Development of a mercury free ultraviolet high pressure plasma discharge for disinfection

Ultraviolet (UV) disinfection is a critical and growing application for the disinfection of water. Current UV systems for disinfection applications are designed around the use of Low Pressure (LP) and High Pressure (HP) mercury based lamps. Increasing demand to reduce and ideally remove the use of mercury requires innovative adaptations and novel approaches to current technology. A potential alternative technology could be Light Emitting Diodes (LEDs) however with current low efficiencies, high costs and low operating powers a development gap for a high power mercury source has been identified. A mercury free tellurium based high pressure plasma was developed and assessed. Although relatively low efficiencies were measured compared to current mercury based technology rapid improvements are likely obtainable. Such an approach enables a novel adaptation to current technology utilising established; manufacturing facilities, approaches of UV system design and validation protocols. As a consequence it offers the potential for a rapid low cost transition to mercury free UV disinfection where no alternative is currently available

Are we overusing IVF?

Peer reviewedPublisher PD

Impact of Caesarean section on subsequent fertility: a systematic review and meta-analysis.

STUDY QUESTION: Is there an association between a Caesarean section and subsequent fertility? SUMMARY ANSWER: Most studies report that fertility is reduced after Caesarean section compared with vaginal delivery. However, studies with a more robust design show smaller effects and it is uncertain whether the association is causal. WHAT IS KNOWN ALREADY: A previous systematic review published in 1996 summarizing six studies including 85 728 women suggested that Caesarean section reduces subsequent fertility. The included studies suffer from severe methodological limitations. STUDY DESIGN, SIZE, DURATION: Systematic review and meta-analysis of cohort studies comparing subsequent reproductive outcomes of women who had a Caesarean section with those who delivered vaginally. PARTICIPANTS/MATERIALS, SETTING, METHODS: Searches of Cochrane Library, Medline, Embase, CINAHL Plus and Maternity and Infant Care databases were conducted in December 2011 to identify randomized and non-randomized studies that compared the subsequent fertility outcomes after a Caesarean section and after a vaginal delivery. Eighteen cohort studies including 591 850 women matched the inclusion criteria. Risk of bias was assessed by the Newcastle-Ottawa scale (NOS). Data extraction was done independently by two reviewers. The meta-analysis was based on a random-effects model. Subgroup analyses were performed to assess whether the estimated effect was influenced by parity, risk adjustment, maternal choice, cohort period, and study quality and size. MAIN RESULTS AND THE ROLE OF CHANCE: The impact of Caesarean section on subsequent pregnancies could be analysed in 10 studies and on subsequent births in 16 studies. A meta-analysis suggests that patients who had undergone a Caesarean section had a 9% lower subsequent pregnancy rate [risk ratio (RR) 0.91, 95% confidence interval (CI) (0.87, 0.95)] and 11% lower birth rate [RR 0.89, 95% CI (0.87, 0.92)], compared with patients who had delivered vaginally. Studies that controlled for maternal age or specifically analysed primary elective Caesarean section for breech delivery, and those that were least prone to bias according to the NOS reported smaller effects. LIMITATIONS, REASONS FOR CAUTION: There is significant variation in the design and methods of included studies. Residual bias in the adjusted results is likely as no study was able to control for a number of important maternal characteristics, such as a history of infertility or maternal obesity. WIDER IMPLICATIONS OF THE FINDINGS: Further research is needed to reduce the impact of selection bias by indication through creating more comparable patient groups and applying risk adjustment

Fatal disseminated varicella zoster infection following zoster vaccination in an immunocompromised patient

A 79-year-old man with chronic lymphocytic leukaemia presented with fever and a widespread vesicular rash on 19 November 2014. The patient had not been under immunosuppressive regime for 6 months. He had received a shingles vaccine on 14th October and developed flu-like symptoms after 2 weeks. Intravenous antimicrobial therapy including aciclovir was started. He remained stable with no evidence of systemic involvement. On day 5, he developed respiratory and renal failure that required transfer to intensive care unit. Vesicle fluid, bronchoalveolar lavage and plasma were positive for varicella zoster virus by PCR. Slight clinical improvement allowed extubation on day 16. He subsequently deteriorated and died on day 25. Multiorgan failure was considered the immediate cause of death whereas disseminated varicella zoster infection was stated in the medical certificate as the other condition leading to this outcome. Varicella zoster Oka vaccine strain was detected in vesicle fluid, using PCR

A population-based cohort study of the effect of Caesarean section on subsequent fertility

