We present the main findings of the 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia (AAGA). Incidences were estimated using reports of accidental awareness as the ...numerator, and a parallel national anaesthetic activity survey to provide denominator data. The incidence of certain/probable and possible accidental awareness cases was ∼1:19 600 anaesthetics (95% confidence interval 1:16 700–23 450). However, there was considerable variation across subtypes of techniques or subspecialities. The incidence with neuromuscular block (NMB) was ∼1:8200 (1:7030–9700), and without, it was ∼1:135 900 (1:78 600–299 000). The cases of AAGA reported to NAP5 were overwhelmingly cases of unintended awareness during NMB. The incidence of accidental awareness during Caesarean section was ∼1:670 (1:380–1300). Two-thirds (82, 66%) of cases of accidental awareness experiences arose in the dynamic phases of anaesthesia, namely induction of and emergence from anaesthesia. During induction of anaesthesia, contributory factors included: use of thiopental, rapid sequence induction, obesity, difficult airway management, NMB, and interruptions of anaesthetic delivery during movement from anaesthetic room to theatre. During emergence from anaesthesia, residual paralysis was perceived by patients as accidental awareness, and commonly related to a failure to ensure full return of motor capacity. One-third (43, 33%) of accidental awareness events arose during the maintenance phase of anaesthesia, mostly due to problems at induction or towards the end of anaesthesia. Factors increasing the risk of accidental awareness included: female sex, age (younger adults, but not children), obesity, anaesthetist seniority (junior trainees), previous awareness, out-of-hours operating, emergencies, type of surgery (obstetric, cardiac, thoracic), and use of NMB. The following factors were not risk factors for accidental awareness: ASA physical status, race, and use or omission of nitrous oxide. We recommend that an anaesthetic checklist, to be an integral part of the World Health Organization Safer Surgery checklist, is introduced as an aid to preventing accidental awareness. This paper is a shortened version describing the main findings from NAP5—the full report can be found at http://www.nationalauditprojects.org.uk/NAP5_home.
We present results of a long-baseline interferometry campaign using the PAVO beam combiner at the CHARA Array to measure the angular sizes of five main-sequence stars, one subgiant and four red giant ...stars for which solar-like oscillations have been detected by either Kepler or CoRoT. By combining interferomettic angular diameters, Hipparcos parallaxes, asteroseismic densities, bolometric fluxes, and high-resolution spectroscopy, we derive a full set of near-model-independent fundamental properties for the sample. We first use these properties to test asteroseismic scaling relations for the frequency of maximum power (v sub(max)) and the large frequency separation ( Delta v). We find excellent agreement within the observational uncertainties, and empirically show that simple estimates of asteroseismic radii for main-sequence stars are accurate to lap4%. We furthermore find good agreement of our measured effective temperatures with spectroscopic and photometric estimates with mean deviations for stars between T sub(eff) = 4600-6200 K of -22 + or - 32 K (with a scatter of 97 K) and -58 + or - 31 K (with a scatter of 93 K), respectively. Finally, we present a first comparison with evolutionary models, and find differences between observed and theoretical properties for the metal-rich main-sequence star HD 173701. We conclude that the constraints presented in this study will have strong potential for testing stellar model physics, in particular when combined with detailed modeling of individual oscillation frequencies.
Bispectrum phase, closure phase and their generalization to kernel phase are all independent of pupil-plane phase errors to first order. This property, when used with sparse aperture masking behind ...adaptive optics, has been used recently in high-contrast observations at or inside the formal diffraction limit of large telescopes. Finding the limitations to these techniques requires an understanding of spatial and temporal third-order phase effects, as well as effects such as time-variable dispersion when coupled with the non-zero bandwidths in real observations. In this paper, formulae describing many of these errors are developed, so that a comparison can be made to fundamental noise processes of photon noise and background noise.
I show that the current generation of aperture-masking observations of young solar-type stars, taken carefully in excellent observing conditions, are consistent with being limited by temporal phase noise and photon noise. This has relevance for plans to combine pupil remapping with spatial filtering.
