How Noninvasive Haemoglobin Measurement with Pulse CO-Oximetry Can Change Your Practice: An Expert Review

Trauma related haemorrhagic anaemia is rarely diagnosed by physical examination alone but typically includes measurement of blood haemoglobin, one of the most frequently ordered laboratory tests. Recently, noninvasive technologies have been developed that allow haemoglobin to be measured immediately without the need for intravenous access or having to take venous, arterial, or capillary blood. Moreover, with these technologies haemoglobin can be continuously measured in patients with active bleeding, to guide the start and stop of blood transfusions and to detect occult bleeding. Recent studies on the accuracy of the devices showed promising results in terms of accuracy of hemoglobin measurement compared to laboratory determination. The present review gives an overview on the technology itself and reviews the current literature on the subject.

Absolute quantitative real-time polymerase chain reaction for the measurement of human papillomavirus E7 mRNA in cervical cytobrush specimens.

BACKGROUND: Few reports of the utilization of an accurate, cost-effective means for measuring HPV oncogene transcripts have been published. Several papers have reported the use of relative quantitation or more expensive Taqman methods. Here, we report a method of absolute quantitative real-time PCR utilizing SYBR-green fluorescence for the measurement of HPV E7 expression in cervical cytobrush specimens. RESULTS: The construction of a standard curve based on the serial dilution of an E7-containing plasmid was the key for being able to accurately compare measurements between cervical samples. The assay was highly reproducible with an overall coefficient of variation of 10.4%. CONCLUSION: The use of highly reproducible and accurate SYBR-based real-time polymerase chain reaction (PCR) assays instead of performing Taqman-type assays allows low-cost, high-throughput analysis of viral mRNA expression. The development of such assays will help in refining the current screening programs for HPV-related carcinomas.

Atmospheric CO₂, δ(O₂/N₂) and δ13CO2 measurements at Jungfraujoch, Switzerland: results from a flask sampling intercomparison program

We present results from an intercomparison program of CO2, δ(O2/N2) and δ13CO2 measurements from atmospheric flask samples. Flask samples are collected on a bi-weekly basis at the High Altitude Research Station Jungfraujoch in Switzerland for three European laboratories: the University of Bern, Switzerland, the University of Groningen, the Netherlands and the Max Planck Institute for Biogeochemistry in Jena, Germany. Almost 4 years of measurements of CO2, δ(O2/N2) and δ13CO2 are compared in this paper to assess the measurement compatibility of the three laboratories. While the average difference for the CO2 measurements between the laboratories in Bern and Jena meets the required compatibility goal as defined by the World Meteorological Organization, the standard deviation of the average differences between all laboratories is not within the required goal. However, the obtained annual trend and seasonalities are the same within their estimated uncertainties. For δ(O2/N2) significant differences are observed between the three laboratories. The comparison for δ13CO2 yields the least compatible results and the required goals are not met between the three laboratories. Our study shows the importance of regular intercomparison exercises to identify potential biases between laboratories and the need to improve the quality of atmospheric measurements.

Cortical bone loss at the tibia in postmenopausal women with osteoporosis is associated with incident non-vertebral fractures: Results of a randomized controlled ancillary study of HORIZON

