Vibrational spectrum and luminescence properties of the system Al2O3-B2O3-Eu2O3

The system Al2O3-B2O3-Eu2O3, with Al/B ratio varying from 4.5 to 2 and Eu/(Al+B)=0.02, was synthesized by solid state reaction. The vibrational spectra of the system Al2O3-B2O3-Eu2O3 were investigated. It was found that no definite change in the regions of 1200 similar to 1000 cm(-1) due to the adsorption BO4 groups with decreasing Al/B ratio, indicating no Al3+ ion was substituted by Eu3+ ions and other changes revealed that there was an amorphous phase and Eu3+ ions may dope into the amorphous phase. The studies on the luminescent properties of the system Al2O3-B2O3 also show that Eu3+ ions dope into amorphous phase. The investigations on the phonon sideband of Eu3+ indicate that electron-phonon coupling strength decreases with Al/B ratio change from 3 to 2, leading to the non-radiative decay rate decreases and the Eu3+-emission intensity increase.

EPITAXIAL BEHAVIOR OF HDPE ON THE BOUNDARY OF HIGHLY ORIENTED IPP SUBSTRATES

The epitaxial crystallization behavior of high-density polyethylene on the boundary of highly oriented isotactic polypropylene (iPP) substrates has been investigated by means of atomic force microscopy (AFM) and transmission electron microscopy (TEM). The results obtained from AFM and TEM indicate that the epitaxial nucleation of HDPE on the highly oriented iPP substrates occurs earlier than that in the pure HDPE phase, i.e., homogeneous nucleation. Therefore the epitaxially grown HDPE lamellae can grow across the boundary of the iPP substrate into the HDPE spherulitic phase with the epitaxial orientation relationship remaining.

Concentrations of Cadmium and Zinc in Seawater of Bohai Bay and Their Effects on Biomarker Responses in the Bivalve Chlamys farreri

Both in-field chemical investigation and in the laboratory toxic tests were carried out to systematically understand the pollution status of cadmium (Cd) and zinc (Zn) in Bohai Bay. Samples collected from surface seawater were determined to describe the distributions of Cd and Zn in Bohai Bay. The average values in our study of Cd and Zn were 0.15 mu g/L and 19.68 mu g/L, respectively. Both of them were lower than the first class limit of seawater quality standard in China. In the laboratory, antioxidant enzymes [SOD (Cu/Zn-SOD, Mn-SOD), CAT], lipid peroxidation (MDA), phase I and phase II enzymes (CYP4501A and GST) were investigated in the bivalves Chlamys farreri exposed to Cd and Zn at the concentration levels of Bohai Bay seawater, which were obtained from our in-field investigation. The reduced SOD, CAT, and EROD (7-ethoxyresorufin-O-deethylase) activities (with the inhibitory rate of 16.8%, 31.5%, and 51.6%, respectively) in Cd treatment were observed and resulted in obvious lipid peroxidation damage. However, treatment of Zn showed elevations in SOD and GST by 13.3% and 29.9%, respectively, and with no influence on lipid peroxidation. In summary, seawater quality in Bohai Bay seawater was ranked as good in general, but it seemed that Cd might possess a potential environmental risk by effecting pro-oxidant/antioxidant balance and phase I detoxification in C. farreri.

