Obstetric Anesthesia Workforce Surveys were conducted in 1981, 1992, and 2001, and the 10-year update was conducted in 2012. Anesthesia providers from US hospitals were surveyed to identify the ...methods used to provide obstetric anesthesia. Our primary hypothesis was that the provision of obstetric anesthesia services has changed in the past 10 years.
A sample of hospitals was generated based on the number of births per year and US census region. Strata were defined as follows: I ≥ 1500 annual births (n = 341), II ≥ 500 to 1499 annual births (n = 438), and III < 500 annual births (n = 414). Contact email information for the anesthesia provider in charge of obstetric services was obtained by phone call. Electronic questionnaires were sent through email.
Administration of neuraxial (referred to as "regional" in previous surveys) labor analgesia was available 24 hours per day in all stratum I hospitals responding to the survey. Respondents across all strata reported high rates of in-house coverage, with 86.3% (95% confidence interval CI = 82.7%-90%) of stratum I providers reporting that they provided in-house anesthesiology services for obstetrics. The use of patient-controlled epidural analgesia in stratum I hospitals was reported to be 35% in 2001 and 77.6% (95% CI = 73.2%-82.1%) in this survey. Independent Certified Registered Nurse Anesthetists were reported to provide obstetric anesthesia services in 68% (95% CI = 57.9%-77.0%) of stratum III hospitals. Although 76% (95% CI = 71.2%-80.3%) of responding stratum I hospitals allow postpartum tubal ligations, 14% report inadequate staffing to provide anesthesia either always or at off-hours.
Since 2001, there have been significant changes in how responding hospitals provide obstetric anesthesia care and staff the labor and delivery ward. Obstetric anesthesia surveys, updated every 10 years, continue to provide information about changes in obstetric anesthesia practice.
We present powderday (available at https://github.com/dnarayanan/powderday), a flexible, fast, open-source dust radiative transfer package designed to interface with both idealized and cosmological ...galaxy formation simulations. powderday builds on fsps stellar population synthesis models, and hyperion dust radiative transfer, and employs yt to interface between different software packages. We include our stellar population synthesis modeling on the fly, allowing significant flexibility in the assumed stellar physics and nebular line emission. The dust content follows either simple observationally motivated prescriptions (i.e., constant dust-to-metals ratios, or dust-to-gas ratios that vary with metallicity), direct modeling from galaxy formation simulations that include dust physics, as well as a novel approach that includes the dust content via learning-based algorithms from the simba cosmological galaxy formation simulation. Active galactic nuclei (AGNs) can additionally be included via a range of prescriptions. The output of these models are broadband (912 -1 mm) spectral energy distributions (SEDs), as well as filter-convolved monochromatic images. powderday is designed to eliminate last-mile efforts by researchers that employ different hydrodynamic galaxy formation models and seamlessly interfaces with gizmo, arepo, gasoline, changa, and enzo. We demonstrate the capabilities of the code via three applications: a model for the star formation rate-infrared luminosity relation in galaxies (including the impact of AGNs), the impact of circumstellar dust around AGB stars on the mid-infrared emission from galaxy SEDs, and the impact of galaxy inclination angle on dust attenuation laws.
ABSTRACT
We analyse a suite of 29 high-resolution zoom-in cosmological hydrodynamic simulations of massive galaxies with stellar masses $M_{\rm star} \gt 10^{10.9} \, \mathrm{M}_\odot$, with the goal ...of better understanding merger activity among active galactic nuclei (AGN), AGN activity in merging systems, SMBH growth during mergers, and the role of gas content in triggering AGN. Using the radiative transfer code Powderday, we generate HST-WFC3 F160W mock observations of central galaxies at redshift 0.5 < z < 3; convolve each image with a CANDELS-like point spread function; stitch each image into a real CANDELS image; and identify mergers within the synthetic images using commonly adopted non-parametric statistics. We study the connection between mergers and AGN activity in both the simulations and synthetic images and find reasonable agreement with observations from CANDELS. We find that AGN activity is not primarily driven by major mergers (stellar mass ratio > 1:4) except in a select few cases of gas-rich mergers at low redshifts (0.5 < z < 0.9). We also find that major mergers do not significantly grow the central SMBHs, indicating major mergers do not sustain long-term accretion. Moreover, the most luminous AGN in our simulations (Lbol > 1045 erg s−1) are no more likely than inactive galaxies (Lbol < 1043 erg s−1) to be found in merging systems. We conclude that mergers are not the primary drivers of AGN activity in the simulated massive galaxies studied here.
The superior cavopulmonary connection (SCPC) or “bidirectional Glenn” is an integral, intermediate stage in palliation of single ventricle patients to the Fontan procedure. The procedure, normally ...performed at 3 to 6 months of life, increases effective pulmonary blood flow and reduces the ventricular volume load in patients with single ventricle (parallel circulation) physiology. While the SCPC, with or without additional sources of pulmonary blood flow, cannot be considered a long-term palliation strategy, there are a subset of patients who require SCPC palliation for a longer interval than the typical patient. In this article, we will review the physiology of SCPC, the consequences of prolonged SCPC palliation, and modes of failure. We will also discuss strategies to augment pulmonary blood flow in the presence of an SCPC. The anesthetic considerations in SCPC patients will also be discussed, as these patients may present for noncardiac surgery from infancy to adulthood.
We recently described a set of drug-like molecules obtained from an in silico screen that stabilize mutant superoxide dismutase-1 (SOD-1) linked to familial amyotrophic lateral sclerosis (ALS) ...against unfolding and aggregation but exhibited poor binding specificity toward SOD-1 in presence of blood plasma. A reasonable but not a conclusive model for the binding of these molecules was proposed on the basis of restricted docking calculations and site-directed mutagenesis of key residues at the dimer interface. A set of hydrogen bonding constraints obtained from these experiments were used to guide docking calculations with compound library around the dimer interface. A series of chemically unrelated hits were predicted, which were experimentally tested for their ability to block aggregation. At least six of the new molecules exhibited high specificity of binding toward SOD-1 in the presence of blood plasma. These molecules represent a new class of molecules for further development into clinical candidates.
In this letter, we demonstrate the improved performance of 1.3-mum seven-layered InAs-GaAs quantum-dot superluminescent light-emitting diodes by the engineering of the epitaxial growth conditions ...alone, namely the thickness of the low-temperature GaAs spacer layer between quantum-dot layers. For laser devices, a significant reduction in threshold current density and increase in external efficiency is observed, while for superluminescent diode structures, a ~4 fold increase in CW power at a given drive current is obtained
In this letter, we demonstrate the improved performance of 1.3-mum seven-layered InAs-GaAs quantum-dot superluminescent light-emitting diodes by the engineering of the epitaxial growth conditions ...alone, namely the thickness of the low-temperature GaAs spacer layer between quantum-dot layers. For laser devices, a significant reduction in threshold current density and increase in external efficiency is observed, while for superluminescent diode structures, a 4 fold increase in CW power at a given drive current is obtained.
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