BACKGROUND In postmenopausal women, yearly intravenous zoledronate (ZOL) compared to placebo (PLB) significantly increased bone mineral density (BMD) at lumbar spine (LS), femoral neck (FN), and total hip (TH) and decreased fracture risk. The effects of ZOL on BMD at the tibial epiphysis (T-EPI) and diaphysis (T-DIA) are unknown. METHODS A randomized controlled ancillary study of the HORIZON trial was conducted at the Department of Osteoporosis of the University Hospital of Berne, Switzerland. Women with ≥1 follow-up DXA measurement who had received ≥1 dose of either ZOL (n=55) or PLB (n=55) were included. BMD was measured at LS, FN, TH, T-EPI, and T-DIA at baseline, 6, 12, 24, and 36 months. Morphometric vertebral fractures were assessed. Incident clinical fractures were recorded as adverse events. RESULTS Baseline characteristics were comparable with those in HORIZON and between groups. After 36 months, BMD was significantly higher in women treated with ZOL vs. PLB at LS, FN, TH, and T-EPI (+7.6%, +3.7%, +5.6%, and +5.5%, respectively, p<0.01 for all) but not T-DIA (+1.1%). The number of patients with ≥1 incident non-vertebral or morphometric fracture did not differ between groups (9 ZOL/11 PLB). Mean changes in BMD did not differ between groups with and without incident fracture, except that women with an incident non-vertebral fracture had significantly higher bone loss at predominantly cortical T-DIA (p=0.005). CONCLUSION ZOL was significantly superior to PLB at T-EPI but not at T-DIA. Women with an incident non-vertebral fracture experienced bone loss at T-DIA.

Effect of continuous gastric enteral feeding on tonometric measurement of gastric intramucosal carbon dioxide levels in healthy volunteers

Purpose. The aim of this research was to evaluate the effect of enteral feeding on tonometric measurement of gastric regional carbon dioxide levels (PrCO2) in normal healthy volunteers. Design and methods. The sample included 12 healthy volunteers recruited by the University Clinical Research Center (UCRC). An air tonometry system monitored PrCO2 levels using a tonometer placed in the lumen of the stomach via orogastric intubation. PrCO2 was automatically measured and recorded every 10 minutes throughout the five hour study period. An oral dose of famotidine 40 mg was self-administered the evening prior to and the morning of the study. Instillation of Isocal® High Nitrogen (HN) was used for enteral feeding in hourly escalating doses of 0, 40, 60, and 80 ml/hr with no feeding during the fifth hour. Results . PrCO2 measurements at time 0 and 10 minutes (41.4 ± 6.5 and 41.8 ± 5.7, respectively) demonstrated biologic precision (Levene's Test statistic = 0.085, p-value 0.774). Biologic precision was lost between T130 and T140 40 when compared to baseline TO (Levene's Test statistic = 1.70, p-value 0.205; and 3.205, p-value 0.042, respectively) and returned to non-significant levels between T270 and T280 (Levene's Test statistic = 3.083, p-value 0.043; and 2.307, p-value 0.143, respectively). Isocal® HN significantly affected the biologic accuracy of PrCO2 measurements (repeated measures ANOVA F 4.91, p-value <0.001). After 20 minutes of enteral feeding at 40 ml/hr, PrCO2 significantly increased (41.4 ± 6.5 to 46.6 ± 4.25, F = 5.4, p-value 0.029). Maximum variance from baseline (41.4 ± 6.5 to 61.3 ± 15.2, F = 17.22, p-value <0.001) was noted after 30 minutes of Isocal® HN at 80 ml/hr or 210 minutes from baseline. The significant elevations in PrCO2 continued throughout the study. Sixty minutes after discontinuation of enteral feeding, PrCO2 remained significantly elevated from baseline (41.4 ± 6.5 to 51.8 ± 9.2, F = 10.15, p-value 0.004). Conclusion. Enteral feeding with Isocal® HN significantly affects the precision and accuracy of PrCO2 measurements in healthy volunteers. ^

Minimally Invasive Intraoperative Stiffness Measurement of Lumbar Spinal Motion Segments

