Optical injection-locking-based pump recovery for phase-sensitively amplified links

An injection-locking-based pump recovery system for phase-sensitively amplified links is proposed and studied experimentally. Measurements with 10 Gbaud DQPSK signals show penalty-free recovery of 0.8 GHz FWHM bandwidth pump with 63 dB overall amplification. © 2012 OSA.

Design of a fiber scheme for nonlinear Raman pump broadening through modulation instability

In this work we explore numerically an experimentally the dependence of the broadened spectra on the choice of fibers and we analyze a series of basic rules to be taken into account when using nonlinear broadening to reduce the gain ripple of broadband Raman amplifiers

Dual-pump Raman amplification with enhanced flatness using modulation instability

In this work, we utilize modulation instability to the broadening of the two CW-pumps of a wideband Raman amplifier. Applying nonlinear fiber process, we demonstrate a feasibility of a certain control over the broadening process, leading to clear improvements in the flatness of the amplifier gain over its operational bandwidth.

An optical pump controlled tunable phase-shifted fiber grating transmission filter

Optical pump controlled, remotely tunable phase-shifted fiber grating transmission filters were analyzed. The transmission peak had a full width hail maximum (FWHM) bandwidth. With increasing control pump power, the resonant peak shifted towards the longer wavelength side. The efficiency of the system was largely affected by the greater number of sections of doped fiber as well as the absence of recirculation of unabsorbed pump beam. The configuration, besides its simplicity and cost-effectiveness, exhibited wavelength-independent pump-induced phase shifts and no anisotropic effects during operation.

Proton pump inhibitor prescribing following Endoscopic diagnosis in a district general hospital

Focal points: A systematic review of the use of proton pump inhibitors was conducted among patients undergoing diagnostic fibreoptic endoscopic examination of the upper gastrointestinal tract during the period July 2001 to February 2002 inclusive A total of 2,557 patients received a PPI following endoscopy and healing doses were prescribed to 75.3 per cent of these patients An “unknown indication” was stated as a diagnosis in 958 patients (37.5 per cent) of patients studied Although endoscopic diagnosis does not appear possible in all cases, the present study demonstrates that NICE guidance to employ the lowest appropriate dose of PPI is followed

Simple design method for gain-flattened three-pump Raman amplifiers

A simple and efficient approach to the optimal design of 3-wavelength backward-pumped Raman amplifiers is proposed. Gain flatness of 1.7 dB is demonstrated in a spectral range of 1520-1595 nm using only three pumps with wavelengths within the 1420-1480 nm interval.

The impact of pump phase-modulation and filtering on WDM signals in a fibre optical parametric amplifier

WDM signal degradation from pump phase-modulation in a one-pump 20dB net-gain fibre optical parametric amplifier is experimentally and numerically characterised for the first time using 10x59Gb/s QPSK signals.

Analisi dinamica e a regime del convertitore Dickson-Charge-Pump

I circuti di tipo charge-pump trovano vasto impiego nell'elettronica moderna in quanto offrono un metodo semplice e totalmente integrato per elevare le basse tensioni di alimentazione tipiche dei circuiti digitali e trasformarle nelle alimentazioni adatte al pilotaggio di circuti di programmazione delle memorie, al pilotaggio dei mos di potenza, alla generazione della tensione di riferimento dei VCO nei PLL e in numerose altre applicazioni. Questa tesi studia il circuito charge-pump di Dickson nel suo comportamento sia a regime stazionario sia a regime dinamico. Al fine di aumentare l'efficienza è infatti importante attivare il circuito solo all'occorrenza, prestando attenzione al transitorio di accensione. Ogni aspetto teorico viene verificato per mezzo di simulazioni su LTSpice. Si è quindi potuto constatare che un dimensionamento corretto del numero di stadi ottimizza le prestazioni sia statiche che dinamiche sotto il vincolo di una massima occupazione d'area. L'impiego dei circuiti charge-pump si prevede possa essere sempre più diffuso in futuro, visto il trend verso un maggiore livello di integrazione dei sistemi elettronici e la tendenza ad utilizzare tensioni di alimentazione sempre più basse.

Las Cruces, New Mexico Balloon Race

General note: Title and date provided by Bettye Lane.

Las Cruces, New Mexico Balloon Race

General note: Title and date provided by Bettye Lane.

Woman rests aching feet by taking off high-heeled pump (these uncomfortable shoes hamper a woman's mobility)

Inscriptions: Verso: [stamped] Photograph by Freda Leinwand. [463 West Street, Studio 229G, New York, NY 10014].

