Internal Delensing of Cosmic Microwave Background Polarization B-Modes with the POLARBEAR Experiment.

Using only cosmic microwave background polarization data from the polarbear experiment, we measure B-mode polarization delensing on subdegree scales at more than 5σ significance. We achieve a 14% B-mode power variance reduction, the highest to date for internal delensing, and improve this result to 22% by applying for the first time an iterative maximum a posteriori delensing method. Our analysis demonstrates the capability of internal delensing as a means of improving constraints on inflationary models, paving the way for the optimal analysis of next-generation primordial B-mode experiments.

Systematic effects from an ambient-temperature, continuously rotating half-wave plate.

We present an evaluation of systematic effects associated with a continuously rotating, ambient-temperature half-wave plate (HWP) based on two seasons of data from the Atacama B-Mode Search (ABS) experiment located in the Atacama Desert of Chile. The ABS experiment is a microwave telescope sensitive at 145 GHz. Here we present our in-field evaluation of celestial (Cosmic Microwave Background (CMB) plus galactic foreground) temperature-to-polarization leakage. We decompose the leakage into scalar, dipole, and quadrupole leakage terms. We report a scalar leakage of ∼0.01%, consistent with model expectations and an order of magnitude smaller than other CMB experiments have been reported. No significant dipole or quadrupole terms are detected; we constrain each to be <0.07% (95% confidence), limited by statistical uncertainty in our measurement. Dipole and quadrupole leakage at this level lead to systematic error on r ≲ 0.01 before any mitigation due to scan cross-linking or boresight rotation. The measured scalar leakage and the theoretical level of dipole and quadrupole leakage produce systematic error of r < 0.001 for the ABS survey and focal-plane layout before any data correction such as so-called deprojection. This demonstrates that ABS achieves significant beam systematic error mitigation from its HWP and shows the promise of continuously rotating HWPs for future experiments.

Patient outcomes and provider perceptions following implementation of a standardized perioperative care pathway for open liver resection.

BACKGROUND: Enhanced recovery after surgery (ERAS) pathways have been associated with improved perioperative outcomes following several surgical procedures. Less is known, however, regarding their use following hepatic surgery. METHODS: An evidence-based, standardized perioperative care pathway was developed and implemented prospectively among patients undergoing open liver surgery between 1 January 2014 and 31 July 2015. Perioperative outcomes, including length of hospital stay, postoperative complications and healthcare costs, were compared between groups of patients who had surgery before and after introduction of the ERAS pathway. Provider perceptions regarding the perioperative pathway were assessed using an online questionnaire. RESULTS: There were no differences in patient or disease characteristics between pre-ERAS (42 patients) and post-ERAS (75) groups. Although mean pain scores were comparable between the two groups, patients treated within the ERAS pathway had a marked reduction in opioid use on the first 3 days after surgery compared with those treated before introduction of the pathway (all P < 0·001). Duration of hospital stay was shorter in the post-ERAS group (median 5 (i.q.r. 4-7) days versus 6 (5-7) days in the pre-ERAS group; P = 0·037) and there was a lower incidence of postoperative complications (1 versus 10 per cent; P = 0·036). Implementation of the ERAS pathway was associated with a 40·7 per cent decrease in laboratory costs (-US $333; -€306, exchange rate 4 January 2016) and a 21·5 per cent reduction in medical supply costs (-US $394; -€362) per patient. Although 91·0 per cent of providers endorsed the ERAS pathway, 33·8 per cent identified provider aversion to a standardized protocol as the greatest hurdle to implementation. CONCLUSION: The introduction of a multimodal ERAS programme following open liver surgery was associated with a reduction in opioid use, shorter hospital stay and decreased hospital costs. ERAS was endorsed by an overwhelming majority of providers.

In-patient diabetes care: the impact of diabetes outreach team on long-term glycaemic control.

AIM: Our aim is to assess the impact of inpatient diabetes services on glycaemic control in patient with diabetes admitted to a secondary care hospital in UK. METHODS: We performed a retrospective analysis of all diabetes mellitus (DM) in-patients who were seen by our Diabetes Outreach Team from June 2007 to December 2010. Those with an admission diagnosis of hypoglycaemia were excluded. Blood samples including HbA1c at the initial visit and subsequent outpatient follow-up at 3-6 months were collected. Patients admitted with newly diagnosed diabetes were analysed separately. RESULTS: In total 2002 patient data were captured. 778 patients were eliminated initially because of failure to attend follow-up clinic, lack of follow-up HbA1c data, and because of planned discharge to the community. Complete blood samples were available for 1224 patients. Of this, 235 patients (19.2% of those with complete data) were analysed separately as their primary diagnosis was hypoglycaemia. In the remaining 989 patients, 31 (3.1%) new onset Type 1 DM patients and 91 (9.2%) new onset Type 2 patients were analysed separately. In patients with known DM (n = 867) HbA1c improved from 75 mmol/mol (9.0% ± 2.39) to 69 mmol/mol (8.46% ± 2.0) (p < 0.001). In the newly diagnosed Type 1 DM (n = 31) patients HbA1c improved from 114 mmol/mol (12.55% ± 2.27) to 58 mmol/mol (7.43% ± 2.05) (p < 0.001). In the newly diagnosed Type 2 DM (n = 91) patients HbA1c improved from 93 mmol/mol (10.70% ± 3.04) to 56 mol/mol (7.29% ± 1.74) (p < 0.001). In those who presented with hypoglycaemia (n = 235) HbA1c changed from 58 mmol/mol (7.48% ± 1.59) to 59 mmol/mol (7.59% ± 1.57) (p = 0.2). CONCLUSION: By providing a comprehensive care, structured education and appropriate intervention through our Diabetes Outreach Team, we have shown a significant reduction in HbA1c for recently hospitalised patients.

