Monitoring Depth of Hypnosis: Mid-Latency Auditory Evoked Potentials Derived aepEX in Children Receiving Desflurane-Remifentanil Anesthesia

BACKGROUND: The aepEXplus monitoring system, which uses mid-latency auditory evoked potentials to measure depth of hypnosis, was evaluated in pediatric patients receiving desflurane-remifentanil anesthesia. METHODS: Seventy-five patients, 1-18 years of age (stratified for age; 1-3, 3-6, 6-18 years, for subgroup analyses), were included in this prospective observational study. The aepEX and the bispectral index (BIS) were recorded simultaneously, the latter serving as a reference. The ability of the aepEX to detect different levels of consciousness, defined according to the University of Michigan Sedation Scale, investigated using prediction probability (Pk), and receiver operating characteristic (ROC) analysis, served as the primary outcome parameter. As a secondary outcome parameter, the relationship between end-tidal desflurane and the aepEX and BIS values were calculated by fitting in a nonlinear regression model. RESULTS: The Pk values for the aepEX and the BIS were, respectively, .68 (95% CI, 0.53-0.82) and .85 (95% CI, 0.73-0.96; P = .02). The aepEX and the BIS had an area under the ROC curve of, respectively, 0.89 (95% CI, 0.80-0.95) and 0.76 (95% CI, 0.68-0.84; P = .04). The maximized sensitivity and specificity were, respectively, 81% (95% CI, 61%-93%) and 86% (95% CI, 74%-94%) for the aepEX at a cutoff value of >52, and 69% (95% CI, 56%-81%) and 70% (95% CI, 57%-81%) for the BIS at a cutoff value of >65. The age-corrected end-tidal desflurane concentration associated with an index value of 50 (EC50) was 0.59 minimum alveolar concentration (interquartile range: 0.38-0.85) and 0.58 minimum alveolar concentration (interquartile range: 0.41-0.70) for, respectively, the aepEX and BIS (P = .69). Age-group analysis showed no evidence of a difference regarding the area under the ROC curve or EC50. CONCLUSIONS: The aepEX can reliably differentiate between a conscious and an unconscious state in pediatric patients receiving desflurane-remifentanil anesthesia

Use, applicability and reliability of depth of hypnosis monitors in children - A survey among members of the European Society for Paediatric Anaesthesiology

Background: To assess the thoughts of practicing anaesthesiologists about the use of depth of hypnosis monitors in children. Methods: Members of the European Society for Paediatric Anaesthesiology were invited to participate in an online survey about their thoughts regarding the use, applicability and reliability of hypnosis monitoring in children. Results: The survey achieved a response rate of 30% (N=168). A total of 138 completed surveys were included for further analysis. Sixty-eight respondents used hypnosis monitoring in children (Users) and 70 did not (Non-users). Sixty-five percent of the Users reported prevention of intra-operative awareness as their main reason to apply hypnosis monitoring. Among the Non-users, the most frequently given reason (43%) not to use hypnosis monitoring in children was the perceived lack or reliability of the devices in children. Hypnosis monitoring is used with a higher frequency during propofol anaesthesia than during inhalation anaesthesia. Hypnosis monitoring is furthermore used more frequently in children >4 years than in younger children. An ideal hypnosis monitor should be reliable for all age groups and any (combination of) anaesthetic drug. We found no agreement in the interpretation of monitor index values and subsequent anaesthetic interventions following from it. Conclusions: Prevention of intraoperative awareness appears to be the most important reason to use hypnosis monitoring in children. The perceived lack of reliability of hypnosis monitoring in children is the most important reasons not to use it. No consensus currently exists on how to adjust anaesthesia according to hypnosis monitor index values in children

Development, intercomparison, and evaluation of an improved mechanism for the oxidation of dimethyl sulfide in the UKCA model

