Infrared spectroscopy of asymptotic giant branch stars in the Galactic bulge

We have selected a homogeneous sample of asymptotic giant branch (AGB) stars in the Galactic bulge population from the ISOGAL survey. Our target stars cover a wide range of mass-loss rates (∼10−8-10−4 M⊙ yr−1) and differ primarily by their age on the AGB. This homogeneous sample is thus ideally suited to study the dust formation process as a function of age on the AGB. We observed our sample with Spitzer-Infrared Spectrograph, and studied the overall properties of the infrared spectra of these targets. The analysis is complicated by the presence of strong and variable background emission, and the extracted infrared AGB star spectra are affected by interstellar extinction. Several stars in our sample have no detectable dust emission, and we used these ‘naked stars’ to characterize the stellar and molecular contributions to the infrared spectra of our target stars. The resulting dust spectra of our targets do indeed show significant variety in their spectral appearance, pointing to differing dust compositions for the targets. We classify the spectra based on the shape of their 10-μm emission following the scheme by Sloan & Price. We find that the early silicate emission classes associated with oxide dust are generally under-represented in our sample due to extinction effects. We also find a weak 13-μm dust feature in two of our otherwise naked star spectra, suggesting that the carrier of this feature could potentially be the first condensate in the sequence of dust condensation

One life ends, another begins: Management of a brain-dead pregnant mother - A systematic review -

Background: An accident or a catastrophic disease may occasionally lead to brain death (BD) during pregnancy. Management of brain-dead pregnant patients needs to follow special strategies to support the mother in a way that she can deliver a viable and healthy child and, whenever possible, also be an organ donor. This review discusses the management of brain-dead mothers and gives an overview of recommendations concerning the organ supporting therapy. Methods: To obtain information on brain-dead pregnant women, we performed a systematic review of Medline, EMBASE and the Cochrane Central Register of Controlled Trials (CENTRAL). The collected data included the age of the mother, the cause of brain death, maternal medical complications, gestational age at BD, duration of extended life support, gestational age at delivery, indication of delivery, neonatal outcome, organ donation of the mothers and patient and graft outcome. Results: In our search of the literature, we found 30 cases reported between1982 and 2010. A nontraumatic brain injury was the cause of BD in 26 of 30 mothers. The maternal mean age at the time of BD was 26.5 years. The mean gestational age at the time of BD and the mean gestational age at delivery were 22 and 29.5 weeks, respectively. Twelve viable infants were born and survived the neonatal period. Conclusion: The management of a brain-dead pregnant woman requires a multidisciplinary team which should follow available standards, guidelines and recommendations both for a nontraumatic therapy of the fetus and for an organ-preserving treatment of the potential donor

Can load carriage system weight, design and placement affect pain and discomfort? A systematic review

Purpose: A systematic review of the literature was conducted to answer the following questions: 1. Does usage or weight of load carriage system cause pain, perceived exertion or discomfort? 2. Can load carriage system placement on the spine influence pain, perceived exertion or discomfort? 3. Can load carriage system design influence the amount of pain, perceived exertion or discomfort caused by their use? Method: Eight databases were searched. Each included study was analysed and quality appraised by two independent reviewers. Results: Forty-seven articles that addressed the research questions were included in the study. Significant variability in the study design and populations of the studies prevented data pooling and the evidence is conflicting. However, qualitative synthesis of the studies shows that carrying loads may provoke low back pain; and it may also trigger neck, thoracic and shoulder pain. Backpack weight can influence perceived pain, however other factors are involved. Discussion: There is conflicting but positive evidence on the correlation between backpack load carrying and experiencing pain during different stages of life. The research to date is lacking with the most commonly identified methodological deficiencies being poor overall design, the lack of justification of sample size, providing training sessions for examiners, and not utilising calibrated, valid and reliable instruments for measurement

Comparison of the efficacy of a neutral wrist splint and a wrist splint incorporating a lumbrical unit for the treatment of patients with carpal tunnel syndrome

Background: Different types of splints have been used as a conservative intervention to improve symptoms in patients with Carpal tunnel syndrome (CTS). Although a number of studies have been undertaken to compare different splints, information and understanding of the influence of these interventions are lacking. Objectives: The purpose of this study was to compare the effect of a classic thermoplastic wrist splint or a wrist splint with an additional metacarpophalangeal unit on pain, function, grip strength, and pinch strength in patients with mild-to-moderate carpal tunnel syndrome. Study design: Quasi experimental design. Methods: A total of 24 patients received conservative treatment using either the classic wrist splint or the wrist splint with the metacarpophalangeal unit for a period of 6 weeks. Primary outcome measures were pain, function, grip strength, and pinch strength. Data were collected immediately before and after using the two types of splints at baseline (0 weeks) and 6 weeks. Statistical analysis was performed using the paired t-test and an independent t-test. Results: Compared to baseline, both the classic thermoplastic wrist splint and the wrist splint with a metacarpophalangeal unit significantly decreased pain and increased function, pinch strength, and grip strength. Comparisons of the two types of splints for grip strength (P = 0.675) and pinch strength (P = 0.650) revealed that there were no significant differences between the two after 6 weeks of wear. However, there were significant differences in pain levels (P = 0.022) and the Disability of the Arm, Shoulder, and Hand score (P = 0.027) between the two types of splints from baseline to 6 weeks. Conclusion: The wrist splint with a metacarpophalangeal unit was more effective than the classic thermoplastic wrist splint in pain reduction and improvement of function. Clinical relevance A wrist splint with a metacarpophalangeal unit may be an appropriate conservative treatment in the rehabilitation of patients with mild-to-moderate carpal tunnel syndrome. © International Society for Prosthetics and Orthotics