The Barriers to the Integration of the Uterine Balloon Tamponade into South Africa and Ghana's Health Systems for the Management of Postpartum Hemorrhage

Background

Postpartum hemorrhage is the most significant contributor to maternal mortality globally, claiming 140,000 lives annually. Postpartum hemorrhage is a leading cause of maternal death in South Africa, with the literature indicating that 80 percent of the postpartum hemorrhage deaths in South Africa are avoidable. Ghana, as of 2010, witnesses 2700 maternal deaths annually, primarily because of poor quality of care in health facilities and services being difficult to access. As per WHO recommendations, uterotonics are integral to treating postpartum hemorrhage as soon as it is diagnosed. In case of persistent bleeding or limited availability of uterotonics, the uterine balloon tamponade (UBT) can be used as a second line of defense. If both these measures are unable to counter the bleeding, providers must perform surgical interventions. Literature on the UBT, as one tool in the protocol to address postpartum hemorrhage, has shown it to have success rates ranging from 60 to 100 percent. Despite the potential to lower the number of postpartum hemorrhage deaths in South Africa and Ghana, the UBT has not been incorporated widely in South Africa and Ghana. The aim of this study is to describe the barriers involved with integrating the UBT into South Africa and Ghana’s health systems to address postpartum hemorrhage.

Methods

The study took place in multiple sites in South Africa (Cape Town, Johannesburg, Durban and Mpumalanga) and in Accra, Ghana. South Africa and Ghana were selected because postpartum hemorrhage contributes greatly to their maternal mortality numbers and there is potential in both countries to lower those rates through greater use of the UBT. A total of 25 participants were interviewed through purposive sampling, snowball sampling and participant referrals, and included various categories of stakeholders integral to the integration process of a medical device. Individual in-depth interviews were used for data collection, with interview questions being tailored to each stakeholder category. The focus of the interviews was on the protocol used to counter postpartum hemorrhage, the frequency with which the UBT is used as part of the protocol, and the process of integrating it into the South Africa and Ghana’s health systems. The data collected were coded using NVivo and analyzed using content analysis.

Results

The barriers to integration of the uterine balloon tamponade to address postpartum hemorrhage in South Africa and Ghana were evident on the political, economic and health delivery levels. The results indicated that the barriers to integration in South Africa included the low recognition of postpartum hemorrhage as a problem, the lack of clarity surrounding the role of the Medicines Control Council as a regulatory body for medical devices, and low awareness of the UBT as an intervention to control postpartum hemorrhage. The barriers in Ghana were the cash constraints experienced by the Ghana Health Services to fund medical devices, a heavy reliance on donors for funding, and the lack of consistent knowledge on processes involving clinical trials for new medical devices in Ghana.

Conclusion

Existing literature on methods to counter postpartum hemorrhage to reduce maternal mortality has focused on and emphasized the efficacy of the UBT. Despite overwhelming evidence supporting the use of the UBT, many health systems across the world, particularly low-income countries, do not have access to the device owing to numerous barriers in integrating the device into obstetric care. This study illustrates the need to focus on incorporating the UBT into health systems for greater availability to health workers and its use as standard of care. Ultimately, this study can be used as a stepping-stone for more research on this subject, providing evidence to influence policymakers to integrate the UBT into their protocols for postpartum hemorrhage response.

Individual Proton Pump Inhibitors and Outcomes in Patients With Coronary Artery Disease on Dual Antiplatelet Therapy: A Systematic Review.

BACKGROUND: Observational studies evaluating the possible interaction between proton pump inhibitors (PPIs) and clopidogrel have shown mixed results. We conducted a systematic review comparing the safety of individual PPIs in patients with coronary artery disease taking clopidogrel. METHODS AND RESULTS: Studies performed from January 1995 to December 2013 were screened for inclusion. Data were extracted, and study quality was graded for 34 potential studies. For those studies in which follow-up period, outcomes, and multivariable adjustment were comparable, meta-analysis was performed.The adjusted odds or hazard ratios for the composite of cardiovascular or all-cause death, myocardial infarction, and stroke at 1 year were reported in 6 observational studies with data on individual PPIs. Random-effects meta-analyses of the 6 studies revealed an increased risk for adverse cardiovascular events for those taking pantoprazole (hazard ratio 1.38; 95% CI 1.12-1.70), lansoprazole (hazard ratio 1.29; 95% CI 1.09-1.52), or esomeprazole (hazard ratio 1.27; 95% CI 1.02-1.58) compared with patients on no PPI. This association was not significant for omeprazole (hazard ratio 1.16; 95% CI 0.93-1.44). Sensitivity analyses for the coronary artery disease population (acute coronary syndrome versus mixed) and exclusion of a single study due to heterogeneity of reported results did not have significant influence on the effect estimates for any PPIs. CONCLUSIONS: Several frequently used PPIs previously thought to be safe for concomitant use with clopidogrel were associated with greater risk of adverse cardiovascular events. Although the data are observational, they highlight the need for randomized controlled trials to evaluate the safety of concomitant PPI and clopidogrel use in patients with coronary artery disease.

S332 pump station, south of TS/Ph-1, Taylor Slough

This material is based upon work supported by the National Science Foundation through the Florida Coastal Everglades Long-Term Ecological Research program under Cooperative Agreements #DBI-0620409 and #DEB-9910514. This image is made available for non-commercial or educational use only.