Patient satisfaction during and following procedural sedation for ambulatory surgery

Background: Patient satisfaction is multidimensional. The clinician's perspective of a good outcome and the patient's experience of a satisfactory service are often two different end-points. The primary aim of our study was to assess the perioperative experience of patients undergoing procedural sedation. A secondary aim was to create a postoperative questionnaire which could be used as a measurement tool. The questions could also be used as an audit to assist with adherence to quality assurance and clinical governance. Method: A questionnaire was compiled to attempt to assess the perioperative aspects of procedural sedation. Five hundred consecutive patients undergoing procedural sedation for dental-related outpatient procedures were asked to complete a questionnaire. Patients who didn't complete it were excluded. Ninety-eight per cent of the patients returned the questionnaire and 489 questionnaires were evaluated. Results: A total of 489 patients were included. Ninetythree per cent of the patients expressed a good (7+/10) overall experience of procedural sedation, and 92.6% indicated that they would recommend it to others. Conclusion: Our study population showed a high level of satisfaction with their sedation experience. It is suggested that the devised questionnaire could be used successfully in future as an assessment tool or audit of patient satisfaction following procedural sedation for ambulatory surgery.DHE

Patient satisfaction during and following procedural sedation for ambulatory surgery

Background: Patient satisfaction is multidimensional. The clinician’s perspective of a good outcome and the patient’s experience of a satisfactory service are often two different end-points. The primary aim of our study was to assess the perioperative experience of patients undergoing procedural sedation. A  secondary aim was to create a postoperative questionnaire which could be used as a measurement tool. The questions could also be used as an audit to assist with adherence to quality assurance and clinical governance.Method: A questionnaire was compiled to attempt to assess the perioperative aspects of procedural  sedation. Five hundred consecutive patients undergoing procedural sedation for dental-related outpatient  procedures were asked to complete a questionnaire. Patients who didn’t complete it were excluded.  Ninety-eight per cent of the patients returned the questionnaire and 489 questionnaires were evaluated.Results: A total of 489 patients were included. Ninety-three per cent of the patients expressed a good (7+/10) overall experience of procedural sedation, and 92.6% indicated that they would recommend it to others.Conclusion: Our study population showed a high level of satisfaction with their sedation experience. It is suggested that the devised questionnaire could be used successfully in future as an assessment tool or audit of patient satisfaction following procedural sedation for ambulatory surgery.Keywords: patient satisfaction, postoperative questionnaire, procedural sedatio

Impingement heat transfer with pressure recovery

A conventional impinging jet is effective at transferring a large heat flux. However a significant pressure loss is also experienced by the free jet of a jet impingement heat transfer device due to rapid expansion because it does not incorporate effective pressure recovery. A novel high-flux impingement heat transfer device, called the Tadpole, is developed to improve the heat transfer and pressure loss (performance) characteristics of the conventional impingement domain by incorporating pressure recovery with a diffuser. The Tadpole is scrutinized through an experimental comparison with a conventional jet impinging on the inner wall of a hemisphere under the turbulent flow regime. The Tadpole demonstrates promising capability by exceeding the performance characteristics of the impinging jet by up to 7.3% for the heat transfer coefficient while reducing the pressure loss by 13%. Multiple dimensional degrees of freedom in the Tadpole’s flow domain can be manipulated for an enhanced heat transfer coefficient, a reduced total pressure loss or a favourable combination of both metrics. A Computational Fluid Dynamics (CFD) model is developed, the Four-Equation Transition SST turbulence model demonstrates satisfactory experimental validation with a deviation of < 5% for the heat transfer coefficient and < 23% for the total pressure loss. The Tadpole is a promising heat transfer device for high-flux applications and is recommended for further work incorporating design improvements and multidimensional optimization.The Solar Thermal Energy Research Group (STERG) at Stellenbosch University.https://link.springer.com/journal/231hj2023Mechanical and Aeronautical Engineerin

Thermal performance characteristics of a tessellated-impinging central receiver

Current central receiver Concentrating Solar Power plants using molten salt as a heat transfer fluid add heat at around 565 °C in a power plant. Adding heat at a higher temperature can improve the thermodynamic performance and may reduce the cost of power. One way to achieve this is by using pressurized air solar receivers. Current receivers have achieved thermal efficiencies of around 80% at an outlet temperature of 800 °C. This paper investigates a novel central receiver technology that makes use of a tessellated array of heat transfer units. The units employ impingement heat transfer within a concave surface. The receiver can be scaled for a desired thermal rating by the number of heat transfer units. The convolution-projection flux modelling approach is used to model and project an incoming flux distribution on the receiver’s surface. This flux distribution is interpreted by a Computational Fluid Dynamics model as a volumetric heat source. Radiative and convective heat losses are considered. An initial performance outlook estimates that an outlet temperature of 801 °C can be reached at a thermal efficiency of 59% and an exterior surface temperature of 1142 °C for an aperture flux of 635 kW/m2. A limitation is an insufficient exterior surface area to absorb the incoming flux which causes a high surface temperature and thermal losses. Similar thermal performance is estimated at high and low pressures, with increased pumping losses at low pressures. The efficiency may be improved by taking advantage of a larger surface area relative to the aperture area.An Erasmus+ mobility grant awarded by Alliance4Universities which made a collaboration at UC3M possible.http://www.elsevier.com/locate/atehj2023Mechanical and Aeronautical Engineerin

Role of Hedgehog signalling at the transition from double-positive to single-positive thymocyte