OBJECTIVE: To test a new tiny-tipped intraoperative diagnostic tool that was designed to provide the surgeon with reliable stiffness data on the motion segment during microdiscectomy. A decrease in stiffness after nuclectomy and a measurable influence of muscle tension were assumed. If the influence of muscle tension on the motion segment could at least be ruled out, there should be no difference with regard to stiffness between women and men. If these criteria are met, this new intraoperative diagnostic tool could be used in further studies for objective decision-making regarding additional stabilization systems after microdiscectomy. METHODS: After evaluation of the influence of muscle relaxation during in vivo measurements with a spinal spreader between the spinous processes, 21 motion segments were investigated in 21 patients. Using a standardized protocol, including quantified muscle relaxation, spinal stiffness was measured before laminotomy and after nuclectomy. RESULTS: The decrease in stiffness after microdiscectomy was highly significant. There were no statistically significant differences between men and women. The average stiffness value before discectomy was 33.7 N/mm, and it decreased to 25.6 N/mm after discectomy. The average decrease in stiffness was 8.1 N/mm (24%). CONCLUSION: In the moderately degenerated spine, stiffness decreases significantly after microdiscectomy. Control for muscle relaxation is essential when measuring in vivo spinal stiffness. The new spinal spreader was found to provide reliable data. This spreader could be used in further studies for objective decision-making about additional stabilization systems after microdiscectomy.

Measurement of Upsilon production in 7 TeV pp collisions at ATLAS

Using 1.8 fb(-1) of pp collisions at a center- of- mass energy of 7 TeV recorded by the ATLAS detector at the Large Hadron Collider, we present measurements of the production cross sections of Upsilon(1S,2S,3S) mesons. Upsilon mesons are reconstructed using the dimuon decay mode. Total production cross sections for p(T) < 70 GeV and in the rapidity interval vertical bar y(Upsilon)vertical bar < 2. 25 are measured to be, 8.01 +/- 0.02 +/- 0.36 +/- 0.31 nb, 2.05 +/- 0.01 +/- 0.12 +/- 0.08 nb, and 0.92 +/- 0.01 +/- 0.07 +/- 0.04 nb, respectively, with uncertainties separated into statistical, systematic, and luminosity measurement effects. In addition, differential cross section times dimuon branching fractions for Upsilon(1S), Upsilon(2S), and Upsilon(3S) as a function of Upsilon transverse momentum pT and rapidity are presented. These cross sections are obtained assuming unpolarized production. If the production polarization is fully transverse or longitudinal with no azimuthal dependence in the helicity frame, the cross section may vary by approximately +/- 20%. If a nontrivial azimuthal dependence is considered, integrated cross sections may be significantly enhanced by a factor of 2 or more. We compare our results to several theoretical models of Upsilon meson production, finding that none provide an accurate description of our data over the full range of Upsilon transverse momenta accessible with this data set.

Measurement of angular correlations in Drell-Yan lepton pairs to probe Z/gamma* boson transverse momentum at sqrt(s)=7 TeV with the ATLAS detector

A measurement of angular correlations in Drell-Yan lepton pairs via the phi(eta)* observable is presented. This variable probes the same physics as the Z/gamma* boson transverse momentum with a better experimental resolution. The Z/gamma* -> e(+)e(-) and Z/gamma* -> mu(+)mu(-) decays produced in proton-proton collisions at a centre-of-mass energy of root s = 7 TeV are used. The data were collected with the ATLAS detector at the LHC and correspond to an integrated luminosity of 4.6 fb(-1). Normalised differential cross sections as a function of phi(eta)* are measured separately for electron and muon decay channels. These channels are then combined for improved accuracy. The cross section is also measured double differentially as a function of phi(eta)* for three independent bins of the Z boson rapidity. The results are compared to QCD calculations and to predictions from different Monte Carlo event generators. The data are reasonably well described, in all measured Z boson rapidity regions, by resummed QCD predictions combined with fixed-order perturbative QCD calculations or by some Monte Carlo event generators. The measurement precision is typically better by one order of magnitude than present theoretical uncertainties.

