from one part of the local health system to another. NHS Direct demonstrated capability in handling calls but may not currently have sufficient capacity to support national implementation

Systematic limits on sin^2{2theta_{13}} in neutrino oscillation experiments with multi-reactors

Sensitivities to sin^2{2theta_{13}} without statistical errors (``systematic limit'') are investigated in neutrino oscillation experiments with multiple reactors. Using an analytical approach, we show that the systematic limit on sin^2{2theta_{13}} is dominated by the uncorrelated systematic error sigma_u of the detector. Even in an experiment with multi-detectors and multi-reactors, it turns out that most of the systematic errors including the one due to the nature of multiple sources is canceled as in the case with a single reactor plus two detectors, if the near detectors are placed suitably. The case of the KASKA plan (7 reactors and 3 detectors) is investigated in detail, and it is explicitly shown that it does not suffer from the extra uncertainty due to multiple reactors.Comment: 26 pages, 10 eps-files, revtex

Parallel approach to sliding window sums

Sliding window sums are widely used in bioinformatics applications, including sequence assembly, k-mer generation, hashing and compression. New vector algorithms which utilize the advanced vector extension (AVX) instructions available on modern processors, or the parallel compute units on GPUs and FPGAs, would provide a significant performance boost for the bioinformatics applications. We develop a generic vectorized sliding sum algorithm with speedup for window size w and number of processors P is O(P/w) for a generic sliding sum. For a sum with commutative operator the speedup is improved to O(P/log(w)). When applied to the genomic application of minimizer based k-mer table generation using AVX instructions, we obtain a speedup of over 5X.Comment: 10 pages, 5 figure