Dimethyl sulfide (DMS) is an important trace gas emitted from the ocean. The oxidation of DMS has long been recognised as being important for global climate through the role DMS plays in setting the sulfate aerosol background in the troposphere. However, the mechanisms in which DMS is oxidised are very complex and have proved elusive to accurately determine in spite of decades of research. As a result the representation of DMS oxidation in global chemistry–climate models is often greatly simplified. Recent field observations and laboratory and ab initio studies have prompted renewed efforts in understanding the DMS oxidation mechanism, with implications for constraining the uncertainty in the oxidation mechanism of DMS as incorporated in global chemistry–climate models. Here we build on recent evidence and develop a new DMS mechanism for inclusion in the UK Chemistry Aerosol (UKCA) chemistry–climate model. We compare our new mechanism (CS2-HPMTF) to a number of existing mechanisms used in UKCA (including the highly simplified three-reactions–two-species mechanism used in CMIP6 studies with the model) and to a range of recently developed mechanisms reported in the literature through a series of global and box model experiments. Global model runs with the new mechanism enable us to simulate the global distribution of hydroperoxylmethyl thioformate (HPMTF), which we calculate to have a burden of 2.6–26 Gg S (in good agreement with the literature range of 0.7–18 Gg S). We show that the sinks of HPMTF dominate uncertainty in the budget, not the rate of the isomerisation reaction forming it and that, based on the observed DMS / HPMTF ratio from the global surveys during the NASA Atmospheric Tomography mission (ATom), rapid cloud uptake of HPMTF worsens the model–observation comparison. Our box model experiments highlight that there is significant variance in simulated secondary oxidation products from DMS across mechanisms used in the literature, with significant divergence in the sensitivity of the rates of formation of these products to temperature exhibited; especially for methane sulfonic acid (MSA). Our global model studies show that our updated DMS scheme performs better than the current scheme used in UKCA when compared against a suite of surface and aircraft observations. However, sensitivity studies underscore the need for further laboratory and observational constraints. In particular our results suggest that as a priority long-term DMS observations be made to better constrain the highly uncertain inputs into the system and that laboratory studies be performed that address (1) the uptake of HPMTF onto aerosol surfaces and the products of this reaction and (2) the kinetics and products of the following reactions: CH3SO3 decomposition, CH3S + O2, CH3SOO decomposition, and CH3SO + O3

Antiphased dust deposition and productivity in the Antarctic Zone over 1.5 million years

The Southern Ocean paleoceanography provides key insights into how iron fertilization and oceanic productivity developed through Pleistocene ice-ages and their role in influencing the carbon cycle. We report a high-resolution record of dust deposition and ocean productivity for the Antarctic Zone, close to the main dust source, Patagonia. Our deep-ocean records cover the last 1.5 Ma, thus doubling that from Antarctic ice-cores. We find a 5 to 15-fold increase in dust deposition during glacials and a 2 to 5-fold increase in biogenic silica deposition, reflecting higher ocean productivity during interglacials. This antiphasing persisted throughout the last 25 glacial cycles. Dust deposition became more pronounced across the Mid-Pleistocene Transition (MPT) in the Southern Hemisphere, with an abrupt shift suggesting more severe glaciations since ~0.9 Ma. Productivity was intermediate pre-MPT, lowest during the MPT and highest since 0.4 Ma. Generally, glacials experienced extended sea-ice cover, reduced bottom-water export and Weddell Gyre dynamics, which helped lower atmospheric CO2 levels.Postprin

Search for W' bosons decaying to an electron and a neutrino with the D0 detector

This Letter describes the search for a new heavy charged gauge boson W' decaying into an electron and a neutrino. The data were collected with the D0 detector at the Fermilab Tevatron proton-antiproton Collider at a center-of-mass energy of 1.96 TeV, and correspond to an integrated luminosity of about 1 inverse femtobarn. Lacking any significant excess in the data in comparison with known processes, an upper limit is set on the production cross section times branching fraction, and a W' boson with mass below 1.00 TeV can be excluded at the 95% C.L., assuming standard-model-like couplings to fermions. This result significantly improves upon previous limits, and is the most stringent to date.Comment: submitted to Phys. Rev. Let

Search for a scalar or vector particle decaying into Zgamma in ppbar collisions at sqrt(s) = 1.96 TeV

