Thoracic epidural for post-thoracotomy pain: a comparison of three concentrations of sufentanil

Background: The aim of this prospective, double blind, randomised trial was to compare the analgesic and adverse effects of three concentrations of the thoracic epidural sufentanil with bupivacaine in patients undergoing thoracotomy.Methods: We studied 60 (randomised) patients who were to receive a 10 ml bolus dose of sufentanil, 1&mu;g/ml, 2 &mu;g/ml and 3 &mu;g/ml, in bupivacaine 0.125%, via thoracic epidural. Postoperatively, pain at rest, on coughing and with ambulation was assessed using a visual analogue scale (VAS) and observer verbal ranking score (OVRS) at 2, 6, 12 and 24 hours. Adverse effects were simultaneously assessed.Results: There was no significant difference in the baseline characteristics between the three groups. The number of patients with episodes of unsatisfactory pain, i.e. a VAS scores &ge; 40 and OVRS &ge; 2, at each of the four assessments postoperatively, was significantly higher with sufentanil 1 g/ml than with sufentanil 2 &mu;g/ml or &mu;3 g/ml (p < 0.05). In the 3 &mu;g/ml sufentanil group, four patients (20%) had a sedation score &ge; 3 compared with one (5%) and no (0%) patients in the 2 &mu;g/ml and 1 &mu;g/ml sufentanil groups, respectively (p < 0.05). In addition, 30% patients experienced pruritus in the 3 &mu;g/ml sufentanil group compared with 10% and 5%, respectively, in the 2 &mu;g/ml and 1 &mu;g/ml sufentanil groups. In the sufentanil 3 &mu;g/ml, 2 &mu;g/ml and 1 &mu;g/ml groups, 30%, 20% and 5% patients, respectively, had emetics symptoms (p < 0.05).Conclusions: We conclude that a thoracic epidural bolus of 10 ml sufentanil 2 &mu;g/ml with bupivacaine 0.125% provides the optimal balance between pain relief and side-effects following thoracotomy

Linguistic Analysis of Requirements of a Space Project and Their Conformity with the Recommendations Proposed by a Controlled Natural Language

International audienceWe propose a linguistic analysis of requirements written in French for a project carried out by the French National Space Agency (CNES). The aim is to determine to what extent they conform to some of the rules laid down in INCOSE, a recent guide for writing requirements, with a focus on the notion of sentence " comprehensibility ". Although CNES engineers are not obliged to follow any Controlled Natural Language, we believe that language regularities are likely to emerge from this task, mainly due to the writers' experience. As a first step, we use natural language processing tools to identify sentences that do not comply with INCOSE rules. We further review these sentences to understand why the recommendations cannot (or should not) always be applied when specifying large-scale projects, and how they could be improved. This paper presents a corpus linguistics approach applied to the melioration of requirements writing. We propose a linguistic diagnosis of the way requirements are written in a space project by comparing these requirements with a guide for writing specifications (a controlled natural language). Initial results obtained from this analysis suggest that guides for writing specifications are not fully adapted to the real writing process: they are sometimes too constraining, and sometimes insufficiently so. In the medium term, the aim is to propose another guide based on the spontaneous regularities observed in requirements. The paper comprises two parts. In the first one (see section 2), we present the context of our study and the tool-assisted method used for making the diagnosis. In the second one (see section 3), we describe and discuss our preliminary results

Dialogicality and imaginings of two 'community' notice boards in post-apartheid Observatory, Cape Town

This article undertakes a poststructuralist multisemiotic analysis of posters and notices found on two 'community' notice boards in the trendy, multicultural neighbourhood of Observatory in Cape Town, South Africa. An analysis of the two notice boards endeavours to reveal different strategic uses of English as well as varying constructions of (transnational) place-making and community in Observatory. The two notice boards reveal voices of transient and permanent groups alike and index new imaginative constructions of this changing neighbourhood. Furthermore, this paper explores the implications of strategic linguistic processes in self-marketisation of transnational and 'local' community members in Observatory. We conclude by expounding on the new perspective of transcultural capital and what it means to the sociolinguistics of a super-diverse neighbourhood in the post-apartheid neighbourhood of Observatory in Cape Town, South Africa.IS

An exploration of concepts of community through a case study of UK university web production

The paper explores the inter-relation and differences between the concepts of occupational community, community of practice, online community and social network. It uses as a case study illustration the domain of UK university web site production and specifically a listserv for those involved in it. Different latent occupational communities are explored, and the potential for the listserv to help realize these as an active sense of community is considered. The listserv is not (for most participants) a tight knit community of practice, indeed it fails many criteria for an online community. It is perhaps best conceived as a loose knit network of practice, valued for information, implicit support and for the maintenance of weak ties. Through the analysis the case for using strict definitions of the theoretical concepts is made

Markets and marketing research on poverty and its alleviation: Summarizing an evolving logic toward human capabilities, well-being goals and transformation

