A novel technique for post-pyloric feeding tube placement in critically ill patients: A pilot study

Publisher's copy made available with the permission of the publisher © Australian Society of AnaesthetistsDelivery of enteral nutrition in critically ill patients is often hampered by gastric stasis necessitating direct feeding into the small intestine. Current techniques for placement of post-pyloric feeding catheters are complex, time consuming or both, and improvements in feeding tube placement techniques are required. The Cathlocator™ is a novel device that permits real time localisation of the end of feeding tubes via detection of a magnetic field generated by a small electric current in a coil incorporated in the tip of the tube. We performed a pilot study evaluating the feasibility of the Cathlocator™ system to guide and evaluate the placement of (1) nasoduodenal feeding tubes, and (2) nasogastric drainage tubes in critically ill patients with feed intolerance due to slow gastric emptying. A prospective study of eight critically ill patients was undertaken in the intensive care unit of a tertiary hospital. The Cathlocator™ was used to (1) guide the positioning of the tubes post-pylorically and (2) determine whether nasogastric and nasoduodenal tubes were placed correctly. Tube tip position was compared with data obtained by radiology. Data are expressed as median (range). Duodenal tube placement was successful in 7 of 8 patients (insertion time 12.6 min (5.3-34.4)). All nasogastric tube placements were successful (insertion time 3.4 min (0.6-10.0)). The Cathlocator™ accurately determined the position of both tubes without complication in all cases. The Cathlocator™ allows placement and location of an enteral feeding tube in real time in critically ill patients with slow gastric emptying. These findings warrant further studies into the application of this technique for placement of post-pyloric feeding tubes.R. J. Young, M. J. Chapman, R. Fraser, R. Vozzo, D. P. Chorley, S. Creedhttp://www.aaic.net.au/Article.asp?D=200430

Genetic Variation and Antioxidant Response Gene Expression in the Bronchial Airway Epithelium of Smokers at Risk for Lung Cancer

Prior microarray studies of smokers at high risk for lung cancer have demonstrated that heterogeneity in bronchial airway epithelial cell gene expression response to smoking can serve as an early diagnostic biomarker for lung cancer. As a first step in applying functional genomic analysis to population studies, we have examined the relationship between gene expression variation and genetic variation in a central molecular pathway (NRF2-mediated antioxidant response) associated with smoking exposure and lung cancer. We assessed global gene expression in histologically normal airway epithelial cells obtained at bronchoscopy from smokers who developed lung cancer (SC, n=20), smokers without lung cancer (SNC, n=24), and never smokers (NS, n=8). Functional enrichment analysis showed that the NRF2-mediated, antioxidant response element (ARE)-regulated genes, were significantly lower in SC, when compared with expression levels in SNC. Importantly, we found that the expression of MAFG (a binding partner of NRF2) was correlated with the expression of ARE genes, suggesting MAFG levels may limit target gene induction. Bioinformatically we identified single nucleotide polymorphisms (SNPs) in putative ARE genes and to test the impact of genetic variation, we genotyped these putative regulatory SNPs and other tag SNPs in selected NRF2 pathway genes. Sequencing MAFG locus, we identified 30 novel SNPs and two were associated with either gene expression or lung cancer status among smokers. This work demonstrates an analysis approach that integrates bioinformatics pathway and transcription factor binding site analysis with genotype, gene expression and disease status to identify SNPs that may be associated with individual differences in gene expression and/or cancer status in smokers. These polymorphisms might ultimately contribute to lung cancer risk via their effect on the airway gene expression response to tobacco-smoke exposure.Intramural Research Program of the National Institute of Environmental Health Sciences; National Institutes of Health (Z01 ES100475, U01ES016035, R01CA124640

e-Social Science and Evidence-Based Policy Assessment : Challenges and Solutions

Peer reviewedPreprin

Nanoscale spin rectifiers controlled by the Stark effect

The control of orbital and spin state of single electrons is a key ingredient for quantum information processing, novel detection schemes, and, more generally, is of much relevance for spintronics. Coulomb and spin blockade (SB) in double quantum dots (DQDs) enable advanced single-spin operations that would be available even for room-temperature applications for sufficiently small devices. To date, however, spin operations in DQDs were observed at sub-Kelvin temperatures, a key reason being that scaling a DQD system while retaining an independent field-effect control on the individual dots is very challenging. Here we show that quantum-confined Stark effect allows an independent addressing of two dots only 5 nm apart with no need for aligned nanometer-size local gating. We thus demonstrate a scalable method to fully control a DQD device, regardless of its physical size. In the present implementation we show InAs/InP nanowire (NW) DQDs that display an experimentally detectable SB up to 10 K. We also report and discuss an unexpected re-entrant SB lifting as a function magnetic-field intensity

Middle pleistocene glaciation in Patagonia dated by cosmogenic-nuclide measurements on outwash gravels