We present a search for a narrow scalar or vector resonance decaying into Zgamma with a subsequent Z decay into a pair of electrons or muons. The data for this search were collected with the D0 detector at the Fermilab Tevatron ppbar collider at a center of mass energy sqrt(s) = 1.96 TeV. Using 1.1 (1.0) fb-1 of data, we observe 49 (50) candidate events in the electron (muon) channel, in good agreement with the standard model prediction. From the combination of both channels, we derive 95% C.L. upper limits on the cross section times branching fraction (sigma x B) into Zgamma. These limits range from 0.19 (0.20) pb for a scalar (vector) resonance mass of 600 GeV/c^2 to 2.5 (3.1) pb for a mass of 140 GeV/c^2.Comment: Published by Phys. Lett.

Search for the associated production of a b quark and a neutral supersymmetric Higgs boson which decays to tau pairs

We report results from a search for production of a neutral Higgs boson in association with a $b$ quark. We search for Higgs decays to $\tau$ pairs with one $\tau$ subsequently decaying to a muon and the other to hadrons. The data correspond to 2.7fb$^{-1}$ of \ppbar collisions recorded by the D0 detector at $\sqrt{s} = 1.96$TeV. The data are found to be consistent with background predictions. The result allows us to exclude a significant region of parameter space of the minimal supersymmetric model.Comment: Submitted to Phys. Rev. Letter

Measurement of the p-pbar -> Wgamma + X cross section at sqrt(s) = 1.96 TeV and WWgamma anomalous coupling limits

The WWgamma triple gauge boson coupling parameters are studied using p-pbar -> l nu gamma + X (l = e,mu) events at sqrt(s) = 1.96 TeV. The data were collected with the DO detector from an integrated luminosity of 162 pb^{-1} delivered by the Fermilab Tevatron Collider. The cross section times branching fraction for p-pbar -> W(gamma) + X -> l nu gamma + X with E_T^{gamma} > 8 GeV and Delta R_{l gamma} > 0.7 is 14.8 +/- 1.6 (stat) +/- 1.0 (syst) +/- 1.0 (lum) pb. The one-dimensional 95% confidence level limits on anomalous couplings are -0.88 < Delta kappa_{gamma} < 0.96 and -0.20 < lambda_{gamma} < 0.20.Comment: Submitted to Phys. Rev. D Rapid Communication

Measurement of the ttbar Production Cross Section in ppbar Collisions at sqrt{s} = 1.96 TeV using Kinematic Characteristics of Lepton + Jets Events

We present a measurement of the top quark pair ttbar production cross section in ppbar collisions at a center-of-mass energy of 1.96 TeV using 230 pb**{-1} of data collected by the DO detector at the Fermilab Tevatron Collider. We select events with one charged lepton (electron or muon), large missing transverse energy, and at least four jets, and extract the ttbar content of the sample based on the kinematic characteristics of the events. For a top quark mass of 175 GeV, we measure sigma(ttbar) = 6.7 {+1.4-1.3} (stat) {+1.6- 1.1} (syst) +/-0.4 (lumi) pb, in good agreement with the standard model prediction.Comment: submitted to Phys.Rev.Let

Measurement of the ttbar Production Cross Section in ppbar Collisions at sqrt(s)=1.96 TeV using Lepton + Jets Events with Lifetime b-tagging

We present a measurement of the top quark pair ($t\bar{t}$) production cross section ($\sigma_{t\bar{t}}$) in $p\bar{p}$ collisions at $\sqrt{s}=1.96$ TeV using 230 pb$^{-1}$ of data collected by the D0 experiment at the Fermilab Tevatron Collider. We select events with one charged lepton (electron or muon), missing transverse energy, and jets in the final state. We employ lifetime-based b-jet identification techniques to further enhance the $t\bar{t}$ purity of the selected sample. For a top quark mass of 175 GeV, we measure $\sigma_{t\bar{t}}=8.6^{+1.6}_{-1.5}(stat.+syst.)\pm 0.6(lumi.)$ pb, in agreement with the standard model expectation.Comment: 7 pages, 2 figures, 3 tables Submitted to Phys.Rev.Let