心算年老化的认知心理机制及功能磁共振成像研究

Mechanisms underlying cognitive psychology and cerebral physiological of mental arithmetic with increasing are were studied by using behavioral methods and functional magnetic resonance imaging (fMRI). I. Studies on mechanism underlying cognitive psychology of mental arithmetic with increasing age These studies were accomplished in 172 normal subjects ranging from 20 to 79 years of age with above 12 years of education (Mean = 1.51, SD = 1.5). Five mental arithmetic tasks, "1000-1", "1000-3", "1000-7", "1000-13", "1000-17", were designed with a serial calculation in which subjects sequentially subtracted the same prime number (1, 3, 7, 13, 17) from another number 1000. The variables studied were mental arithmetic, age, working memory, and sensory-motor speed, and four studies were conducted: (1) Aging process of mental arithmetic with different difficulties, (2) mechanism of aging of mental arithmetic processing. (3) effects of working memory and sensory-motor speed on aging process of mental arithmetic, (4) model of cognitive aging of mental arithmetic, with statistical methods such as MANOVA, hierarchical multiple regression, stepwise regression analysis, structural equation modelling (SEM). The results were indicated as following: Study 1: There was an obvious interaction between age and mental arithmetic, in which reaction time (RT) increased with advancing age and more difficult mental arithmetic, and mental arithmetic efficiency (the ratio of accuracy to RT) deceased with advancing age and more difficult mental arithmetic; Mental arithmetic efficiency with different difficulties decreased in power function: Study 2: There were two mediators (latent variables) in aging process of mental arithmetic, and age had an effect on mental arithmetic with different difficulties through the two mediators; Study 3: There were obvious interactions between age and working memory, working memory and mental arithmetic; Working memory and sensory-motor speed had effects on aging process of mental arithmetic, in which the effect of working memory on aging process of mental arithmetic was about 30-50%, and the effect of sensory-motor speed on aging process of mental arithmetic was above 35%. Study 4: Age, working memory, and sensory-motor speed had effects on two latent variables (factor 1 and factor 2), then had effects on mental arithmetic with different difficulties through factor 1 which was relative to memory component, and factor 2 which relative to speed component and had an effect on factor 1 significantly. II. Functional magnetic resonance imaging study on metal arithmetic with increasing age This study was accomplished in 14 normal right-handed subjects ranging from 20 to 29 (7 subjects) and 60 to 69 (7 subjects) years of age by using functional magnetic resonance imaging apparatus, a superconductive Signa Horizon 1.5T MRI system. Two mental arithmetic tasks, "1000-3" and "1000-17", were designed with a serial calculation in which subjects sequentially subtracted the same prime number (3 or 17) from another number 1000 silently, and controlling task, "1000-0", in which subjects continually rehearsed number 1000 silently, was regarded as baseline, based on current "baseline-task" OFF-ON subtraction pattern. Original data collected by fMRI apparatus, were analyzed off-line in SUN SPARC working station by using current STIMULATE software. The analytical steps were composed of within-subject analysis, in which brain activated images about mental arithmetic with two difficulties were obtained by using t-test, and between-subject analysis, in which features of brain activation about mental arithmetic with two difficulties, the relationship between left and right hemisphere during mental arithmetic, and age differences of brain activation in young and elderly adults were examined by using non-parameter Wilcoxon test. The results were as following:

Novel processes, test structures and characterisation for future germanium technologies

In order to widely use Ge and III-V materials instead of Si in advanced CMOS technology, the process and integration of these materials has to be well established so that their high mobility benefit is not swamped by imperfect manufacturing procedures. In this dissertation number of key bottlenecks in realization of Ge devices are investigated; We address the challenge of the formation of low resistivity contacts on n-type Ge, comparing conventional and advanced rapid thermal annealing (RTA) and laser thermal annealing (LTA) techniques respectively. LTA appears to be a feasible approach for realization of low resistivity contacts with an incredibly sharp germanide-substrate interface and contact resistivity in the order of 10 -7 Ω.cm2. Furthermore the influence of RTA and LTA on dopant activation and leakage current suppression in n+/p Ge junction were compared. Providing very high active carrier concentration > 1020 cm-3, LTA resulted in higher leakage current compared to RTA which provided lower carrier concentration ~1019 cm-3. This is an indication of a trade-off between high activation level and junction leakage current. High ION/IOFF ratio ~ 107 was obtained, which to the best of our knowledge is the best reported value for n-type Ge so far. Simulations were carried out to investigate how target sputtering, dose retention, and damage formation is generated in thin-body semiconductors by means of energetic ion impacts and how they are dependent on the target physical material properties. Solid phase epitaxy studies in wide and thin Ge fins confirmed the formation of twin boundary defects and random nucleation growth, like in Si, but here 600 °C annealing temperature was found to be effective to reduce these defects. Finally, a non-destructive doping technique was successfully implemented to dope Ge nanowires, where nanowire resistivity was reduced by 5 orders of magnitude using PH3 based in-diffusion process.

Doxorubicin-paclitaxel: a safe regimen in terms of cardiac toxicity in metastatic breast carcinoma patients. Results from a European Organization for Research and Treatment of Cancer multicenter trial.