In the thymus, developing T cells receive signals that determine lineage choice, specificity, MHC restriction and tolerance to self-antigen. One way in which thymocytes receive instruction is by secretion of Sonic hedgehog (Shh) from thymic epithelial cells. We have previously shown that Hedgehog (Hh) signalling in the thymus decreases the CD4:CD8 single-positive (SP) thymocyte ratio. Here, we present data indicating that double-positive (DP) thymocytes are Hh-responsive and that thymocyte-intrinsic Hh signalling plays a role in modulating the production of CD4+ (SP4), CD8+ (SP8) and unconventional T-cell subsets. Repression of physiological Hh signalling in thymocytes altered the proportions of DP and SP4 cells. Thymocyte-intrinsic Hh-dependent transcription also attenuated both the production of mature SP4 and SP8 cells, and the establishment of peripheral T-cell compartments in TCR-transgenic mice. Additionally, stimulation or withdrawal of Hh signals in the WT foetal thymus impaired or enhanced upregulation of the CD4 lineage-specific transcription factor Gata3 respectively. These data together suggest that Hh signalling may play a role in influencing the later stages of thymocyte development

Understanding Group Structures and Properties in Social Media

Abstract. The rapid growth of social networking sites enables people to connect to each other more conveniently than ever. With easy-to-use social media, people contribute and consume contents, leading to a new form of human interaction and the emergence of online collective behav-ior. In this chapter, we aim to understand group structures and proper-ties by extracting and profiling communities in social media. We present some challenges of community detection in social media. A prominent one is that networks in social media are often heterogeneous. We intro-duce two types of heterogeneity presented in online social networks and elaborate corresponding community detection approaches for each type, respectively. Social media provides not only interaction information but also textual and tag data. This variety of data can be exploited to profile individual groups in understanding group formation and relationships. We also suggest some future work in understanding group structures and properties. Key words: social media, community detection, group profiling, het-erogeneous networks, multi-mode networks, multi-dimensional networks

Removal of non-CO2 greenhouse gases by large-scale atmospheric solar photocatalysis

Large-scale atmospheric removal of greenhouse gases (GHGs) including methane, nitrous oxide and ozone-depleting halocarbons could reduce global warming more quickly than atmospheric removal of CO2. Photocatalysis of methane oxidizes it to CO2, effectively reducing its global warming potential (GWP) by at least 90%. Nitrous oxide can be reduced to nitrogen and oxygen by photocatalysis; meanwhile halocarbons can be mineralized by red-ox photocatalytic reactions to acid halides and CO2. Photocatalysis avoids the need for capture and sequestration of these atmospheric components. Here review an unusual hybrid device combining photocatalysis with carbon-free electricity with no-intermittency based on the solar updraft chimney. Then we review experimental evidence regarding photocatalytic transformations of non-CO2 GHGs. We propose to combine TiO2-photocatalysis with solar chimney power plants (SCPPs) to cleanse the atmosphere of non-CO2 GHGs. Worldwide installation of 50,000 SCPPs, each of capacity 200 MW, would generate a cumulative 34 PWh of renewable electricity by 2050, taking into account construction time. These SCPPs equipped with photocatalyst would process 1 atmospheric volume each 14–16 years, reducing or stopping the atmospheric growth rate of the non-CO2 GHGs and progressively reducing their atmospheric concentrations. Removal of methane, as compared to other GHGs, has enhanced efficacy in reducing radiative forcing because it liberates more °OH radicals to accelerate the cleaning of the troposphere. The overall reduction in non-CO2 GHG concentration would help to limit global temperature rise. By physically linking greenhouse gas removal to renewable electricity generation, the hybrid concept would avoid the moral hazard associated with most other climate engineering proposals

Kernels on Graphs as Proximity Measures

International audienceKernels and, broadly speaking, similarity measures on graphs are extensively used in graph-based unsupervised and semi-supervised learning algorithms as well as in the link prediction problem. We analytically study proximity and distance properties of various kernels and similarity measures on graphs. This can potentially be useful for recommending the adoption of one or another similarity measure in a machine learning method. Also, we numerically compare various similarity measures in the context of spectral clustering and observe that normalized heat-type similarity measures with log modification generally perform the best

Serotonin controlling feeding and satiety

Serotonin has been implicated in the control of satiety for almost four decades. Historically, the insight that the appetite suppressant effect of fenfluramine is linked to serotonin has stimulated interest in and research into the role of this neurotransmitter in satiety. Various rodent models, including transgenic models, have been developed to identify the involved 5-HT receptor subtypes. This approach also required the availability of receptor ligands of different selectivity, and behavioural techniques had to be developed simultaneously which allow differentiating between unspecific pharmacological effects of these ligands and ‘true’ satiation and satiety. Currently, 5-HT1B, 5-HT2C and 5-HT6 receptors have been identified to mediate serotonergic satiety in different ways. The recently approved anti-obesity drug lorcaserin is a 5-HT2C receptor agonist. In brain, both hypothalamic (arcuate nucleus, paraventricular nucleus) and extrahypothalamic sites (parabrachial nucleus, nucleus of the solitary tract) have been identified to mediate the serotonergic control of satiety. Serotonin interacts within the hypothalamus with endogenous orexigenic (Neuropeptide Y/Agouti related protein) and anorectic (α-melanocyte stimulating hormone) peptides. In the nucleus of the solitary tract serotonin integrates peripheral satiety signals. Here, the 5-HT3, but possibly also the 5-HT2C receptor play a role. It has been found that 5-HT acts in concert with such peripheral signals as cholecystokinin and leptin. Despite the recent advances of our knowledge, many of the complex interactions between 5-HT and other satiety factors are not fully understood yet. Further progress in research will also advance the development of new serotonergic anti-obesity drugs