Dexmedetomidine is increasingly used for surgical patients requiring general anaesthesia. However, its effectiveness on patient-centred outcomes remains uncertain. Our main objective was to evaluate ...the patient-centred effectiveness of intraoperative dexmedetomidine for adult patients requiring surgery under general anaesthesia.
We conducted a systematic search of MEDLINE, Embase, CENTRAL, Web of Science, and CINAHL from inception to October 2023. Randomised controlled trials (RCTs) comparing the intraoperative use of dexmedetomidine with placebo, opioid, or usual care in adult patients requiring surgery under general anaesthesia were included. Study selection, data extraction, and risk of bias assessment were performed by two reviewers independently. We synthesised data using a random-effects Bayesian regression framework to derive effect estimates and the probability of a clinically important effect. For continuous outcomes, we pooled instruments with similar constructs using standardised mean differences (SMDs) and converted SMDs and credible intervals (CrIs) to their original scale when appropriate. We assessed the certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. Our primary outcome was quality of recovery after surgery. To guide interpretation on the original scale, the Quality of Recovery-15 (QoR-15) instrument was used (range 0–150 points, minimally important difference MID of 6 points).
We identified 49,069 citations, from which 44 RCTs involving 5904 participants were eligible. Intraoperative dexmedetomidine administration was associated with an improvement in postoperative QoR-15 (mean difference 9, 95% CrI 4–14, n=21 RCTs, moderate certainty of evidence). We found a 99% probability of any benefit and an 88% probability of achieving the MID. There was a reduction in chronic pain incidence (odds ratio OR 0.42, 95% CrI 0.19–0.79, n=7 RCTs, low certainty of evidence). There was also an increased risk of clinically significant hypotension (OR 1.98, 95% CrI 0.84–3.92, posterior probability of harm 94%, n=8 RCTs) and clinically significant bradycardia (OR 1.74, 95% CrI 0.93–3.34, posterior probability of harm 95%, n=10 RCTs), with very low certainty of evidence for both. There was limited evidence to inform other secondary patient-centred outcomes.
Compared with placebo or standard of care, intraoperative dexmedetomidine likely results in meaningful improvement in the quality of recovery and chronic pain after surgery. However, it may increase clinically important bradycardia and hypotension.
PROSPERO (CRD42023439896).
We present the results from four stellar occultations by (486958) Arrokoth, the flyby target of the New Horizons extended mission. Three of the four efforts led to positive detections of the body, ...and all constrained the presence of rings and other debris, finding none. Twenty-five mobile stations were deployed for 2017 June 3 and augmented by fixed telescopes. There were no positive detections from this effort. The event on 2017 July 10 was observed by SOFIA with one very short chord. Twenty-four deployed stations on 2017 July 17 resulted in five chords that clearly showed a complicated shape consistent with a contact binary with rough dimensions of 20 by 30 km for the overall outline. A visible albedo of 10% was derived from these data. Twenty-two systems were deployed for the fourth event on 2018 Aug 4 and resulted in two chords. The combination of the occultation data and the flyby results provides a significant refinement of the rotation period, now estimated to be 15.9380 \(\pm\) 0.0005 hours. The occultation data also provided high-precision astrometric constraints on the position of the object that were crucial for supporting the navigation for the New Horizons flyby. This work demonstrates an effective method for obtaining detailed size and shape information and probing for rings and dust on distant Kuiper Belt objects as well as being an important source of positional data that can aid in spacecraft navigation that is particularly useful for small and distant bodies.
Reviews and other notices Martin, G. H.; Hallam, Elizabeth; Smith, Anthony ...
Journal of the Society of Archivists,
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13, Številka:
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Book Review, Journal Article
Winchester Studies 7: Artefacts from Medieval Winchester, Part 2: Object and Economy in Medieval Winchester Edited by Martin Biddle Oxford: Clarendon Press, 1990 cxxii + 1271 pp. in 2 volumes, 65 ...plates. £200
Domesday York D.M. Palliser York: University of York, Borthwick Paper No. 78, 1990 31 pp. £1.80
English Sheriffs to 1154 Judith A. Green London: HMSO, Public Record Office Handbooks No. 24, 1990 105 pp. £17.50
Camden Miscellany XXX London: Royal Historical Society, Camden Fourth Series, Volume 39, 1990 540 pp. £15
The Register of John Catterick Bishop of Coventry and Lichfield 1415-1419 Edited by R. N. Swanson Woodbridge: Boydell Press for the Canterbury and York Society, Volume LXXVII, 1990 xiv + 98 pp. £25 to non-members
The Administration of the County Palatine of Chester 1442-1485 Dorothy J. Clayton Manchester: Chetham Society, Third Series, Volume XXXV, 1990 xii + 313 pp. £35
A Guide to the Archives of the Company of Merchant Adventurers of York David M. Smith York: University of York, Borthwick Texts and Calendars No. 16, 1990 ix + 202 pp. £10
The Overseas Trade of London: Exchequer Customs Accounts 1480-1 Edited by H. S. Cobb London: London Record Society Volume XXVII, 1990 xlvii + 220 pp. £20 to non-members
The Stationers' Company Archive. An Account of the Records 1554-1984 Robin Myers Winchester: St Paul's Bibliographies, and Detroit: Omnigraphics, 1990 xlviii + 376 pp., illus. £65
Guide to Documents Relating to French and British North America in the Archives of the Sacred Congregation de Propaganda Fide in Rome, 1622-1799 Luca Codignola Ottawa: National Archives of Canada, 1991 xiii + 250 pp.