BACKGROUND: The potential cardiotoxicity of the doxorubicin-paclitaxel regimen, when paclitaxel is given shortly after the end of the anthracycline infusion, is an issue of concern, as suggested by small single institution Phase II studies. METHODS: In a large multicenter Phase III trial, 275 anthracycline naive metastatic breast carcinoma patients were randomized to receive either doxorubicin (60 mg/m(2)) followed 30 minutes later by paclitaxel (175 mg/m(2) 3-hour infusion; AT) or a standard doxorubicin-cyclophosphamide regimen (AC; 60/600 mg/m(2)). Both treatments were given once every 3 weeks for a maximum of six cycles. Close cardiac monitoring was implemented in the study design. RESULTS: Congestive heart failure (CHF) occurred in three patients in the AT arm and in one patient in the AC arm (P = 0.62). Decreases in left ventricular ejection fraction to below the limit of normal were documented in 33% AT and 19% AC patients and were not predictive of CHF development. CONCLUSIONS: AT is devoid of excessive cardiac risk among metastatic breast carcinoma patients, when the maximum planned cumulative dose of doxorubicin does not exceed 360 mg/m(2).

Safety profile of L-arginine infusion in moderately severe falciparum malaria.

BACKGROUND: L-arginine infusion improves endothelial function in malaria but its safety profile has not been described in detail. We assessed clinical symptoms, hemodynamic status and biochemical parameters before and after a single L-arginine infusion in adults with moderately severe malaria. METHODOLOGY AND FINDINGS: In an ascending dose study, adjunctive intravenous L-arginine hydrochloride was infused over 30 minutes in doses of 3 g, 6 g and 12 g to three separate groups of 10 adults hospitalized with moderately severe Plasmodium falciparum malaria in addition to standard quinine therapy. Symptoms, vital signs and selected biochemical measurements were assessed before, during, and for 24 hours after infusion. No new or worsening symptoms developed apart from mild discomfort at the intravenous cannula site in two patients. There was a dose-response relationship between increasing mg/kg dose and the maximum decrease in systolic (rho = 0.463; Spearman's, p = 0.02) and diastolic blood pressure (r = 0.42; Pearson's, p = 0.02), and with the maximum increment in blood potassium (r = 0.70, p<0.001) and maximum decrement in bicarbonate concentrations (r = 0.53, p = 0.003) and pH (r = 0.48, p = 0.007). At the highest dose (12 g), changes in blood pressure and electrolytes were not clinically significant, with a mean maximum decrease in mean arterial blood pressure of 6 mmHg (range: 0-11; p<0.001), mean maximal increase in potassium of 0.5 mmol/L (range 0.2-0.7 mmol/L; p<0.001), and mean maximal decrease in bicarbonate of 3 mEq/L (range 1-7; p<0.01) without a significant change in pH. There was no significant dose-response relationship with blood phosphate, lactate, anion gap and glucose concentrations. All patients had an uncomplicated clinical recovery. CONCLUSIONS/SIGNIFICANCE: Infusion of up to 12 g of intravenous L-arginine hydrochloride over 30 minutes is well tolerated in adults with moderately severe malaria, with no clinically important changes in hemodynamic or biochemical status. Trials of adjunctive L-arginine can be extended to phase 2 studies in severe malaria. TRIAL REGISTRATION: ClinicalTrials.gov NCT00147368.

The providing resources to enhance African American patients' readiness to make decisions about kidney disease (PREPARED) study: protocol of a randomized controlled trial.

BACKGROUND: Living related kidney transplantation (LRT) is underutilized, particularly among African Americans. The effectiveness of informational and financial interventions to enhance informed decision-making among African Americans with end stage renal disease (ESRD) and improve rates of LRT is unknown. METHODS/DESIGN: We report the protocol of the Providing Resources to Enhance African American Patients' Readiness to Make Decisions about Kidney Disease (PREPARED) Study, a two-phase study utilizing qualitative and quantitative research methods to design and test the effectiveness of informational (focused on shared decision-making) and financial interventions to overcome barriers to pursuit of LRT among African American patients and their families. Study Phase I involved the evidence-based development of informational materials as well as a financial intervention to enhance African American patients' and families' proficiency in shared decision-making regarding LRT. In Study Phase 2, we are currently conducting a randomized controlled trial in which patients with new-onset ESRD receive 1) usual dialysis care by their nephrologists, 2) the informational intervention (educational video and handbook), or 3) the informational intervention in addition to the option of participating in a live kidney donor financial assistance program. The primary outcome of the randomized controlled trial will include patients' self-reported rates of consideration of LRT (including family discussions of LRT, patient-physician discussions of LRT, and identification of a LRT donor). DISCUSSION: Results from the PREPARED study will provide needed evidence on ways to enhance the decision to pursue LRT among African American patients with ESRD.

Impact of Funding Source on Clinical Trial Results Including Cardiovascular Outcome Trials.