Marketing practitioners and business scholars now view some of the world’s poorest communities as profitable growth markets. Hence a market-based approach to poverty alleviation has gathered momentum. This article traces the evolution of such a market-based approach over four decades and highlights a gradual trend away from a deficit-reduction approach (focused on constraints and justice) towards an opportunity-expansion approach (focused on capabilities and well-being). This trend is summarized in an analytical framework of human capabilities, well-being goals and transformative impact evolved from the literature. The framework is then used to analyse the practice of sanitation marketing, which has emerged as a key method in one of the highest priority domains in international development discourse – sanitation. The article concludes with a discussion of how contemporary work can further take forward the key tenets of the framework and guide the development of ‘good markets’ for the poor

Fragmentation and Multifragmentation of 10.6A GeV Gold Nuclei

We present the results of a study performed on the interactions of 10.6A GeV gold nuclei in nuclear emulsions. In a minimum bias sample of 1311 interac- tions, 5260 helium nuclei and 2622 heavy fragments were observed as Au projec- tile fragments. The experimental data are analyzed with particular emphasis of target separation interactions in emulsions and study of criticalexponents. Multiplicity distributions of the fast-moving projectile fragments are inves- tigated. Charged fragment moments, conditional moments as well as two and three -body asymmetries of the fast moving projectile particles are determined in terms of the total charge remaining bound in the multiply charged projectile fragments. Some differences in the average yields of helium nuclei and heavier fragments are observed, which may be attributed to a target effect. However, two and three-body asymmetries and conditional moments indicate that the breakup mechanism of the projectile seems to be independent of target mass. We looked for evidence of critical point observable in finite nuclei by study the resulting charged fragments distributions. We have obtained the values for the critical exponents gamma, beta and tau and compare our results with those at lower energy experiment (1.0A GeV data). The values suggest that a phase transition like behavior, is observed.Comment: latex, revtex, 28 pages, 12 figures, 3tables, submitted to Europysics Journal

Estimates of global, regional, and national incidence, prevalence, and mortality of HIV, 1980�2015: the Global Burden of Disease Study 2015

Background Timely assessment of the burden of HIV/AIDS is essential for policy setting and programme evaluation. In this report from the Global Burden of Disease Study 2015 (GBD 2015), we provide national estimates of levels and trends of HIV/AIDS incidence, prevalence, coverage of antiretroviral therapy (ART), and mortality for 195 countries and territories from 1980 to 2015. Methods For countries without high-quality vital registration data, we estimated prevalence and incidence with data from antenatal care clinics and population-based seroprevalence surveys, and with assumptions by age and sex on initial CD4 distribution at infection, CD4 progression rates (probability of progression from higher to lower CD4 cell-count category), on and off antiretroviral therapy (ART) mortality, and mortality from all other causes. Our estimation strategy links the GBD 2015 assessment of all-cause mortality and estimation of incidence and prevalence so that for each draw from the uncertainty distribution all assumptions used in each step are internally consistent. We estimated incidence, prevalence, and death with GBD versions of the Estimation and Projection Package (EPP) and Spectrum software originally developed by the Joint United Nations Programme on HIV/AIDS (UNAIDS). We used an open-source version of EPP and recoded Spectrum for speed, and used updated assumptions from systematic reviews of the literature and GBD demographic data. For countries with high-quality vital registration data, we developed the cohort incidence bias adjustment model to estimate HIV incidence and prevalence largely from the number of deaths caused by HIV recorded in cause-of-death statistics. We corrected these statistics for garbage coding and HIV misclassification. Findings Global HIV incidence reached its peak in 1997, at 3·3 million new infections (95 uncertainty interval UI 3·1�3·4 million). Annual incidence has stayed relatively constant at about 2·6 million per year (range 2·5�2·8 million) since 2005, after a period of fast decline between 1997 and 2005. The number of people living with HIV/AIDS has been steadily increasing and reached 38·8 million (95% UI 37·6�40·4 million) in 2015. At the same time, HIV/AIDS mortality has been declining at a steady pace, from a peak of 1·8 million deaths (95% UI 1·7�1·9 million) in 2005, to 1·2 million deaths (1·1�1·3 million) in 2015. We recorded substantial heterogeneity in the levels and trends of HIV/AIDS across countries. Although many countries have experienced decreases in HIV/AIDS mortality and in annual new infections, other countries have had slowdowns or increases in rates of change in annual new infections. Interpretation Scale-up of ART and prevention of mother-to-child transmission has been one of the great successes of global health in the past two decades. However, in the past decade, progress in reducing new infections has been slow, development assistance for health devoted to HIV has stagnated, and resources for health in low-income countries have grown slowly. Achievement of the new ambitious goals for HIV enshrined in Sustainable Development Goal 3 and the 90-90-90 UNAIDS targets will be challenging, and will need continued efforts from governments and international agencies in the next 15 years to end AIDS by 2030. Funding Bill & Melinda Gates Foundation, and National Institute of Mental Health and National Institute on Aging, National Institutes of Health. © 2016 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY licens

A Genre-Based Approach to ESP Materials

World Englishes102153-166WOEN