Platelet-rich plasmapheresis in cardiac surgery: A meta-analysis of the effect on transfusion requirements

AbstractObjective:Our purpose was to determine whether intraoperative platelet-rich plasmapheresis in cardiac surgery is effective in reducing the proportion of patients exposed to allogeneic red cell transfusions. Methods: A systematic search for prospective, randomized trials of platelet-rich plasmapheresis in cardiac surgery, using MEDLINE, HEALTHSTAR, Current Contents, “Biological Abstracts,” and EMBASE/Excerpta Medica up to August 1997, was completed. Trials were included if they reported either the proportion of patients exposed to allogeneic red cells or the units of allogeneic red cells transfused. Trials were abstracted by 2 independent investigators and the quality of trial design was assessed with the use of a validated scale. Results: Seventeen references met the inclusion criteria (1369 patients [675 control: 694 platelet-rich plasmapheresis]). Platelet-rich plasmapheresis reduced the likelihood of exposure to allogeneic red cells in cardiac surgery (odds ratio 0.44; 95% confidence interval 0.27, 0.72, P = .001). Platelet-rich plasmapheresis had a small but statistically significant effect on both the volume of blood lost in the first 24 hours (weighted mean difference –102 mL; 95% confidence interval –148, –55 mL, P < .0001) and the mean units transfused (weighted mean difference –0.33 units; 95% confidence interval –0.43, –0.23, P < .0001). However, platelet-rich plasmapheresis was only marginally effective (odds ratio 0.83, 95% confidence interval 0.34, 2.01, P = .68) for “good” quality trials, whereas it appeared very effective in trials with poor methodologic quality (odds ratio 0.33, 95% confidence interval 0.17, 0.62, P = .0007). Conclusions: Although platelet-rich plasmapheresis appeared effective in decreasing the proportion of patients receiving transfusions after cardiac operations, the quality of most of the supporting trials was low and the benefit was small in trials of good quality. Further clinical trials should be completed. (J Thorac Cardiovasc Surg 1998;116:641-7

Prevention of childhood poisoning in the home: overview of systematic reviews and a systematic review of primary studies

Unintentional poisoning is a significant child public health problem. This systematic overview of reviews, supplemented with a systematic review of recently published primary studies synthesizes evidence on non-legislative interventions to reduce childhood poisonings in the home with particular reference to interventions that could be implemented by Children's Centres in England or community health or social care services in other high income countries. Thirteen systematic reviews, two meta-analyses and 47 primary studies were identified. The interventions most commonly comprised education, provision of cupboard/drawer locks, and poison control centre (PCC) number stickers. Meta-analyses and primary studies provided evidence that interventions improved poison prevention practices. Twenty eight per cent of studies reporting safe medicine storage (OR from meta-analysis 1.57, 95% CI 1.22–2.02), 23% reporting safe storage of other products (OR from meta-analysis 1.63, 95% CI 1.22–2.17) and 46% reporting availability of PCC numbers (OR from meta-analysis 3.67, 95% CI 1.84–7.33) demonstrated significant effects favouring the intervention group. There was a lack of evidence that interventions reduced poisoning rates. Parents should be provided with poison prevention education, cupboard/drawer locks and emergency contact numbers to use in the event of a poisoning. Further research is required to determine whether improving poison prevention practices reduces poisoning rates

Atomic Dark Matter

We propose that dark matter is dominantly comprised of atomic bound states. We build a simple model and map the parameter space that results in the early universe formation of hydrogen-like dark atoms. We find that atomic dark matter has interesting implications for cosmology as well as direct detection: Protohalo formation can be suppressed below $M_{proto} \sim 10^3 - 10^6 M_{\odot}$ for weak scale dark matter due to Ion-Radiation interactions in the dark sector. Moreover, weak-scale dark atoms can accommodate hyperfine splittings of order 100 \kev, consistent with the inelastic dark matter interpretation of the DAMA data while naturally evading direct detection bounds.Comment: 17 pages, 3 figure

Surveying Standard Model Flux Vacua on T6/Z2×Z2T^6/Z_2\times Z_2

We consider the SU(2)LxSU(2)R Standard Model brane embedding in an orientifold of T6/Z2xZ2. Within defined limits, we construct all such Standard Model brane embeddings and determine the relative number of flux vacua for each construction. Supersymmetry preserving brane recombination in the hidden sector enables us to identify many solutions with high flux. We discuss in detail the phenomenology of one model which is likely to dominate the counting of vacua. While Kahler moduli stabilization remains to be fully understood, we define the criteria necessary for generic constructions to have fixed moduli.Comment: 30 pages, LaTeX, v2: added reference

Two-Dimensional Twisted Sigma Models, the Mirror Chiral de Rham Complex, and Twisted Generalised Mirror Symmetry