Previous authors have suggested a higher likelihood for industry-sponsored (IS) studies to have positive outcomes than non-IS studies, though the influence of publication bias was believed to be a likely confounder. We attempted to control for the latter using a prepublication database to compare the primary outcome of recent trials based on sponsorship. We used the "advanced search" feature in the clinicaltrials.gov website to identify recently completed phase III studies involving the implementation of a pharmaceutical agent or device for which primary data were available. Studies were categorized as either National Institutes of Health (NIH) sponsored or IS. Results were labeled "favorable" if the results favored the intervention under investigation or "unfavorable" if the intervention fared worse than standard medical treatment. We also performed an independent literature search to identify the cardiovascular trials as a case example and again categorized them into IS versus NIH sponsored. A total of 226 studies sponsored by NIH were found. When these were compared with the latest 226 IS studies, it was found that IS studies were almost 4 times more likely to report a positive outcome (odds ratio [OR] 3.90, 95% confidence interval [CI] 2.6087 to 5.9680, p <0.0001). As a case example of a specialty, we also identified 25 NIH-sponsored and 215 IS cardiovascular trials, with most focusing on hypertension therapy (31.6%) and anticoagulation (17.9%). IS studies were 7 times more likely to report favorable outcomes (OR 7.54, 95% CI 2.19 to 25.94, p = 0.0014). They were also considerably less likely to report unfavorable outcomes (OR 0.11, 95% CI 0.04 to 0.26, p <0.0001). In conclusion, the outcomes of large clinical studies especially cardiovascular differ considerably on the basis of their funding source, and publication bias appears to have limited influence on these findings.

Utility of a molecular prescreening program in advanced colorectal cancer for enrollment on biomarker-selected clinical trials.

BACKGROUND: Incorporation of multiple enrichment biomarkers into prospective clinical trials is an active area of investigation, but the factors that determine clinical trial enrollment following a molecular prescreening program have not been assessed. PATIENTS AND METHODS: Patients with 5-fluorouracil-refractory metastatic colorectal cancer at the MD Anderson Cancer Center were offered screening in the Assessment of Targeted Therapies Against Colorectal Cancer (ATTACC) program to identify eligibility for companion phase I or II clinical trials with a therapy targeted to an aberration detected in the patient, based on testing by immunohistochemistry, targeted gene sequencing panels, and CpG island methylation phenotype assays. RESULTS: Between August 2010 and December 2013, 484 patients were enrolled, 458 (95%) had a biomarker result, and 157 (32%) were enrolled on a clinical trial (92 on biomarker-selected and 65 on nonbiomarker selected). Of the 458 patients with a biomarker result, enrollment on biomarker-selected clinical trials was ninefold higher for predefined ATTACC-companion clinical trials as opposed to nonpredefined biomarker-selected clinical trials, 17.9% versus 2%, P < 0.001. Factors that correlated positively with trial enrollment in multivariate analysis were higher performance status, older age, lack of standard of care therapy, established patient at MD Anderson, and the presence of an eligible biomarker for an ATTACC-companion study. Early molecular screening did result in a higher rate of patients with remaining standard of care therapy enrolling on ATTACC-companion clinical trials, 45.1%, in contrast to nonpredefined clinical trials, 22.7%; odds ratio 3.1, P = 0.002. CONCLUSIONS: Though early molecular prescreening for predefined clinical trials resulted in an increase rate of trial enrollment of nonrefractory patients, the majority of patients enrolled on clinical trials were refractory to standard of care therapy. Within molecular prescreening programs, tailoring screening for preidentified and open clinical trials, temporally linking screening to treatment and optimizing both patient and physician engagement are efforts likely to improve enrollment on biomarker-selected clinical trials. CLINICAL TRIALS NUMBER: The study NCT number is NCT01196130.

Multicenter randomized trial of dacarbazine alone or in combination with two different doses and schedules of interferon alfa-2a in the treatment of advanced melanoma