Finally, I describe calibration strategies for kernel phase, including the optimized calibrator weighting as used for LkCa15, and the restricted kernel phase POISE (phase observationally independent of systematic errors) technique that avoids explicit dependence on calibrators.
The GALAH survey: scientific motivation De Silva, G. M; Freeman, K. C; Bland-Hawthorn, J ...
Monthly Notices of the Royal Astronomical Society,
05/2015, Volume:
449, Issue:
3
Journal Article
Peer reviewed
Open access
The Galactic Archaeology with HERMES (GALAH) survey is a large high-resolution spectroscopic survey using the newly commissioned High Efficiency and Resolution Multi-Element Spectrograph (HERMES) on ...the Anglo-Australian Telescope. The HERMES spectrograph provides high-resolution (R ∼ 28 000) spectra in four passbands for 392 stars simultaneously over a 2 deg field of view. The goal of the survey is to unravel the formation and evolutionary history of the Milky Way, using fossil remnants of ancient star formation events which have been disrupted and are now dispersed throughout the Galaxy. Chemical tagging seeks to identify such dispersed remnants solely from their common and unique chemical signatures; these groups are unidentifiable from their spatial, photometric or kinematic properties. To carry out chemical tagging, the GALAH survey will acquire spectra for a million stars down to V ∼ 14. The HERMES spectra of FGK stars contain absorption lines from 29 elements including light proton-capture elements, α-elements, odd-Z elements, iron-peak elements and n-capture elements from the light and heavy s-process and the r-process. This paper describes the motivation and planned execution of the GALAH survey, and presents some results on the first-light performance of HERMES.
We present new 0.6-4 m imaging of the SR 21 transition disk from Keck/NIRC2 and Magellan/MagAO. The protoplanetary disk around SR 21 has a large (∼30-40 au) clearing first inferred from its spectral ...energy distribution and later detected in submillimeter imaging. Both the gas and small dust grains are known to have a different morphology, with an inner truncation in CO at ∼7 au, and micron-sized dust detected within the millimeter clearing. Previous near-infrared imaging could not distinguish between an inner dust disk with a truncation at ∼7 au or one that extended to the sublimation radius. The imaging data presented here require an inner dust disk radius of a few au, and complex structure such as a warp or spiral. We present a parametric warped disk model that can reproduce the observations. Reconciling the images with the spectral energy distribution gathered from the literature suggests grain growth to 2-5 m within the submillimeter clearing. The complex disk structure and possible grain growth can be connected to dynamical shaping by a giant-planet-mass companion, a scenario supported by previous observational and theoretical studies.
Summary
This guideline updates and replaces the 4th edition of the AAGBI Standards of Monitoring published in 2007. The aim of this document is to provide guidance on the minimum standards for ...physiological monitoring of any patient undergoing anaesthesia or sedation under the care of an anaesthetist. The recommendations are primarily aimed at anaesthetists practising in the United Kingdom and Ireland. Minimum standards for monitoring patients during anaesthesia and in the recovery phase are included. There is also guidance on monitoring patients undergoing sedation and also during transfer of anaesthetised or sedated patients. There are new sections discussing the role of monitoring depth of anaesthesia, neuromuscular blockade and cardiac output. The indications for end‐tidal carbon dioxide monitoring have been updated.
