2,779 research outputs found

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    Worsening of cerebral hyperemia by the administration of terlipressin in acute liver failure with severe hepatic encephalopathy

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    There is increasing evidence that terlipressin is useful in patients with cirrhosis and hepatorenal syndrome, but there are no data of its use in patients with acute liver failure (ALF) in whom hepatorenal syndrome is common. Although terlipressin produces systemic vasoconstriction, it produces cerebral vasodilatation and may increase cerebral blood flow (CBF). Increased CBF contributes to intracranial hypertension in patients with ALF. The aim of this study was to evaluate the safety of terlipressin in patients with ALF with respect to cerebral haemodynamics. Six successive patients with ALF were electively ventilated for grade IV hepatic encephalopathy. Patients were monitored invasively and CBF was measured (Kety- Schmidt technique). Measurements were made before, at 1, 3 hour and 5 hours after intravenous (single bolus) administration of terlipressin (0.005 mg/kg) )intravenously (single bolus), median 0.25mg (range 0.2-0.3). There was no significant change in heart rate, mean arterial pressure or cardiac output. CBF and jugular venous oxygen saturation both increased significantly at 1 hour (p<0.0=0.016) respectively. Intracranial pressure increased significantly at 21 hours (p<0=.0.031), returning back to baseline values at 42 hours. This study shows that administration of terlipressin, at a dose that did not alter systemic haemodynamicshemodynamics, resulted in worsening of cerebral hyperemia and intracranial hypertension in patients with ALF and severe hepatic encephalopathy. These data suggest the need to exercise extreme caution in the use of terlipressin in these patients in view of its potentially deleterious consequences on cerebral haemodynamics

    Characterising the within-field scale spatial variation of nitrogen in a grassland soil to inform the efficient design of in-situ nitrogen sensor networks for precision agriculture

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    The use of in-situ sensors capable of real-time monitoring of soil nitrogen (N) may facilitate improvements in agricultural N-use efficiency (NUE) through better fertiliser management. The optimal design of such sensor networks, consisting of clusters of sensors each attached to a data logger, depends upon the spatial variation of soil N and the relative cost of the data loggers and sensors. The primary objective of this study was to demonstrate how in-situ networks of N sensors could be optimally designed to enable the cost-efficient monitoring of soil N within a grassland field (1.9 ha). In the summer of 2014, two nested sampling campaigns (June & July) were undertaken to assess spatial variation in soil amino acids, ammonium (NH4+) and nitrate (NO3−) at a range of scales that represented the within (less than 2 m) and between (greater than 2 m) data logger/sensor cluster variability. Variance at short range (less than 2 m) was found to be dominant for all N forms. Variation at larger scales (greater than 2 m) was not as large but was still considered an important spatial component for all N forms, especially NO3−. The variance components derived from the nested sampling were used to inform the efficient design of theoretical in-situ networks of NH4+ and NO3− sensors based on the costs of a commercially available data logger and ion-selective electrodes (ISEs). Based on the spatial variance observed in the June nested sampling, and given a budget of £5000, the NO3− field mean could be estimated with a 95% confidence interval width of 1.70 μg N g−1 using 2 randomly positioned data loggers each with 5 sensors. Further investigation into “aggregate-scale” (less than 1 cm) spatial variance revealed further large variation at the sub 1-cm scale for all N forms. Sensors, for which the measurement represents an integration over a sensor-soil contact area of diameter less than 1 cm, would be subject to this aggregate-scale variability. As such, local replication at scales less than 1 cm would be needed to maintain the precision of the resulting field mean estimation. Adoption of in-situ sensor networks will depend upon the development of suitable low‐cost sensors, demonstration of the cost-benefit and the construction of a decision support system that utilises the generated data to improve the NUE of fertiliser N management

    A context model for semantic mediation in Web services composition

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    This paper presents a context-driven approach that aims at supporting semantic mediation between composed Web services. Despite the widespread adoption of Web services by the IT community, innovative solutions are needed in order to overcome the challenging issue that relates to the semantic disparity of exchanged data. Indeed, there is a lack of means for interpreting these data according to the contextual requirements of each Web service. The context-driven approach suggests two steps. The first step consists of developing a model for anchoring context to data flowing between Web services. In the second step, we use this model to support the semantic mediation between Web services engaged in a composition. © Springer-Verlag Berlin Heidelberg 2006

    Microbial diversity of a disused copper mine site (Parys Mountain, UK), dominated by intensive eukaryotic filamentous growth

