Summary
The protection of healthcare workers from the risk of nosocomial severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection is a paramount concern. SARS‐CoV‐2 is likely to remain ...endemic and measures to protect healthcare workers against nosocomial infection will need to be maintained. This review aims to inform the assessment and management of the risk of SARS‐CoV‐2 transmission to healthcare workers involved in elective peri‐operative care. In the absence of data specifically related to the risk of SARS‐CoV‐2 transmission in the peri‐operative setting, we explore the evidence‐base that exists regarding modes of viral transmission, historical evidence for the risk associated with aerosol‐generating procedures and contemporaneous data from the COVID‐19 pandemic. We identify a significant lack of data regarding the risk of transmission in the management of elective surgical patients, highlighting the urgent need for further research.
Emerging data highlights the potential role of cyclooxygenase (COX) inhibitors in the primary prevention of malignancy, reducing metastatic spread and improving overall mortality. Despite ...nonsteroidal anti-inflammatory drugs (NSAIDs) forming a key component of the WHO analgesic ladder, their use in cancer pain management remains relatively low. This review re-appraises the current evidence regarding the efficacy of COX inhibitors as analgesics in cancer pain, providing a succinct resource to aid clinicians’ decision making when determining treatment strategies.
Medline® and Embase® databases were searched for publications up to November 2018. Randomised controlled trials (RCTs) and double-blind controlled studies considering the use of NSAIDs for management of cancer-related pain in adults were included. Animal studies, case reports, and retrospective observational data were excluded.
Thirty studies investigating the use of NSAIDs in cancer pain management were identified. There is a lack of high-quality evidence regarding the analgesic efficacy of NSAIDs in cancer pain, with short study durations and heterogeneity in outcome measures limiting the ability to draw meaningful conclusions.
Despite the renewed interest in these cost-effective, well-established medications in cancer treatment outcomes, there is a paucity of data from the past 15 yr regarding their efficacy in cancer pain management. However, when analgesic strategies in the cancer population are being formulated, it is important that the potential benefits of this class of drug are considered. Further work investigating the role of NSAIDs in cancer pain management is undoubtedly warranted.
Antiretroviral preexposure prophylaxis is a promising approach for preventing human immunodeficiency virus type 1 (HIV-1) infection in heterosexual populations.
We conducted a randomized trial of ...oral antiretroviral therapy for use as preexposure prophylaxis among HIV-1-serodiscordant heterosexual couples from Kenya and Uganda. The HIV-1-seronegative partner in each couple was randomly assigned to one of three study regimens--once-daily tenofovir (TDF), combination tenofovir-emtricitabine (TDF-FTC), or matching placebo--and followed monthly for up to 36 months. At enrollment, the HIV-1-seropositive partners were not eligible for antiretroviral therapy, according to national guidelines. All couples received standard HIV-1 treatment and prevention services.
We enrolled 4758 couples, of whom 4747 were followed: 1584 randomly assigned to TDF, 1579 to TDF-FTC, and 1584 to placebo. For 62% of the couples followed, the HIV-1-seronegative partner was male. Among HIV-1-seropositive participants, the median CD4 count was 495 cells per cubic millimeter (interquartile range, 375 to 662). A total of 82 HIV-1 infections occurred in seronegative participants during the study, 17 in the TDF group (incidence, 0.65 per 100 person-years), 13 in the TDF-FTC group (incidence, 0.50 per 100 person-years), and 52 in the placebo group (incidence, 1.99 per 100 person-years), indicating a relative reduction of 67% in the incidence of HIV-1 with TDF (95% confidence interval CI, 44 to 81; P<0.001) and of 75% with TDF-FTC (95% CI, 55 to 87; P<0.001). Protective effects of TDF-FTC and TDF alone against HIV-1 were not significantly different (P=0.23), and both study medications significantly reduced the HIV-1 incidence among both men and women. The rate of serious adverse events was similar across the study groups. Eight participants receiving active treatment were found to have been infected with HIV-1 at baseline, and among these eight, antiretroviral resistance developed in two during the study.
Oral TDF and TDF-FTC both protect against HIV-1 infection in heterosexual men and women. (Funded by the Bill and Melinda Gates Foundation; Partners PrEP ClinicalTrials.gov number, NCT00557245.).
Forest and savanna are the two dominant vegetation types of the tropical regions with very few tree species common to both. At a broad scale, it has long been recognised that the distributions of ...these two biomes are principally governed by precipitation and its seasonality, but with soil physical and chemical properties also potentially important. For tree species drawn from a range of forest and savanna sites in tropical Far North Queensland, Australia, we compared leaf traits of photosynthetic capacity, structure and nutrient concentrations. Area-based photosynthetic capacity was higher for the savanna species with a steeper slope to the photosynthesis ↔ nitrogen (N) relationship compared with the forest group. Higher leaf mass per unit leaf area for the savanna trees derived from denser rather than thicker leaves and did not appear to restrict rates of light-saturated photosynthesis when expressed on either an area or mass basis. Median ratios of foliar N to phosphorus (P) were relatively high (>20) at all sites, but we found no evidence for a dominant P limitation of photosynthesis for either forest or savanna trees. A parsimonious mixed-effects model of area-based photosynthetic capacity retained vegetation type and both N and P as explanatory terms. Resulting model-fitted predictions suggested a good fit to the observed data (R2 = 0.82). The model's random component found variation in area-based photosynthetic response to be much greater among species (71% of response variance) than across sites (9%). These results suggest that, on a leaf-area basis, savanna trees of Far North Queensland, Australia, are capable of photosynthetically outperforming forest species at their common boundaries.