Measurement of ℤℤ production in pp collisions at sqrts=7 TeV and limits on anomalous ℤℤℤ ℤℤgamma couplings with the ATLAS detector

A measurement of the ZZ production cross section in proton-proton collisions at root s = 7 TeV using data recorded by the ATLAS experiment at the Large Hadron Collider is presented. In a data sample corresponding to an integrated luminosity of 4.6 fb(-1) collected in 2011, events are selected that are consistent either with two Z bosons decaying to electrons or muons or with one Z boson decaying to electrons or muons and a second Z boson decaying to neutrinos. The ZZ((*)) -> l(+)l(-)l'(+)l'(-) and ZZ -> l(+)l(-) nu(nu) over bar cross sections are measured in restricted phase-space regions. These results are then used to derive the total cross section for ZZ events produced with both Z bosons in the mass range 66 to 116 GeV, sigma(tot)(ZZ) = 6.7 +/- 0.7 (stat.) (+0.4)(-0.3) (syst.) +/- 0.3 (lumi.) pb, which is consistent with the Standard Model prediction of 5.89(-0.18)(+0.22) pb calculated at next-to-leading order in QCD. The normalized differential cross sections in bins of various kinematic variables are presented. Finally, the differential event yield as a function of the transverse momentum of the leading Z boson is used to set limits on anomalous neutral triple gauge boson couplings in ZZ production.

Measurement of isolated-photon pair production in pp collisions at sqrts=7 TeV with the ATLAS detector

The ATLAS experiment at the LHC has measured the production cross section of events with two isolated photons in the final state, in proton-proton collisions at root s = 7 TeV. The full data set collected in 2011, corresponding to an integrated luminosity of 4.9 fb(-1), is used. The amount of background, from hadronic jets and isolated electrons, is estimated with data-driven techniques and subtracted. The total cross section, for two isolated photons with transverse energies above 25 GeV and 22 GeV respectively, in the acceptance of the electromagnetic calorimeter (vertical bar eta vertical bar < 1.37 and 1.52 < vertical bar eta vertical bar 2.37) and with an angular separation Delta R > 0.4, is 44.0(-4.2)(+3.2) pb. The differential cross sections as a function of the di-photon invariant mass, transverse momentum, azimuthal separation, and cosine of the polar angle of the largest transverse energy photon in the Collins-Soper di-photon rest frame are also measured. The results are compared to the prediction of leading-order parton-shower and next-to-leading-order and next-to-next-to-leading-order parton-level generators.

Measurement of the flavour composition of dijet events in pp collisions at sqrts=7 TeV with the AT detector

This paper describes a measurement of the flavour composition of dijet events produced in pp collisions at root s = 7 TeV using the ATLAS detector. The measurement uses the full 2010 data sample, corresponding to an integrated luminosity of 39 pb(-1). Six possible combinations of light, charm and bottom jets are identified in the dijet events, where the jet flavour is defined by the presence of bottom, charm or solely light flavour hadrons in the jet. Kinematic variables, based on the properties of displaced decay vertices and optimised for jet flavour identification, are used in a multidimensional template fit to measure the fractions of these dijet flavour states as functions of the leading jet transverse momentum in the range 40 GeV to 500 GeV and jet rapidity vertical bar y vertical bar < 2.1. The fit results agree with the predictions of leading-and next-to-leading-order calculations, with the exception of the dijet fraction composed of bottom and light flavour jets, which is underestimated by all models at large transverse jet momenta. The ability to identify jets containing two b-hadrons, originating from e. g. gluon splitting, is demonstrated. The difference between bottom jet production rates in leading and subleading jets is consistent with the next-to-leading-order predictions.

