Factors influencing decision making in neonatology: inhaled nitric oxide in preterm infants.

ObjectiveWe studied decision making regarding inhaled nitric oxide (iNO) in preterm infants with Pulmonary Hypertension (PH).Study designWe asked members of the AAP-Society of Neonatal-Perinatal Medicine and Division-Chiefs to select from three management options- initiate iNO, engage parents in shared decision making or not consider iNO in an extremely preterm with PH followed by rating of factors influencing their decision.ResultsThree hundred and four respondents (9%) completed the survey; 36.5% chose to initiate iNO, 42% to engage parents, and 21.5% did not consider iNO. Provider's prior experience, safety, and patient-centered care were rated higher by those who initiated or offered iNO; lack of effectiveness and cost considerations by participants who did not chose iNO.ConclusionsMost neonatologists offer or initiate iNO therapy based on their individual experience. The minority who chose not to consider iNO placed higher value on lack of effectiveness and cost. These results demonstrate a tension between evidence and pathophysiology-based-therapy/personal experience

Novel Analytical Microbial Fuel Cell Design for Rapid in Situ Optimisation of Dilution Rate and Substrate Supply Rate, by Flow, Volume Control and Anode Placement

© 2018 MDPI AG. All rights reserved. A new analytical design of continuously-fed microbial fuel cell was built in triplicate in order to investigate relations and effects of various operating parameters such as flow rate and substrate supply rate, in terms of power output and chemical oxygen demand (COD) removal efficiency. This novel design enables the microbial fuel cell (MFC) systems to be easily adjusted in situ by changing anode distance to the membrane or anodic volume without the necessity of building many trial-and-error prototypes for each condition. A maximum power output of 20.7 ± 1.9 µW was obtained with an optimal reactor configuration; 2 mM acetate concentration in the feedstock coupled with a flow rate of 77 mL h−1, an anodic volume of 10 mL and an anode electrode surface area of 70 cm2 (2.9 cm2 projected area), using a 1 cm anode distance from the membrane. COD removal almost showed the reverse pattern with power generation, which suggests trade-off correlation between these two parameters, in this particular example. This novel design may be most conveniently employed for generating empirical data for testing and creating new MFC designs with appropriate practical and theoretical modelling

Excited states in lattice QCD with the stochastic LapH method

Progress in computing the spectrum of excited baryons and mesons in lattice QCD is described. Results in the zero-momentum bosonic I=1/2, S=1, T1u symmetry sector of QCD using a correlation matrix of 58 operators are presented. All needed Wick contractions are efficiently evaluated using a stochastic method of treating the low-lying modes of quark propagation that exploits Laplacian Heaviside quark-field smearing. Level identification using probe operators is discussed.Comment: 4 pages, 3 figures, talk presented at the 13th International Conference on Meson-Nucleon Physics and the Structure of the Nucleon (MENU 2013), Sept 30 - Oct 4, 2013, Rome, Ital

The Fading Radio Emission from SN 1961V: Evidence for a Type II Peculiar Supernova?

Using the Very Large Array (VLA), we have detected radio emission from the site of SN 1961V in the Sc galaxy NGC 1058. With a peak flux density of 0.063 +/- 0.008 mJy/beam at 6 cm and 0.147 +/- 0.026 mJy/beam at 18 cm, the source is non-thermal, with a spectral index of -0.79 +/- 0.23. Within errors, this spectral index is the same value reported for previous VLA observations taken in 1984 and 1986. The radio emission at both wavelengths has decayed since the mid 1980's observations with power-law indices of beta(20cm) = -0.69 +/- 0.23 and beta(6cm) = -1.75 +/- 0.16. We discuss the radio properties of this source and compare them with those of Type II radio supernovae and luminous blue variables.Comment: 19 pages, 3 figures; To appear in the Astronomical Journa

Educational interventions to train healthcare professionals in end-of-life communication: a systematic review and meta-analysis

GRADE Summary of Findings for Primary Outcomes – Overall quality of evidence by GRADE criteria. (PDF 47 kb

Communication tools for end-of-life decision-making in the intensive care unit: a systematic review and meta-analysis

Appendix: Electronic search strategies. (DOC 72 kb

The Nature of SN 1961V

The nature of SN 1961V has been uncertain. Its peculiar optical light curve and slow expansion velocity are similar to those of super-outbursts of luminous blue variables (LBVs), but its nonthermal radio spectral index and declining radio luminosity are consistent with decades-old supernovae (SNe). We have obtained Hubble Space Telescope STIS images and spectra of the stars in the vicinity of SN 1961V, and find Object 7 identified by Filippenko et al. to be the closest to the optical and radio positions of SN 1961V. Object 7 is the only point source detected in our STIS spectra and only its H-alpha emission is detected; it cannot be the SN or its remnant because of the absence of forbidden lines. While the H-alpha line profile of Object 7 is remarkably similar to that of eta Car, the blue color (similar to an A2Ib supergiant) and lack of appreciable variability are unlike known post-outburst LBVs. We have also obtained Very Long Baseline Array (VLBA) observations of SN 1961V at 18 cm. The non-detection of SN 1961V places a lower limit on the size of the radio-emitting region, 7.6 mas or 0.34 pc, which implies an average expansion velocity in excess of 4,400 km/s, much higher than the optical expansion velocity measured in 1961. We conclude the following: (1) A SN occurred in the vicinity of SN 1961V a few decades ago. (2) If the SN 1961V light maximum originates from a giant eruption of a massive star, Object 7 is the most probable candidate for the survivor, but its blue color and lack of significant variability are different from a post-outburst eta Car. (3) The radio SN and Object 7 could be physically associated with each other through a binary system. (4) Object 7 needs to be monitored to determine its nature and relationship to SN 1961V.Comment: 16 pages, 3 figures, accepted by the Astronomical Journal for the 2004 May issu

Microrheology of polyethylene oxide using diffusing wave spectroscopy and single scattering

Experiments investigating the local viscoelastic properties of a simple uncross-linked flexible polymer are performed on polyethylene oxide solutions in the semidilute regime using polystyrene beads of varying sizes and surface chemistry as probes. We measure the thermal motions of the beads to obtain the elastic and viscous moduli of our sample. Two different dynamic light scattering techniques, diffusing wave spectroscopy and quasielastic light scattering (QELS), are used to determine the dynamics of the probe particles. Diffusing wave spectroscopy probes the short time dynamics of the scatterers while QELS or single scattering measures the dynamics at larger times. This results in a larger frequency overlap of the data obtained from the microrheological techniques with the data obtained from the conventional bulk measurements. The moduli are estimated using a modified algebraic form of the generalized Stokes-Einstein equation. Comparison of microrheology with bulk measurements shows excellent similarity confirming the applicability of this method for simple, uncross-linked polymeric systems