The terminal navigation of the Near Earth Asteroid Rendezvous (NEAR) spacecraft during its close flyby of asteroid 253 Mathilde involved coordinated efforts to determine the heliocentric orbits of ...the spacecraft and Mathilde and then to determine the relative trajectory of the spacecraft with respect to Mathilde. The gravitational perturbation of Mathilde on the passing spacecraft was apparent in the spacecraft tracking data. As a result of the accurate targeting achieved, these data could be used to determine Mathilde's mass as 1.033 (± 0.044) x 10$^{20}$ grams. Coupled with a volume estimate provided by the NEAR imaging team, this mass suggests a low bulk density for Mathilde of 1.3 grams per cubic centimeter.
The mechanisms whereby As(III) and As(V) in aqueous solution (pH 5.5−6.5) interact with the surfaces of goethite, lepidocrocite, mackinawite, and pyrite have been investigated using As K-edge EXAFS ...and XANES spectroscopy. Arsenic species retain original oxidation states and occupy similar environments on the oxyhydroxide substrates, with first-shell coordination to four oxygens at 1.78 Å for As(III) and 1.69 Å for As(V). In agreement with other workers, we find that inner sphere complexes form, apparently involving bidentate (bridging) arsenate or arsenite. Interaction of As(III) and As(V) with the sulfide surfaces shows primary coordination to four oxygens (As−O: 1.69−1.76 Å) with further sulfur (∼3.1 Å) and iron (3.4−3.5 Å) shells suggesting outer sphere complexation. Arsenic species were also coprecipitated with mackinawite (pH 4.0), and these samples were further studied following oxidation. At high As(III) or As(V) concentrations, arsenate or arsenite species form, probably as sorption complexes, along with poorly crystalline arsenic sulfide (the only product at low As(V) concentrations). All oxidized samples show primary coordination to four oxygens at 1.7 Å, indicating As(V); these arsenates may show both outer sphere complexation with residual mackinawite and inner sphere complexation with new oxyhydroxides. These experiments help to clarify our understanding of As mobility in near-surface environments.
Highlights ► Single-trial detection of imagined auditory accents from EEG. ► Support for shared mechanisms in auditory perception and imagery. ► A machine-learning technique for neuroscience.
The design and construction of an instrument for full‐field imaging of the X‐ray fluorescence emitted by a fully illuminated sample are presented. The aim is to produce an X‐ray microscope with a few ...micrometers spatial resolution, which does not need to scan the sample. Since the fluorescence from a spatially inhomogeneous sample may contain many fluorescence lines, the optic which will provide the magnification of the emissions must be achromatic, i.e. its optical properties must be energy‐independent. The only optics which fulfill this requirement in the X‐ray regime are mirrors and pinholes. The throughput of a simple pinhole is very low, so the concept of coded apertures is an attractive extension which improves the throughput by having many pinholes, and retains the achromatic property. Modified uniformly redundant arrays (MURAs) with 10 µm openings and 50% open area have been fabricated using gold in a lithographic technique, fabricated on a 1 µm‐thick silicon nitride membrane. The gold is 25 µm thick, offering good contrast up to 20 keV. The silicon nitride is transparent down into the soft X‐ray region. MURAs with various orders, from 19 up to 73, as well as their respective negative (a mask where open and closed positions are inversed compared with the original mask), have been made. Having both signs of mask will reduce near‐field artifacts and make it possible to correct for any lack of contrast.
First results from a 10 µm MURA coded aperture optic for a full‐field X‐ray fluorescence microscope are presented.
We determined the mass of asteroid 433 Eros, its lower order gravitational harmonics, and rotation state, using ground-based Doppler and range tracking of the Near Earth Asteroid Rendezvous ...(NEAR)-Shoemaker spacecraft and images of the asteroid's surface landmarks. The mass of Eros is (6.687 ± 0.003) × 1018grams, which, coupled with our volume estimate, implies a bulk density of 2.67 ± 0.03 grams per cubic centimeter. The asteroid appears to have a uniform density distribution. The right ascension and declination of the rotation pole are 11.37 ± 0.05 and 17.22 ± 0.05 degrees, respectively, and at least over the short term, the rotation state of Eros is stable with no measurable free precession of the spin pole. Escape velocities on the surface vary from 3.1 to 17.2 meters per second. The dynamical environment of Eros suggests that it is covered with regolith and that one might expect material transport toward the deepest potential wells in the saddle and 5.5-kilometer crater regions.
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