Purpose: Some phase II studies have suggested that the combination of interferons (IFNs) with dacarbazine (DTIC) in the treatment of malignant melanoma (MM) increases the antitumor activity of DTIC alone. In an attempt to confirm this hypothesis, a randomized study was performed with the further intent of observing whether low doses of recombinant interferon alfa-2a (rIFNα2a) could be as effective as intermediate doses. Patients and Methods: Two hundred sixty-six patients were randomized onto three different treatment arms: DTIC 800 mg/m 2 intravenously (IV) days 1 and 21; DTIC plus rIFNα2a 9 mIU intramuscularly (IM) daily; and DTIC plus rIFNα2a 3 mIU IM three times per week. Major prognostic factors were well balanced among the three arms. Chemotherapy was administered for a maximum of eight cycles. After 6 months of therapy, rIFNα2a was continued until disease progression at 3 mIU three times per week in responding patients who had received the combined treatment. Results: The percentage of objective responses did not differ among the three groups (20%, 28%, and 23%, respectively), although a significant prolongation of response duration was observed when rIFNα2a was added to DTIC (2.6 v 8.4 v 5.5 months, respectively). However, this improvement in response duration did not translate into an amelioration of overall survival. The addition of rIFNα2a led to the onset of flu-like syndrome, but in no case was it necessary to withdraw the treatment program and no toxic deaths or life-threatening toxicities were reported. Conclusion: In this study, rIFNα2a significantly prolonged response duration, whereas no effects on response rate and survival were observed; rIFNα2a 3 mIU appeared to be equally effective and better tolerated than 9 mIU.

Assessment of the potential impacts of coasteering on rocky intertidal habitats in Wales

The relatively new recreational pursuit of coasteering, which has developed in the St David's area of Pembrokeshire, appears to be expanding rapidly. The majority of local commercial recreation providers (outdoor pursuit centers etc.) now appear to offer this pursuit. The majority of the rocky coastlines where it takes place lie within Pembrokeshire Marine Special Area of Conservation (SAC), and are also Sites of Special Scientific Interest (SSSI). No assessment has yet been undertaken of coasteering's potential impact on the intertidal habitats. Therefore the Countryside Council for Wales (CCW) commissioned the Marine Life Information Network (MarLIN) to undertake a desk study of the likely environmental effects of coasteering on rocky intertidal habitats within the Pembrokeshire marine SAC. The desk study was based on a review of the available literature, and in particular the effects of trampling on rocky intertidal communities. Communities (as biotopes) within the Pembrokeshire marine SAC likely to be exposed to coasteering activities were identified from Phase I biotope data for the area, provided by CCW. Where possible, existing research by MarLIN into the intolerance, recoverability and sensitivity of the biotopes identified, was used to identify their potential vulnerability to trampling. The literature review revealed that: - foliose canopy forming algae (e.g. fucoids) were particularly intolerant and sensitive to trampling impacts; - trampling damaged erect coralline turfs, barnacles, and resulted in an increase in bare space; in some cases paths across the shore were visible; - on brown algae dominated shores, understorey algae could suffer due to increased desiccation but algal turf species, opportunists and gastropod grazers (e.g. limpets) could increase in abundance as an indirect effect of trampling, and that - trampling impacts resulted from physical contact and wear and were dependant on the intensity, duration, and frequency of trampling, and even the type of footwear used. A total of 19 intolerant rocky intertidal biotopes were identified as potentially vulnerable to trampling and hence coasteering within the Pembrokeshire marine SAC, of which six are of Welsh importance and eight are nationally rare or scarce. Trampling is a highly localized impact and it was not possible to identify biotopes, and hence communities, actually impacted by coasteering activities in the Pembrokeshire marine SAC. In addition, the majority of the literature addresses the impacts of trampling on wave sheltered or moderately exposed brown algal dominated shores, while coasteering occurs on more wave exposed, steeply inclined shores. Therefore, direct survey of the routes used by coasteering groups within the Pembrokeshire marine SAC is required to identify the intensity, duration and frequency of trampling impact, together with the communities impacted. Given the paucity of data concerning trampling effects in the rocky intertidal in the UK, a survey of the impacts of coasteering would provide an opportunity to examine the effects of trampling and visitor use in steep rocky, wave exposed shores. The report recognizes the potential to engage coasteerers in contributing to the development of strategies for minimizing adverse impacts, recording impacts and collecting information of use in identifying climate change and the occurrence of non-native species.