STUDY QUESTION Is there an association between Caesarean section and subsequent fertility? SUMMARY ANSWER There is no or only a slight effect of Caesarean section on future fertility. WHAT IS KNOWN ALREADY Previous studies have reported that delivery by a Caesarean section is associated with fewer subsequent pregnancies and longer inter-pregnancy intervals. The interpretation of these findings is difficult because of significant weaknesses in study designs and analytical methods, notably the potential effect of the indication for Caesarean section on subsequent delivery. STUDY DESIGN, SIZE, DURATION Retrospective cohort study of 1 047 644 first births to low-risk women using routinely collected, national administrative data of deliveries in English maternity units between 1 April 2000 and 31 March 2012. PARTICIPANTS/MATERIALS, SETTING, METHODS Primiparous women aged 15–40 years who had a singleton, term, live birth in the English National Health Service were included. Women with high-risk pregnancies involving placenta praevia, pre-eclampsia, eclampsia (gestational or pre-existing), hypertension or diabetes were excluded from the main analysis. Kaplan–Meier analyses and Cox proportional hazard models were used to assess the effect of mode of delivery on time to subsequent birth, adjusted for age, ethnicity, socio-economic deprivation and year of index delivery. MAIN RESULTS AND THE ROLE OF CHANCE Among low-risk primiparous women, 224 024 (21.4%) were delivered by Caesarean section. The Kaplan–Meier estimate of the subsequent birth rate at 10 years for the cohort was 74.7%. Compared with vaginal delivery, subsequent birth rates were marginally lower after elective Caesarean for breech (adjusted hazard ratio, HR 0.96, 95% CI 0.94–0.98). Larger effects were observed after elective Caesarean for other indications (adjusted HR 0.81, 95% CI 0.78–0.83), and emergency Caesarean (adjusted HR 0.91, 95% CI 0.90–0.93). The effect was smallest for elective Caesarean for breech, and this was not statistically significant in women younger than 30 years of age (adjusted HR 0.98, 95% CI 0.96–1.01). LIMITATIONS, REASONS FOR CAUTION We used birth cohorts from maternity units with good quality parity information. The data are likely to be nationally representative because the characteristics of the deliveries in included and omitted units were similar. There may be residual bias in our adjusted results due to unmeasured maternal factors such as obesity and voluntary absence of conception. Any residual bias would lead to an overestimate of the effect of Caesarean section on fertility, and the true effect is therefore likely to be smaller than the effect reported in our study. WIDER IMPLICATIONS OF THE FINDINGS Our results provide strong evidence that there is no or only a slight effect of Caesarean section on future fertility. The clinical and social circumstances leading to the Caesarean section have a greater effect on future fertility than the Caesarean section itself. This finding is important in light of rising Caesarean section rates. STUDY FUNDING/COMPETING INTEREST(S) IG-U is supported by the Lindsay Stewart R&D Centre, Royal College of Obstetricians and Gynaecologists, UK. The authors have no conflicts of interest to declare. TRIAL REGISTRATION NUMBER n/a

A New Atomic Force Microscopy Technique for the Measurement of the Elastic Properties of Biological Materials

We developed a new technique to measure elastic properties by using the atomic force microscope (AFM) tip to press samples into grooves etched in a GaAs substrate. We measured the Young\u27s modulus of β-chitin fibres with cross-sections less than 40 nm X 20 nm to be 1-2 X 1011 N/m2. In the isotropic approximation, the Young\u27s modulus of the S-layer sheath of the archaeobacterium Methanospirillum hungatei was 1-3 X 1010 N/m2. By testing the sheath to breaking strength we estimated the bacterium can sustain an internal pressure as high as 100-200 atmospheres (1-2 x 107 N/m2)

Comment on "X-ray resonant scattering studies of orbital and charge ordering in Pr1-xCaxMnO3"

In a recent published paper [Phys. Rev. B 64, 195133 (2001)], Zimmermann et al. present a systematic x-ray scattering study of charge and orbital ordering phenomena in the Pr1-xCaxMnO3 series with x= 0.25, 0.4 and 0.5. They propose that for Ca concentrations x=0.4 and 0.5, the appearance of (0, k+1/2, 0) reflections are originated by the orbital ordering of the eg electrons in the a-b plane while the (0, 2k+1, 0) reflections are due to the charge ordering among the Mn3+ and Mn4+ ions. Moreover, for small Ca concentrations (x<0.3), the orbital ordering is only considered and it occurs at (0, k, 0) reflections. A rigorous analysis of all these resonance reflections will show the inadequacy of the charge-orbital model proposed to explain the experimental results. In addition, this charge-orbital model is highly inconsistent with the electronic balance. On the contrary, these reflections can be easily understood as arising from the anisotropy of charge distribution induced by the presence of local distortions, i.e. due to a structural phase transition.Comment: 10 pages, 2 figures.To be published Phys. Rev.

Reducing Viral Load Measurements to Once a Year in Patients on Stable, Virologically Suppressive Cart Regimen: Findings from the Australian HIV Observational Database.

Reducing viral-load measurements to annual testing in virologically suppressed patients increases the estimated mean time those patients remain on a failing regimen by 6 months. This translates to an increase in the proportion of patients with at least one Thymidine Analogue Mutation from 10% to 32% over one year

Dynamical mass generation of a two-component fermion in Maxwell-Chern-Simons QED_3: The lowest ladder approximation

Dynamical mass generation of a two-component fermion in $QED_3$ with a Chern-Simons term is investigated by solving the Schwinger-Dyson equation formulated in the lowest ladder approximation. Dependence of the dynamical fermion mass on a gauge-fixing parameter, a gauge coupling constant, and a topological mass is examined by approximated analytical and also numerical methods. The inclusion of the Chern-Simons term makes impossible to choose a peculiar gauge in which a wave function renormalization is absent. The numerical evaluation shows that the wave function renormalization is fairly close to 1 in the Landau gauge. It means that this gauge is still a specific gauge where the Ward-Takahashi identity is satisfied approximately. We also find that the dynamical mass is almost constant if the topological mass is larger than the coupling constant, while it decreases when the topological mass is comparable to or smaller than the coupling constant and tends to the value in $QED_3$ without the Chern-Simons term.Comment: 22 pages, 9 figures, Version to appear in Phys. Rev.