British Society of Gastroenterology guidelines on sedation in gastrointestinal endoscopy.

Over 2.5 million gastrointestinal endoscopic procedures are carried out in the United Kingdom (UK) every year. Procedures are carried out with local anaesthetic r with sedation.

Beam Spray Thresholds in ICF-Relevant Plasmas.

Beam spray measurements suggest thresholds that are a factor of ≈2 to 15× less than expected based on the filamentation figure of merit often quoted in the literature. In this moderate-intensity regime, the relevant mechanism is forward stimulated Brillouin scattering. Both weak ion acoustic wave damping and thermal enhancement of ion acoustic waves contribute to the low thresholds.

Spatiotemporal control of laser intensity through cross-phase modulation.

Spatiotemporal pulse shaping provides control over the trajectory and range of an intensity peak. While this control can enhance laser-based applications, the optical configurations required for shaping the pulse can constrain the transverse or temporal profile, duration, or orbital angular momentum (OAM). Here we present a novel technique for spatiotemporal control that mitigates these constraints by using a "stencil" pulse to spatiotemporally structure a second, primary pulse through cross-phase modulation (XPM) in a Kerr lens.

High-flow nasal oxygen, procedural sedation, and clinical governance.

Procedural sedation for therapeutic and diagnostic procedures can now be achieved through deep sedation techniques that guarantee procedural success. Deep sedation techniques are delivered in a variety of non-theatre environments where the usual levels of anesthetic equipment are not practical or economical. Hypoxic events are particularly frequent, and challenge sedation providers.

Nonlinear spatiotemporal control of laser intensity.

Spatiotemporal control over the intensity of a laser pulse has the potential to enable or revolutionize a wide range of laser-based applications that currently suffer from the poor flexibility offered by conventional optics. Specifically, these optics limit the region of high intensity to the Rayleigh range and provide little to no control over the trajectory of the peak intensity. Here, we introduce a nonlinear technique for spatiotemporal control, the "self-flying focus," that produces an arbitrary trajectory intensity peak that can be sustained for distances comparable to the focal length.

Anesthetic management of peripartum cardiomyopathy.

Introduction: Peripartum cardiomyopathy (PPCM) is a rare idiopathic cardiomyopathy frequently presenting with heart failure secondary to left ventricular systolic dysfunction towards the end of pregnancy or in the months following delivery. Within the published literature, there are case reports extolling the safety of both regional and general anesthetic interventions in PPCM. However, there is an absence of high-quality evidence to define a suitable paradigm for peri-operative care.

Measurement and control of large diameter ionization waves of arbitrary velocity.

Large diameter, flying focus driven ionization waves of arbitrary velocity (IWAV's) were produced by a defocused laser beam in a hydrogen gas jet, and their spatial and temporal electron density characteristics were measured using a novel, spectrally resolved interferometry diagnostic. A simple analytic model predicts the effects of power spectrum non-uniformity on the IWAV trajectory and transverse profile. This model compares well with the measured data and suggests that spectral shaping can be used to customize IWAV behavior and increase controlled propagation of ionization fronts for plasma-photonics applications.

Deep sedation and anaesthesia in complex gastrointestinal endoscopy: a joint position statement endorsed by the British Society of Gastroenterology (BSG), Joint Advisory Group (JAG) and Royal College of Anaesthetists (RCoA).

In the UK, more than 2.5 million endoscopic procedures are carried out each year. Most are performed under conscious sedation with benzodiazepines and opioids administered by the endoscopist.

Paradigm shift: should the elderly undergo propofol sedation for DBE? A prospective cohort study.

Objective: Evaluate the safety of propofol-assisted double balloon enteroscopy (DBE) in elderly patients against a younger cohort.

Design: Prospective cohort study.

Setting: All patients undergoing DBE over a 30-month period were recruited at our tertiary centre.

Mild and Regioselective Pd(OAc)-Catalyzed C-H Arylation of Tryptophans by [ArN]X, Promoted by Tosic Acid.

A regioselective Pd-mediated C-H bond arylation methodology for tryptophans, utilizing stable aryldiazonium salts, affords C2-arylated tryptophan derivatives, in several cases quantitatively. The reactions proceed in air, without base, and at room temperature in EtOAc. The synthetic methodology has been evaluated and compared against other tryptophan derivative arylation methods using the CHEM21 green chemistry toolkit.

A Systematic Appraisal of Neurosurgical Seizure Prophylaxis: Guidance for Critical Care Management.

Clinical decisions are often made in the presence of some uncertainty. Health care should be based on a combination of scientific evidence, clinical experience, economics, patient value judgments, and preferences. Seizures are not uncommon following brain injury, surgical trauma, hemorrhage, altered brain metabolism, hypoxia, or ischemic events.

Psychological Factors as Outcome Predictors for Spinal Cord Stimulation.

Background And Aims: The mechanism of action of spinal cord stimulation (SCS) is poorly understood and the success of treatment can depend on factors beyond the technical aspects of implantation. The aim of this retrospective analysis is the identification of preimplantation psychological values that may predict outcome of SCS treatment.

Methods: The retrospective analysis consisted of data from 83 patients who underwent SCS implantation from 2005 to 2013.

Shade provision for UV minimization: a review.

Minimizing exposure to ultraviolet (UV) radiation is an essential component of skin cancer prevention. Providing and using natural and built shade is an effective protection measure against harmful UV. This article describes the factors that must be addressed to ensure quality, effective, well-designed shade and recommends best practice approaches to improving the protection factor (PF) of shade structures.

Dosimetric and radiobiological consequences of computed tomography-guided adaptive strategies for intensity modulated radiation therapy of the prostate.

Purpose: To examine a range of scenarios for image-guided adaptive radiation therapy of prostate cancer, including different schedules for megavoltage CT imaging, patient repositioning, and dose replanning.

Methods And Materials: We simulated multifraction dose distributions with deformable registration using 35 sets of megavoltage CT scans of 13 patients. We computed cumulative dose-volume histograms, from which tumor control probabilities and normal tissue complication probabilities (NTCPs) for rectum were calculated.

Influence of high levels of cloud cover on vitamin D effective and erythemal solar UV irradiances.

The solar irradiances for the initiation of vitamin D synthesis (UV(D3)) have been measured concurrently with the amount of cloud cover to investigate the influence of high cloud cover fraction. The cases of 6.5 and more octa cloud cover were considered for five solar zenith angle (SZA) ranges up to 80°.

Potential dosemeter for quantifying biologically effective blue light exposures.

This paper reports on the development of a blue light (VIS(BL)) dosemeter. The VIS(BL) dosemeter is based on the combination of polysulfone and phenothiazine as a potential VIS(BL) dosemeter for population studies of exposures related to the blue light hazard. This research found that this combination of photosensitive chromophores reacts to both ultraviolet and visible wavelengths of the solar spectrum.