Pastors and People: the Biography of a Baptist Church: Queen's Road, Coventry Clyde Binfield Coventry: Queen's Road Baptist Church, 1984 348 pp., illus. £4.95 (available from Mr J. A. Spurgeon, 56 Armorial Road, Stivichall, Coventry CV3 6GJ)
Pulpit and Pew: a History of Warwick Road Church 1891-1991 David Rimmer Coventry: Warwick Road United Reformed Church 1991 70 pp., illus. £3 (available from Mr H. C. Thomas, c/o Warwick Road United Reformed Church, Coventry CV1 1EX)
The Correspondence of Lord Fitzwilliam of Milton and Francis Guybon his Steward 1697-1709 Edited by D. R. Hainsworth and Cherry Walker Northampton: Northamptonshire Record Society, Volume XXXVI, 1990 for 1988 xxiii + 312 pp.. £ 18 to non-members
Calendar of Bradford-on-Avon Settlement Examinations and Removal Orders 1725-98 Edited by Phyllis Hembry Trowbridge: Wiltshire Record Society, Volume XLVI, 1990 xxii +164 pp., illus. £15 to non-members (available from M.J. Lansdown, 53 Clarendon Road, Trowbridge, Wiltshire BA14 7BS)
Records of British Business and Industry 1760-1914: Textiles and Leather London: HMSO for the Royal Commission on Historical Manuscripts, Guides to Sources for British History 8, 1990 xiv+ 130 pp. £10.95
The Brewing Industry: A Guide to Historical Records Edited by Lesley Richmond and Alison Turton Manchester and New York: Manchester University Press, 1990 485 pp. £45
John Bennet Lawes: the Record of his Genius G.V. Dyke Taunton: Research Studies Press and Chichester: John Wiley & Sons, 1991 xiv + 482 pp. £69.50
A Biography of Sir Charles Hartley, Civil Engineer (1825-1915), the Father of the Danube C.W.S. Hartley Lewisham, New York, Queenston, Ontario and Lampeter: The Edwin Mellen Press, 2 vols, 1989 xiv + 840 pp. $100
Recent publications of the Federation of Family History Societies
English Genealogy: An Introductory Bibliography, 2nd edition Stuart Raymond and Jeremy Gibson 40 pp. £2
British Genealogical Periodicals, Volume 1 Stuart Raymond, 84 pp. £5
British Genealogical Periodicals, Volume 2 Stuart Raymond, 40 pp. £3
Dorset: A Genealogical Bibliography Stuart Raymond, 120 pp. £6
Somerset: A Genealogical Bibliography Stuart Raymond, 108 pp. £6
The Hearth Tax, Other Later Stuart Tax Lists and the Association Oath Rolls Jeremy Gibson 60 pp. £2.50
Poll Books, c. 1696-1872: A Directory to Holdings in Great Britain, 2nd edition Jeremy Gibson and Colin Rogers 60 pp. £2.50
Electoral Registers since 1832; and Burgess Lists: A Directory to Holdings in Great Britain, 2nd edition Jeremy Gibson and Colin Rogers 60 pp. £2.50
Militia Lists and Musters, 1757-1876: A Directory of Holdings in the British Isles 2nd edition. Jeremy Gibson and Mervyn Medlycott 44 pp. £2
World War I Army Ancestry, 2nd edition Norman Holding 72 pp. £3.95
The Records of the Royal Air Force: How to Find the Few Eunice Wilson 66 pp. £3.95
Local Studies Collections: A Manual, Volume 2 Edited by Michael Dewe Aldershot and Brookfield, Vermont: Gower, 1991 ix+ 375 pp. £47.50
Record Repositories in Great Britain: A Geographical Directory London: HMSO for the Royal Commission on Historical Manuscripts, 9th edition, 1991 vi + 46 pp. £3.50
Calderdale Archives 1964-1989: An Illustrated Guide to Calderdale District Archives Wakefield: West Yorkshire Archive Service, 1990 120 pp., illus. £6.95
Guide des Archives Communales d'Arles Françoise Heurley-Chaunier Aries: Archives Communales, 1989 168 pp., illus. 45F
General Guide Series: Government Archives Division, compiled by Cynthia Lovering (National Archives of Canada, 1991. xiv + 318 pp., illus.).
Federal Records Centres Users' Guide Ottawa: National Archives of Canada, 1990 80 pp.
Archives Accessions Annual 1988 Edited by William L. Joyce Westport and London: Meckler, 1990 129 pp. £42.50
Managing Archives and Archival Institutions Edited by James Gregory Bradsher London: Mansell, 1988 xvi + 304 pp. £30
Preservation and the Management of Library Collections John Feather London: The Library Association, 1991 ix + 122 pp. £19.50 to non-members