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    The Parys Mountain copper mine (Wales, UK) contains a wide range of discrete environmental microniches with various physicochemical conditions that shape microbial community composition. Our aim was to assess the microbial community in the sediments and overlying water column in an acidic mine drainage (AMD) site containing abundant filamentous biogenic growth via application of a combination of chemical analysis and taxonomic profiling using 16S rRNA gene amplicon sequencing. Our results were then compared to previously studied sites at Parys Mt. Overall, the sediment microbiome showed a dominance of bacteria over archaea, particularly those belonging to Proteobacteria (genera Acidiphilium and Acidisphaera), Acidobacteriota (subgroup 1), Chloroflexota (AD3 cluster), Nitrospirota (Leptospirillum) and the uncultured Planctomycetota/CPIa-3 termite group. Archaea were only present in the sediment in small quantities, being represented by the Terrestrial Miscellaneous Euryarchaeota Group (TMEG), Thermoplasmatales and Ca. Micrarchaeota (Ca. Micracaldota). Bacteria, mostly of the genera Acidiphilium and Leptospirillum, also dominated within the filamentous streamers while archaea were largely absent. This study found pH and dissolved solutes to be the most important parameters correlating with relative proportions of bacteria to archaea in an AMD environment and revealed the abundance patterns of native acidophilic prokaryotes inhabiting Parys Mt sites and their niche specificities

    The safety and efficacy of using moxibustion and or acupuncture for cancer-related insomnia: A systematic review and meta-analysis of randomised controlled trials

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    Introduction: This study aimed to synthesise the best available evidence on the safety and efficacy of using moxibustion and/or acupuncture to manage cancer-related insomnia (CRI). Methods: The PRISMA framework guided the review. Nine databases were searched from its inception to July 2020, published in English or Chinese. Randomised clinical trials (RCTs) of moxibustion and or acupuncture for the treatment of CRI were selected for inclusion. Methodological quality was assessed using the method suggested by the Cochrane collaboration. The Cochrane Review Manager was used to conduct a meta-analysis. Results: Fourteen RCTs met the eligibility criteria. Twelve RCTs used the Pittsburgh Sleep Quality Index (PSQI) score as continuous data and a meta-analysis showed positive effects of moxibustion and or acupuncture (n = 997, mean difference (MD) = −1.84, 95% confidence interval (CI) = −2.75 to −0.94, p < 0.01). Five RCTs using continuous data and a meta-analysis in these studies also showed significant difference between two groups (n = 358, risk ratio (RR) = 0.45, 95% CI = 0.26–0.80, I2 = 39%). Conclusion: The meta-analyses demonstrated that moxibustion and or acupuncture showed a positive effect in managing CRI. Such modalities could be considered an add-on option in the current CRI management regimen

    Consequential life cycle assessment of biogas, biofuel and biomass energy options within an arable crop rotation

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    Feed in tariffs (FiTs) and renewable heat incentives (RHIs) are driving a rapid expansion in anaerobic digestion (AD) coupled with combined heat and power (CHP) plants in the UK. Farm models were combined with consequential life cycle assessment (CLCA) to assess the net environmental balance of representative biogas, biofuel and biomass scenarios on a large arable farm, capturing crop rotation and digestate nutrient cycling effects. All bioenergy options led to avoided fossil resource depletion. Global warming potential (GWP) balances ranged from -1732kgCO(2)eMg(-1) dry matter (DM) for pig slurry AD feedstock after accounting for avoided slurry storage to +2251kgCO(2)eMg(-1) DM for oilseed rape biodiesel feedstock after attributing indirect land use change (iLUC) to displaced food production. Maize monoculture for AD led to net GWP increases via iLUC, but optimized integration of maize into an arable rotation resulted in negligible food crop displacement and iLUC. However, even under best-case assumptions such as full use of heat output from AD-CHP, crop-biogas achieved low GWP reductions per hectare compared with Miscanthus heating pellets under default estimates of iLUC. Ecosystem services (ES) assessment highlighted soil and water quality risks for maize cultivation. All bioenergy crop options led to net increases in eutrophication after displaced food production was accounted for. The environmental balance of AD is sensitive to design and management factors such as digestate storage and application techniques, which are not well regulated in the UK. Currently, FiT payments are not dependent on compliance with sustainability criteria. We conclude that CLCA and ES effects should be integrated into sustainability criteria for FiTs and RHIs, to direct public money towards resource-efficient renewable energy options that achieve genuine climate protection without degrading soil, air or water qualit
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