Effect of ocean acidification and elevated fCO2 on trace gas production by a Baltic Sea summer phytoplankton community

The Baltic Sea is a unique environment as the largest body of brackish water in the world. Acidification of the surface oceans due to absorption of anthropogenic CO2 emissions is an additional stressor facing the pelagic community of the already challenging Baltic Sea. To investigate its impact on trace gas biogeochemistry, a large-scale mesocosm experiment was performed off Tvärminne Research Station, Finland in summer 2012. During the second half of the experiment, dimethylsulphide (DMS) concentrations in the highest fCO2 mesocosms (1075–1333 μatm) were 34 % lower than at ambient CO2 (350 μatm). However the net production (as measured by concentration change) of seven halocarbons analysed was not significantly affected by even the highest CO2 levels after 5 weeks exposure. Methyl iodide (CH3I) and diiodomethane (CH2I2) showed 15 % and 57 % increases in mean mesocosm concentration (3.8 ± 0.6 pmol L−1 increasing to 4.3 ± 0.4 pmol L−1 and 87.4 ± 14.9 pmol L−1 increasing to 134.4 ± 24.1 pmol L−1 respectively) during Phase II of the experiment, which were unrelated to CO2 and corresponded to 30 % lower Chl-ɑ concentrations compared to Phase I. No other iodocarbons increased or showed a peak, with mean chloroiodomethane (CH2ClI) concentrations measured at 5.3 (± 0.9) pmol L−1 and iodoethane (C2H5I) at 0.5 (± 0.1) pmol L−1. Of the concentrations of bromoform (CHBr3; mean 88.1 ± 13.2 pmol L−1), dibromomethane (CH2Br2; mean 5.3 ± 0.8 pmol L−1) and dibromochloromethane (CHBr2Cl, mean 3.0 ± 0.5 pmol L−1), only CH2Br2 showed a decrease of 17 % between Phases I and II, with CHBr3 and CHBr2Cl showing similar mean concentrations in both Phases. Outside the mesocosms, an upwelling event was responsible for bringing colder, high CO2, low pH water to the surface starting on day t16 of the experiment; this variable CO2 system with frequent upwelling events implies the community of the Baltic Sea is acclimated to regular significant declines in pH caused by up to 800 μatm fCO2. After this upwelling, DMS concentrations declined, but halocarbon concentrations remained similar or increased compared to measurements prior to the change in conditions. Based on our findings, with future acidification of Baltic Sea waters, biogenic halocarbon emissions are likely to remain at similar values to today, however emissions of biogenic sulphur could significantly decrease from this region.

Retinal Pigment Epithelial Cell DNA is Damaged by Exposure to Benzo[a]pyrene, a Constituent of Cigarette Smoke.

This study examined the effect of exogenous benzo[ a ]pyrene (BaP), an important constituent of cigarette smoke, on cultured bovine retinal pigment epithelial (RPE) cells. Evidence is presented for its metabolic conversion into benzo[ a ]pyrene diol epoxide (BPDE) and the consequent formation of potentially cytotoxic nucleobase adducts in DNA. Cultured RPE cells were treated with BaP at concentrations in the range of 0–100 µm. The presence of BaP was found to cause inhibition of cell growth and replication. BaP induced the expression of a phase I drug metabolizing enzyme which was identified as cytochrome P450 1A1 (CYP 1A1) by RT–PCR and by Western blotting. Coincident with the increased expression of CYP 1A1, covalent adducts between the mutagenic metabolite BPDE and DNA could be detected within RPE cells by immunocytochemical staining. Additional support for their formation was afforded by nuclease P1 enhanced 32P-postlabelling assays on cellular DNA. Single-cell gel electrophoresis (comet) assays showed that exposure of RPE cells to BaP rendered them markedly more susceptible to DNA damage induced by broad band UVB or blue light laser irradiation. In the case of UVB, this is consistent with the photosensitization of DNA cleavage by nucleobase adducts of BPDE. Collectively, these findings imply that BaP has a significant impact on RPE cell pathophysiology and suggest mechanisms whereby exposure to cigarette smoke might cause RPE dysfunction and cell death, thus possibly contributing to degenerative disorders of the retina.

An evaluation of protocolised weaning on the duration of mechanical ventilation

Using a before and after study design, we compared protocolised weaning from mechanical ventilation with usual non-protocolised practice in intensive care. Outcomes (duration of mechanical ventilation, duration of intubation, intensive care stay) and complications (re-intubations, tracheostomy, mortality) were compared between baseline (Phase I) and following implementation of protocolised weaning (Phase II). Over the same period, we collected data in a second (reference) unit to monitor practice changes over time. In the intervention unit, outcomes were longer in Phase II compared with Phase I (all p < 0.005). When adjusted for admission APACHE II score and diagnostic category, only intensive care stay remained significantly longer (p = 0.002). There were significantly more tracheostomies in Phase II (p = 0.004). The reference unit demonstrated no statistically significant differences in study outcomes or complications between Phases. Protocolised weaning did not reduce the duration of mechanical ventilation and was not associated with an increased rate of re-intubation or intensive care unit mortality.