Printing conducting polymers.

Recent developments in both materials science and printing technologies have led to a rapid expansion in the field of printed conducting polymers. This review provides an overview of the most common printing methods currently in use and the material requirements of each. Examples of printed devices fabricated from a range of conducting polymers are given with an emphasis on the development of sensors.

The influence of storing beef aerobically or in vacuum packs on the shelf life of mince.

AIMS: To investigate the influence of aerobic or vacuum pack storage of beef trimmings on the microbiology, colour and odour of subsequently produced mince. METHODS AND RESULTS: Trimmings stored aerobically for 7 or 10 days and in vacuum packs for 7, 10, 14 or 22 days at 0 or 5°C were minced, stored aerobically at 0 or 5°C for up to 7 days and examined daily to determine Total viable, Pseudomonas, Lactic acid bacteria, Brochothrix thermosphacta, and Enterobacteriaceae counts, colour and odour. Mincing reduced counts, particularly of Pseudomonas, B. thermosphacta and Enterobacteriaceae, probably because of the action free radicals released from muscle and bacterial cells. Storage of vacuum-packed trimmings for 22 days resulted in improved mince colour and inhibition of the growth of Pseudomonas. CONCLUSIONS: The shelf life of mince from trimmings is directly influenced by the trimmings storage conditions, and longer-term vacuum storage of trimmings produced improvements in mince quality. SIGNIFICANCE AND IMPACT OF THE STUDY: There appears to be no scientific rationale for limiting the storage of vacuum packaging beef trimmings to 15 days, prior to mince production, as stated in EU 835/2004. This study identifies advantages in storing trimmings in vacuum packs for at least 21 days prior to mincing, in terms of improved mince quality.

Survival of Pseudomonas fluorescens on beef carcass surfaces in a commercial abattoir.

The influence of a commercial chilling process (18 h at 10 degrees C followed by up to 78 h at 2 degrees C) on Pseudomonas fluorescens inoculated on beef carcass surfaces at four sites, neck (NE), outside round (OR), brisket (BR) and foreshank/brisket (FB) before chilling ("hot inoculated") or after chilling for 24h ("cold inoculated") was investigated. Pseudomonas counts increased significantly at all sites on "hot inoculated" carcasses during storage, but on "cold inoculated" carcasses, counts declined or remained unchanged. On hot and cold inoculated carcasses, differences in Pseudomonas growth or survival were demonstrated between sites. No clear relationships were observed between Pseudomonas growth or survival and chiller relative humidity (RH) or surface water activity (a(w)) at the different sites. These results were unexpected, and are discussed in relation to environmental factors that affect the growth/survival of P. fluorescens on carcass surfaces during chilling i.e. temperature, RH, and the relationship of these parameters to surface water activity (a(w)).

Changes in Escherichia coli O157:H7 numbers during holding on excised lean, fascia and fat beef surfaces at different temperatures.

AIM: To investigate changes in Escherichia coli O157:H7 numbers on excised beef carcass surfaces over 72 h at different temperatures. METHODS AND RESULTS: Excised lean meat, fascia and fat were inoculated with E. coli O157:H7 and held in an environmental chamber for 72 h, at air speed 0.5 m s(-1), relative humidity (RH) 90%, and temperatures 4, 8 and 12 degrees C. On lean, pathogen counts increased significantly at 12 degrees C. On fascia, significant reductions in counts occurred at 4 and 8 degrees C. Pathogen numbers were significantly reduced on fat at 4, 8 and 12 degrees C (64 h). Counts on fat were significantly less at all temperatures, compared to lean or fascia and surface water activity, a(w), decreased significantly over time on fat at 4 degrees C. Significant decreases in surface pH values were recorded on all meat substrates. CONCLUSIONS: The survival of E. coli O157:H7 varied in relation to the meat substrate and the holding temperature. Reductions in counts on fat surfaces appeared to be related to low surface a(w) values. No relationship between pathogen survival and surface pH was established. SIGNIFICANCE AND IMPACT OF THE STUDY: The use of excised meat pieces in an environmental cabinet offers a more flexible approach to determining the use of different chilling regimes in the production of safe meat.