Summary
We present the main findings of the 5th National Audit Project on accidental awareness during general anaesthesia. Incidences were estimated using reports of accidental awareness as the ...numerator, and a parallel national anaesthetic activity survey to provide denominator data. The incidence of certain/probable and possible accidental awareness cases was ~1:19 600 anaesthetics (95% CI 1:16 700–23 450). However, there was considerable variation across subtypes of techniques or subspecialties. The incidence with neuromuscular blockade was ~1:8200 (1:7030–9700), and without it was ~1:135 900 (1:78 600–299 000). The cases of accidental awareness during general anaesthesia reported to 5th National Audit Project were overwhelmingly cases of unintended awareness during neuromuscular blockade. The incidence of accidental awareness during caesarean section was ~1:670 (1:380–1300). Two thirds (82, 66%) of cases of accidental awareness experiences arose in the dynamic phases of anaesthesia, namely induction of and emergence from anaesthesia. During induction of anaesthesia, contributory factors included: use of thiopental; rapid sequence induction; obesity; difficult airway management; neuromuscular blockade; and interruptions of anaesthetic delivery during movement from anaesthetic room to theatre. During emergence from anaesthesia, residual paralysis was perceived by patients as accidental awareness, and commonly related to a failure to ensure full return of motor capacity. One third (43, 33%) of accidental awareness events arose during the maintenance phase of anaesthesia, most due to problems at induction or towards the end of anaesthesia. Factors increasing the risk of accidental awareness included: female sex; age (younger adults, but not children); obesity; anaesthetist seniority (junior trainees); previous awareness; out‐of‐hours operating; emergencies; type of surgery (obstetric, cardiac, thoracic); and use of neuromuscular blockade. The following factors were not risk factors for accidental awareness: ASA physical status; race; and use or omission of nitrous oxide. We recommend that an anaesthetic checklist, to be an integral part of the World Health Organization Safer Surgery checklist, is introduced as an aid to preventing accidental awareness. This paper is a shortened version describing the main findings from 5th National Audit Project – the full report can be found at http://www.nationalauditprojects.org.uk/NAP5_home#pt.
Increasing attention is being paid to how adults on the autism spectrum perceive and interpret the interoceptive sense. This 20-item Interoception Sensory Questionnaire represents a single factor ...scale that can be interpreted as representing confusion about interoceptive bodily states unless these states are extreme (Alexisomia), and has been designed to discriminate across populations (total sample 511 participants). Findings showed that 74% of adults with autism reported interoceptive confusion. Another finding of the study was that as autistic traits increased, interoceptive confusion increased, with adults with diagnosed autism scoring highest on the construct. Implications for physiological self-regulation as well as physical health outcomes are discussed, as well as recommendations for future research.
We present 237 new spectroscopically confirmed pre-main-sequence K- and M-type stars in the young Upper Scorpius subgroup of the Sco–Cen association, the nearest region of recent massive star ...formation. Using the Wide-Field Spectrograph at the Australian National University 2.3 m telescope at Siding Spring, we observed 397 kinematically and photometrically selected candidate members of Upper Scorpius, and identified new members by the presence of lithium absorption. The HR-diagram of the new members shows a spread of ages, ranging from ∼3 to 20 Myr, which broadly agrees with the current age estimates of ∼5–10 Myr. We find a significant range of Li 6708 equivalent widths among the members, and a minor dependence of HR-diagram position on the measured equivalent width of the Li 6708 Å line, with members that appear younger having more lithium. This could indicate the presence of either populations of different age, or a spread of ages in Upper Scorpius. We also use Wide-Field Infrared Survey Explorer data to infer circumstellar disc presence in 25 of the members on the basis of infrared excesses, including two candidate transition discs. We find that 11.2 ± 3.4 per cent of the M0–M2 spectral type (0.4–0.8 M⊙) Upper Sco stars display an excess that indicates the presence of a gaseous disc.
The process of bone formation, remodelling and healing involves a coordinated action of various cell types. Advances in understanding the biology of osteoblast cells during these processes have been ...enabled through the use of various in vitro culture models from different origins. In an era of intensive bone tissue engineering research, these cell models are more and more often applied due to limited availability of primary human osteoblast cells. While they are a helpful tool in developing novel therapies or biomaterials; concerns arise regarding their phenotypic state and differences in relation to primary human osteoblast cells. In this review we discuss the osteoblastic development of some of the available cell models; such as primary human, rat, mouse, bovine, ovine and rabbit osteoblast cells; as well as MC3T3-E1, MG-63 and SaOs-2 cell lines, together with their advantages and disadvantages. Through this, we provide suggestions on the selection of the appropriate and most relevant osteoblast model for in vitro studies, with specific emphasis on cell-material based studies.
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