In this paper, we study the perturbative aspects of a "B-twisted" two-dimensional $(0,2)$ heterotic sigma model on a holomorphic gauge bundle $\mathcal E$ over a complex, hermitian manifold $X$. We show that the model can be naturally described in terms of the mathematical theory of ``Chiral Differential Operators". In particular, the physical anomalies of the sigma model can be reinterpreted as an obstruction to a global definition of the associated sheaf of vertex superalgebras derived from the free conformal field theory describing the model locally on $X$. In addition, one can also obtain a novel understanding of the sigma model one-loop beta function solely in terms of holomorphic data. At the $(2,2)$ locus, one can describe the resulting half-twisted variant of the topological B-model in terms of a $\it{mirror}$ "Chiral de Rham complex" (or CDR) defined by Malikov et al. in \cite{GMS1}. Via mirror symmetry, one can also derive various conjectural expressions relating the sheaf cohomology of the mirror CDR to that of the original CDR on pairs of Calabi-Yau mirror manifolds. An analysis of the half-twisted model on a non-K\"ahler group manifold with torsion also allows one to draw conclusions about the corresponding sheaves of CDR (and its mirror) that are consistent with mathematically established results by Ben-Bassat in \cite{ben} on the mirror symmetry of generalised complex manifolds. These conclusions therefore suggest an interesting relevance of the sheaf of CDR in the recent study of generalised mirror symmetry.Comment: 97 pages. Companion paper to hep-th/0604179. Published versio

Measurement of the partial widths of the Z into up- and down-type quarks

Using the entire OPAL LEP1 on-peak Z hadronic decay sample, Z -> qbarq gamma decays were selected by tagging hadronic final states with isolated photon candidates in the electromagnetic calorimeter. Combining the measured rates of Z -> qbarq gamma decays with the total rate of hadronic Z decays permits the simultaneous determination of the widths of the Z into up- and down-type quarks. The values obtained, with total errors, were Gamma u = 300 ^{+19}_{-18} MeV and Gamma d = 381 ^{+12}_{-12} MeV. The results are in good agreement with the Standard Model expectation.Comment: 22 pages, 5 figures, Submitted to Phys. Letts.

Search for R-Parity Violating Decays of Scalar Fermions at LEP

A search for pair-produced scalar fermions under the assumption that R-parity is not conserved has been performed using data collected with the OPAL detector at LEP. The data samples analysed correspond to an integrated luminosity of about 610 pb-1 collected at centre-of-mass energies of sqrt(s) 189-209 GeV. An important consequence of R-parity violation is that the lightest supersymmetric particle is expected to be unstable. Searches of R-parity violating decays of charged sleptons, sneutrinos and squarks have been performed under the assumptions that the lightest supersymmetric particle decays promptly and that only one of the R-parity violating couplings is dominant for each of the decay modes considered. Such processes would yield final states consisting of leptons, jets, or both with or without missing energy. No significant single-like excess of events has been observed with respect to the Standard Model expectations. Limits on the production cross- section of scalar fermions in R-parity violating scenarios are obtained. Constraints on the supersymmetric particle masses are also presented in an R-parity violating framework analogous to the Constrained Minimal Supersymmetric Standard Model.Comment: 51 pages, 24 figures, Submitted to Eur. Phys. J.

Measurement of the Strong Coupling alpha s from Four-Jet Observables in e+e- Annihilation

Data from e+e- annihilation into hadrons at centre-of-mass energies between 91 GeV and 209 GeV collected with the OPAL detector at LEP, are used to study the four-jet rate as a function of the Durham algorithm resolution parameter ycut. The four-jet rate is compared to next-to-leading order calculations that include the resummation of large logarithms. The strong coupling measured from the four-jet rate is alphas(Mz0)= 0.1182+-0.0003(stat.)+-0.0015(exp.)+-0.0011(had.)+-0.0012(scale)+-0.0013(mass) in agreement with the world average. Next-to-leading order fits to the D-parameter and thrust minor event-shape observables are also performed for the first time. We find consistent results, but with significantly larger theoretical uncertainties.Comment: 25 pages, 15 figures, Submitted to Euro. Phys. J.

Measurement of the Hadronic Photon Structure Function F_2^gamma at LEP2

The hadronic structure function of the photon F_2^gamma is measured as a function of Bjorken x and of the factorisation scale Q^2 using data taken by the OPAL detector at LEP. Previous OPAL measurements of the x dependence of F_2^gamma are extended to an average Q^2 of 767 GeV^2. The Q^2 evolution of F_2^gamma is studied for average Q^2 between 11.9 and 1051 GeV^2. As predicted by QCD, the data show positive scaling violations in F_2^gamma. Several parameterisations of F_2^gamma are in agreement with the measurements whereas the quark-parton model prediction fails to describe the data.Comment: 4 pages, 2 figures, to appear in the proceedings of Photon 2001, Ascona, Switzerlan