The well-preserved glacial record in Argentine Patagonia offers a ~ 1 Ma archive of terrestrial climate extremes in southern South America. These glacial deposits remain largely undated beyond the range of radiocarbon dating at ca. 40 ka. Dating old glacial deposits (> several 105 a) by cosmogenic surface exposure methods is problematic because of the uncertainty in moraine degradation and boulder erosion rates. Here, we show that cobbles on outwash terraces can reliably date ‘old’ glacial deposits in the Lago Pueyrredón valley, 47.5° S, Argentina. Favorable environmental conditions (e.g., aridity and strong winds) have enabled continuous surface exposure of cobbles and preservation of outwash terraces. The data demonstrate that nuclide inheritance is negligible and we therefore use the oldest surface cobbles to date the deposit. 10Be concentrations in outwash cobbles reveal a major glacial advance at ca. 260 ka, concurrent with Marine Isotope Stage 8 (MIS 8) and dust peaks in Antarctic ice cores. A 10Be concentration depth-profile in the outwash terrace supports the age and suggests a low terrace erosion rate of ca. 0.5 mm ka− 1. We compare these data to exposure ages obtained from associated moraines and find that surface boulders underestimate the age of the glaciation by ~ 100 ka; thus the oldest boulders in this area do not date closely moraine deposition. The 10Be concentration in moraine cobbles help to constrain moraine degradation rates. These data together with constraints from measured 26Al/10Be ratios suggest that all moraine boulders were likely exhumed after original deposition. We determine the local Last Glacial Maximum (LGM) occurred at ~ 27–25 ka, consistent with the maximum LGM in other parts of Patagonia

Giga-Hertz quantized charge pumping in bottom gate defined InAs nanowire quantum dots

Semiconducting nanowires (NWs) are a versatile, highly tunable material platform at the heart of many new developments in nanoscale and quantum physics. Here, we demonstrate charge pumping, i.e., the controlled transport of individual electrons through an InAs NW quantum dot (QD) device at frequencies up to $1.3\,$GHz. The QD is induced electrostatically in the NW by a series of local bottom gates in a state of the art device geometry. A periodic modulation of a single gate is enough to obtain a dc current proportional to the frequency of the modulation. The dc bias, the modulation amplitude and the gate voltages on the local gates can be used to control the number of charges conveyed per cycle. Charge pumping in InAs NWs is relevant not only in metrology as a current standard, but also opens up the opportunity to investigate a variety of exotic states of matter, e.g. Majorana modes, by single electron spectroscopy and correlation experiments.Comment: 21 page

Dispersively detected Pauli Spin-Blockade in a Silicon Nanowire Field-Effect Transistor

We report the dispersive readout of the spin state of a double quantum dot formed at the corner states of a silicon nanowire field-effect transistor. Two face-to-face top-gate electrodes allow us to independently tune the charge occupation of the quantum dot system down to the few-electron limit. We measure the charge stability of the double quantum dot in DC transport as well as dispersively via in-situ gate-based radio frequency reflectometry, where one top-gate electrode is connected to a resonator. The latter removes the need for external charge sensors in quantum computing architectures and provides a compact way to readout the dispersive shift caused by changes in the quantum capacitance during interdot charge transitions. Here, we observe Pauli spin-blockade in the high-frequency response of the circuit at finite magnetic fields between singlet and triplet states. The blockade is lifted at higher magnetic fields when intra-dot triplet states become the ground state configuration. A lineshape analysis of the dispersive phase shift reveals furthermore an intradot valley-orbit splitting $\Delta_{vo}$ of 145 $\mu$eV. Our results open up the possibility to operate compact CMOS technology as a singlet-triplet qubit and make split-gate silicon nanowire architectures an ideal candidate for the study of spin dynamics

NRF2-driven miR-125B1 and miR-29B1 transcriptional regulation controls a novel anti-apoptotic miRNA regulatory network for AML survival

Transcription factor NRF2 is an important regulator of oxidative stress. It is involved in cancer progression, and has abnormal constitutive expression in acute myeloid leukaemia (AML). Posttranscriptional regulation by microRNAs (miRNAs) can affect the malignant phenotype of AML cells. In this study, we identified and characterised NRF2-regulated miRNAs in AML. An miRNA array identified miRNA expression level changes in response to NRF2 knockdown in AML cells. Further analysis of miRNAs concomitantly regulated by knockdown of the NRF2 inhibitor KEAP1 revealed the major candidate NRF2-mediated miRNAs in AML. We identified miR-125B to be upregulated and miR-29B to be downregulated by NRF2 in AML. Subsequent bioinformatic analysis identified putative NRF2 binding sites upstream of the miR-125B1 coding region and downstream of the mir-29B1 coding region. Chromatin immunoprecipitation analyses showed that NRF2 binds to these antioxidant response elements (AREs) located in the 5′ untranslated regions of miR-125B and miR-29B. Finally, primary AML samples transfected with anti-miR-125B antagomiR or miR-29B mimic showed increased cell death responsiveness either alone or co-treated with standard AML chemotherapy. In summary, we find that NRF2 regulation of miR-125B and miR-29B acts to promote leukaemic cell survival, and their manipulation enhances AML responsiveness towards cytotoxic chemotherapeutics

A rainfall model for drought risk analysis in south-east UK

Drought risk assessment ideally requires long-term rainfall records especially where inter-annual droughts are of potential concern, and spatially consistent estimates of rainfall to support regional and inter-regional scale assessments. This paper addresses these challenges by developing a spatially consistent stochastic model of monthly rainfall for south-east UK. Conditioned on 50 gauged sites, the model infills the historic record from 1855-2011 in both space and time, and extends the record by synthesising droughts which are consistent with the observed rainfall statistics. The long record length allows more insight into the variability of rainfall and potentially a stronger basis for risk assessment than is generally possible. It is shown that, although localised biases exist in both space and time, the model results are generally consistent with the observed record including for a range of inter-annual droughts and spatial statistics. Simulations show that some of the most severe inter-annual droughts on the record may recur, despite a trend towards generally wetter winters