Measurement of the jet radius and transverse momentum dependence of inclusive jet suppression in lead-lead collisions at sqrtsNN=2.76 TeV with the AT detector

Measurements of inclusive jet suppression in heavy ion collisions at the LHC provide direct sensitivity to the physics of jet quenching. In a sample of lead-lead collisions at root S-NN = 2.76 TeV corresponding to an integrated luminosity of approximately 7 mu b(-1), ATLAS has measured jets with a calorimeter system over the pseudorapidity interval vertical bar eta vertical bar < 2.1 and over the transverse momentum range 38 < pT <210 GeV. Jets were reconstructed using the anti-k(t) algorithm with values for the distance parameter that determines the nominal jet radius of R = 0.2, 0.3, 0.4 and 0.5. The centrality dependence of the jet yield is characterized by the jet "central-to-peripheral ratio," R-CP. Jet production is found to be suppressed by approximately a factor of two in the 10% most central collisions relative to peripheral collisions. R-CP varies smoothly with centrality as characterized by the number of participating nucleons. The observed suppression is only weakly dependent on jet radius and transverse momentum. These results provide the first direct measurement of inclusive jet suppression in heavy ion collisions and complement previous measurements of dijet transverse energy imbalance at the LHC.

Measurement of the Inclusive NuMu Charged Current Cross Section on Carbon in the Near Detector of the T2K

T2K has performed the first measurement of nu(mu) inclusive charged current interactions on carbon at neutrino energies of similar to 1 GeV where the measurement is reported as a flux-averaged double differential cross section in muon momentum and angle. The flux is predicted by the beam Monte Carlo and external data, including the results from the NA61/SHINE experiment. The data used for this measurement were taken in 2010 and 2011, with a total of 10.8 x 10(19) protons-on-target. The analysis is performed on 4485 inclusive charged current interaction candidates selected in the most upstream fine-grained scintillator detector of the near detector. The flux-averaged total cross section is (phi) = (6.91 +/- 0.13(stat) +/- 0.84(syst)) x 10(-39) cm(2)/nucleon for a mean neutrino energy of 0.85 GeV.

Measurement of the production cross section of jets in association with a Z boson in pp collisions at sqrt(s) = 7 TeV with the ATLAS detector

Measurements of the production of jets of particles in association with a Z boson in pp collisions at root s = 7 TeV are presented, using data corresponding to an integrated luminosity of 4.6 fb(-1) collected by the ATLAS experiment at the Large Hadron Collider. Inclusive and differential jet cross sections in Z events, with Z decaying into electron or muon pairs, are measured for jets with transverse momentum p(T) > 30 GeV and rapidity vertical bar y vertical bar < 4.4. The results are compared to next-to-leading-order perturbative QCD calculations, and to predictions from different Monte Carlo generators based on leading-order and next-to-leading-order matrix elements supplemented by parton showers.

Measurement of the inclusive jet cross section in pp collisions at sqrt(s)=2.76 TeV and comparison to the inclusive jet cross section at sqrt(s)=7 TeV using the ATLAS detector

The inclusive jet cross-section has been measured in proton-proton collisions at root s = 2.76 TeV in a dataset corresponding to an integrated luminosity of 0.20 pb(-1) collected with the ATLAS detector at the Large Hadron Collider in 2011. Jets are identified using the anti-k(t) algorithm with two radius parameters of 0.4 and 0.6. The inclusive jet double-differential cross-section is presented as a function of the jet transverse momentum p(T) and jet rapidity y, covering a range of 20 <= p(T) < 430 GeV and vertical bar y vertical bar < 4.4. The ratio of the cross-section to the inclusive jet cross-section measurement at root s = 7 TeV, published by the ATLAS Collaboration, is calculated as a function of both transverse momentum and the dimensionless quantity x(T) = 2p(T)/root s, in bins of jet rapidity. The systematic uncertainties on the ratios are significantly reduced due to the cancellation of correlated uncertainties in the two measurements. Results are compared to the prediction from next-to-leading order perturbative QCD calculations corrected for non-perturbative effects, and next-to-leading order Monte Carlo simulation. Furthermore, the ATLAS jet cross-section measurements at root s = 2.76 TeV and root s = 7 TeV are analysed within a framework of next-to-leading order perturbative QCD calculations to determine parton distribution functions of the proton, taking into account the correlations between the measurements.