Proplyene glycol intake from medications used on paediatric intensive care

here is an increasing number of reports of propylene glycol (PG) toxicity in the literature, regardless of its inclusion on the Generally Recognized as Safe List (GRAS).1 PG is an excipient used in many medications as a solvent for water-insoluble drugs. Polypharmacy may increase PG exposure in vulnerable PICU patients who may accumulate PG due to compromised liver and renal function. The study aim was to quantify PG intake in PICU patients and attitudes of clinicians towards PG. Method A snapshot of 50 PICU patients oral or intravenous medication intake was collected. Other data collected included age, weight, diagnosis, lactate levels and renal function. Manufacturers were contacted for PG content and then converted to mg/kg. Excipients in formulations that compete with the PG metabolism pathway were recorded. The Intensivists' opinions on PG intake was sought via e-survey. Results The 50 patients were prescribed 62 drugs and 83 formulations, 43/83 (52%) were parenteral formulations. Median weight of the patients was 5.5 kg (range 2–50 kg), ages ranged from 1 day to 13 years of age. Eleven of the patients were classed as renally impaired (defined as 1.5 times the baseline creatinine). Sixteen formulations contained PG, 2/16 were parenteral, 6/16 unlicensed preparations. Thirty-eight patients received at least one prescription containing PG and 29/38 of these patients were receiving formulations that contained excipients that may have competed with the metabolic pathways of PG. PG intake ranged from 0.002 mg/kg/day to 250 mg/kg/day. Total intake was inconclusive for 2 patients due to a of lack of availability of information from the manufacturer; these formulations were licensed but used in for off-label indications. Five commonly used formulations contributed to higher intakes of PG, namely co-trimoxazole, dexamethasone, potassium chloride, dipyridamole and phenobarbitone. Lactate levels were difficult to interpret due to the underlying conditions of the patients. One of the sixteen intensivist was aware of PG content in drugs, 16/16 would actively change therapy if intake was above European Medicines Agency recommendations. Conclusions Certain formulations used on PICU can considerably increase PG exposure to patients. Due to a lack of awareness of PG content, these should be highlighted to the clinician to assist with making informed decisions regarding risks versus benefits in continuing that drug, route of administration or formulation.

Dual-polarization multi-band optical OFDM transmission and transceiver limitations for up to 500 Gb/s uncompensated long-haul links

A number of critical issues for dual-polarization single- and multi-band optical orthogonal-frequency division multiplexing (DPSB/ MB-OFDM) signals are analyzed in dispersion compensation fiber (DCF)-free long-haul links. For the first time, different DP crosstalk removal techniques are compared, the maximum transmission-reach is investigated, and the impact of subcarrier number and high-level modulation formats are explored thoroughly. It is shown, for a bit-error-rate (BER) of 10-3, 2000 km of quaternary phase-shift keying (QPSK) DP-MBOFDM transmission is feasible. At high launched optical powers (LOP), maximum-likelihood decoding can extend the LOP of 40 Gb/s QPSK DPSB- OFDM at 2000 km by 1.5 dB compared to zero-forcing. For a 100 Gb/s DP-MB-OFDM system, a high number of subcarriers contribute to improved BER but at the cost of digital signal processing computational complexity, whilst by adapting the cyclic prefix length the BER can be improved for a low number of subcarriers. In addition, when 16-quadrature amplitude modulation (16QAM) is employed the digital-toanalogue/ analogue-to-digital converter (DAC/ADC) bandwidth is relaxed with a degraded BER; while the 'circular' 8QAM is slightly superior to its 'rectangular' form. Finally, the transmission of wavelength-division multiplexing DP-MB-OFDM and single-carrier DP-QPSK is experimentally compared for up to 500 Gb/s showing great potential and similar performance at 1000 km DCF-free G.652 line. © 2014 Optical Society of America.

Phase noise influence in coherent optical DnPSK systems with DSP based dispersion compensation

We present a comparative study of the influence of dispersion induced phase noise for n-level PSK systems. From the analysis, we conclude that the phase noise influence for classical homodyne/heterodyne PSK systems is entirely determined by the modulation complexity (expressed in terms of constellation diagram) and the analogue demodulation format. On the other hand, the use of digital signal processing (DSP) in homodyne/intradyne systems renders a fiber length dependence originating from the generation of equalization enhanced phase noise. For future high capacity systems, high constellations must be used in order to lower the symbol rate to practically manageable speeds, and this fact puts severe requirements to the signal and local oscillator (LO) linewidths. Our results for the bit-error-rate (BER) floor caused by the phase noise influence in the case of QPSK, 16PSK and 64PSK systems outline tolerance limitations for the LO performance: 5 MHz linewidth (at 3-dB level) for 100 Gbit/s QPSK; 1 MHz for 400 Gbit/s QPSK; 0.1 MHz for 400 Gbit/s 16PSK and 1 Tbit/s 64PSK systems. This defines design constrains for the phase noise impact in distributed-feed-back (DFB) or distributed-Bragg-reflector (DBR) semiconductor lasers, that would allow moving the system capacity from 100 Gbit/s system capacity to 400 Gbit/s in 3 years (1 Tbit/s in 5 years). It is imperative at the same time to increase the analogue to digital conversion (ADC) speed such that the single quadrature symbol rate goes from today's 25 GS/s to 100 GS/s (using two samples per symbol). © 2014 by Walter de Gruyter Berlin/Boston.

Numerical modelling of multimode fibre-optic communication lines

The results of numerical modelling of nonlinear propagation of an optical signal in multimode fibres with a small differential group delay are presented. It is found that the dependence of the error vector magnitude (EVM) on the differential group delay can be reduced by increasing the number of ADC samples per symbol in the numerical implementation of the differential group delay compensation algorithm in the receiver. The possibility of using multimode fibres with a small differential group delay for data transmission in modern digital communication systems is demonstrated. It is shown that with increasing number of modes the strong coupling regime provides a lower EVM level than the weak coupling one.