Survival of Escherichia coli O157:H7 and non-pathogenic E. coli on irradiated and non-irradiated beef surfaces.

This study examined changes in numbers of pathogenic (PEC) and non-pathogenic (NPEC) Escherichia coli during storage at 10°C on the surfaces of irradiated (IR) and non-irradiated (NIR) meat pieces excised from the neck, brisket and rump of beef carcasses and in Brain Heart Infusion Broth (BHI) and Maximum Recovery Diluent (MRD). On irradiated meat pieces, there were significant differences between mean PEC and NPEC counts at all sites. Differences in counts were also observed between IR and NIR surfaces and among the three meat sites for both E. coli types. These differences occurred only on IR samples, suggesting that the irradiation associated reductions in normal beef surface flora influenced survival of both E. coli types. PEC and NPEC counts increased during storage in BHI, but only NPEC counts increased in MRD. The results of this study highlight the impact of meat surface type and the presence/absence of the normal beef carcass surface flora on E. coli survival and/or growth during meat storage. Such previously unreported effects, and their precise mechanisms, have direct implications in the development and application of accurate models for the prediction of the safety and shelf life of stored meat.

Changes in cardiovascular function during the sleep onset period in young adults.

Blood pressure (BP) and heart rate (HR) are influenced by the sleep-wake cycle, with relatively abrupt falls occurring in association with sleep onset (SO). However, the pattern and rate of fall in BP and HR during SO and the processes that contribute to the fall in these variables have not been fully identified. Continuous BP and HR recordings were collected beginning 1 h before lights out (LO) until the end of the first non-rapid eye movement sleep period in 21 young, healthy participants maintained in a supine position. Five consecutive phases were defined: 1) the 30 min of wakefulness before LO; 2) LO to stage 1 sleep; 3) stage 1 to stage 2 sleep; 4) stage 2 sleep to the last microarousal before stable sleep; and 5) the first 30 min of undisturbed stable sleep. The data were analyzed on a beat-by-beat basis and reported as 2-min periods for phases 1 and 5 and 10% epochs for phases 2, 3, and 4 (as participants had variable time periods in these phases). The level of baroreflex (BR) activity was assessed by the sequence technique and an autoregressive multivariate model. Furthermore, during phases 3 and 4, the BP and HR responses to arousal from sleep were determined. There were substantial falls in BP and HR after LO before the initial onset of theta;-activity (phase 3) and again after the onset of stable sleep after the cessation of spontaneous arousals. During phases 3 and 4 when there were repeated arousals from sleep, the fall in both variables was retarded. Furthermore, both the rate and magnitude of the fall in BP were negatively associated with the number of arousals during phases 3 and 4. There was a small increase in the sensitivity of the BR and indirect evidence of a substantial fall in its set point.

Parents explain more often to boys than to girls during shared scientific thinking.

Young children's everyday scientific thinking often occurs in the context of parent-child interactions. In a study of naturally occurring family conversation, parents were three times more likely to explain science to boys than to girls while using interactive science exhibits in a museum. This difference in explanation occurred despite the fact that parents were equally likely to talk to their male and female children about how to use the exhibits and about the evidence generated by the exhibits. The findings suggest that parents engaged in informal science activities with their children may be unintentionally contributing to a gender gap in children's scientific literacy well before children encounter formal science instruction in grade school.

Pulmonary tuberculosis in pregnancy.

Tuberculosis (TB) was once a formidable public health hazard but is now less feared because of the development of an armamentarium of effective drugs. The incidence of TB had been declining for decades until recently when the number of cases of TB began to rise. The most obvious reasons for this trend were the rising rate of human immunodeficiency virus infection and the development of multiple drug-resistant TB. The largest percentage increase in TB cases occurred among persons 25 to 44 years of age; many of them are women. A number of these women will first be diagnosed with TB infection during pregnancy. It is important for the clinician to be aware of the impact of TB on this population. Patients must be screened as recommended by the Centers for Disease Control and Prevention because it is important to quickly diagnose TB. Prompt and effective therapy will benefit the mother and the neonate. This article reviews the diagnosis, prevention, and treatment regimens of TB in pregnancy, as well as the effects on the HIV patient, the neonate, and breastfeeding. Prompt recognition and treatment of TB infection will ensure that the rates of TB cases decline.

A rapid method to detect dried saliva stains swabbed from human skin using fluorescence spectroscopy.

Saliva on skin is important in forensic trace evidence. If areas where saliva is present can be outlined, this may lead to DNA analysis and identification. This study describes a rapid and non-destructive method to detect dried saliva on the surface of the skin by fluorescence spectroscopy. Eighty-two volunteers deposited samples of their own saliva on the skin of their ventral forearm. A control sample of water was deposited at three different sites on the contralateral arm. Saliva and water control were then allowed to air-dry. Swab samples were taken from dried saliva and control sites and were dissolved in 0.1M KCl solution. Emission spectra were obtained from the solution and were characterized by a principal maximum at 345-355nm with excitation at 282nm. The fluorescence emission intensity was greater than background readings obtained from the control swab site in 80 of 82 volunteers (approximately 97.6%). The fluorescence profile of saliva samples were similar to those obtained from aqueous samples of pure amylase and tryptophan, an endogenous fluorophore in alpha-amylase. The presence of an emission peak at 345-355nm with excitation at 282nm could provide a strong presumptive indication of saliva deposition.

Characterization of oleic acid and propranolol oleate mesomorphism using (13)C solid-state nuclear magnetic resonance spectroscopy (SSNMR).

Lipids regularly exhibit complicated thermotropic and lyotropic phase behavior. In this study, the utility of (13)C solid-state nuclear magnetic resonance spectroscopy (SSNMR) in characterizing the phase properties of pharmaceutical lipids was investigated. Variable temperature (13)C SSNMR spectra and spin-lattice relaxation times (T(1)(C)) were obtained for high-purity oleic acid (OA) and propranolol oleate (POA). Spectral changes took place following OA gamma-to-alpha phase transition that indicated increased nuclear inequivalence of aliphatic chain carbons in the alpha phase. T(1)(C) data for the alpha phase demonstrated considerable conformational changes throughout the aliphatic chain, not solely in the methyl side chain as previously reported. These data support alpha-OA classification as a conformationally disordered crystalline phase. The prevalence of low T(1)(C) values in both POA I and II suggested the absence of a rigid crystalline molecular lattice, so both phases were described as conformationally disordered crystalline phases. A two-phase mixture of POA I and II was also identified, emphasizing the sensitivity of this technique. (13)C SSNMR provided valuable information regarding the nuclear environment of specific functional groups in lipid crystalline and mesomorphic structures. Understanding phase behavior at the molecular level can aid selection of appropriate formulation strategies for lipids by allowing prediction of processing properties, and physical and chemical stability. (13)C SSNMR is a powerful technique for pharmaceutical lipid characterization.

Drug-fatty acid salt with wax-like properties employed as binder in melt granulation.

The tacky and deformable properties of a wax-like drug-fatty acid salt, propranolol oleate (POA), make particle size reduction and separation challenging. The aim of this study was to investigate the use of POA as binder in a melt granulation procedure to improve processing properties. POA is a suitable candidate for binder phase in melt granulation with a melting temperature of 50-56 degrees C. Small batches (ca 30 g) were manufactured using a high shear mixer with lactose monohydrate as the substrate phase. Optimum uniformity of drug content and minimum friability were found at 10% w/w POA binder concentration. POA melt granules exhibited a >10-fold increase in the rate of in vitro dissolution at pH 7.4 with 0.2% w/v sodium lauryl sulphate compared with raw POA. The increased drug surface area in granular form was thought to be responsible for the change in dissolution behaviour. This study has demonstrated that melt granulation using POA as binder is a viable process which leads to beneficial changes in dissolution behaviour for the lipophilic drug-fatty acid salt.

Factors relating to readmission of term and near-term neonates in the first two weeks of life. Early Discharge Survey Group of the Health Professional Advisory Board of the Greater New York Chapter of the March of Dimes.

AIMS: A multisite study of term and near term infants readmitted in the first two weeks of life to 9 New York City area hospitals in 1995 was conducted to evaluate factors related to readmission, including length of newborn stay. RESULTS: Of the 30,884 infants born at the 9 study hospitals 391 newborns were readmitted. The major admission diagnoses were infection, 40.7%, hyperbilirubinemia, 39.1%, and feeding and/or gastrointestinal problems, 10.5%. In the first week, 65.1% of readmissions were for hyperbilirubinemia and 19.1% were for infection or suspected sepsis. In the second week, 67.8% of readmissions were for infection and 7.6% were for hyperbilirubinemia. Hyperbilirubinemia was the most frequent diagnosis for White and Asian infants, while infection was most frequent for African-American and Hispanic infants. Age at readmission was younger and the interval from discharge was shorter for infants with hyperbilirubinemia. Abnormalities which should have precluded early discharge included feeding difficulties, cyanotic congenital heart defects, hemolytic disease of the newborn, early jaundice or early high bilirubin levels. CONCLUSION: Attention to identification of infants at risk and programs such as lactation counseling and universal screening for bilirubin (with appropriate interpretation) prior to discharge could have reduced the necessity for readmission regardless of the newborn length of stay.