The influence of reusing ‘Formtex’ controlled permeability

The effects of the reuse of ‘Formtex’ Controlled Permeability Formwork (CPF) liner on strength and durability properties of concrete were investigated at two different water-cement ratios and the results are reported in this paper. Test blocks were cast using the CPF on one side and impermeable formwork (IF) on the opposite side of the mould so that direct comparisons could be made between the two. The strength was assessed using the Limpet pulloff tester and both the air permeability and the water absorption (sorptivity) were measured using the Autoclam Permeability System. Both these instruments measured the ‘covercrete’ properties. In addition, cores cut from the test specimens were subjected to an accelerated carbonation test and a chloride exposure test. The results showed that the ‘Formtex’ CPF increases the surface strength and the durability of concrete compared to the IF. There was an almost complete elimination of blowholes. The permeability of concrete decreased and its resistance to the ingress of both carbon dioxide and chlorides increased when CPF was used. The beneficial effects of the Formtex CPF were most evident in concrete of higher water-cement ratio. With the reuse of the Formtex liner twice, that is a total of three uses, the performance of the CPF to improve the properties of concrete remained almost the same. In this research the CPF liner was cleaned thoroughly between each use, which must be adhered to for site applications for reproducing the beneficial effects observed in the laboratory.

A randomised, controlled trial of conventional versus automated weaning from mechanical ventilation using SmartcareTM/PS

Objective
Preliminary assessment of an automated weaning system (SmartCare™/PS) compared to usual management of weaning from mechanical ventilation performed in the absence of formal protocols.


Design and setting
A randomised, controlled pilot study in one Australian intensive care unit.


Patients
A total of 102 patients were equally divided between SmartCare/PS and Control.

Interventions
The automated system titrated pressure support, conducted a spontaneous breathing trial and provided notification of success (“separation potential”).

Measurements and results
The median time from the first identified point of suitability for weaning commencement to the state of “separation potential” using SmartCare/PS was 20 h (interquartile range, IQR, 2–40) compared to 8 h (IQR 2–43) with Control (log-rank P = 0.3). The median time to successful extubation was 43 h (IQR 6–169) using SmartCare/PS and 40 (14–87) with Control (log-rank P = 0.6). Unadjusted, the estimated probability of reaching “separation potential” was 21% lower (95% CI, 48% lower to 20% greater) with SmartCare/PS compared to Control. Adjusted for other covariates (age, gender, APACHE II, SOFAmax, neuromuscular blockade, corticosteroids, coma and elevated blood glucose), these estimates were 31% lower (95% CI, 56% lower to 9% greater) with SmartCare/PS. The study groups showed comparable rates of reintubation, non-invasive ventilation post-extubation, tracheostomy, sedation, neuromuscular blockade and use of corticosteroids.

Conclusions
Substantial reductions in weaning duration previously demonstrated were not confirmed when the SmartCare/PS system was compared to weaning managed by experienced critical care specialty nurses, using a 1:1 nurse-to-patient ratio. The effect of SmartCare/PS may be influenced by the local clinical organisational context.

Does additional support by nurses enhance the effect of a brief smoking cessation intervention in people with moderate to severe chronic obstructive pulmonary disease? A randomised controlled trial

Background: Smoking cessation is the primary disease modifying intervention for chronic obstructive pulmonary disease (COPD).

Vitamins C and E for prevention of pre-eclampsia in women with type 1 diabetes (DAPIT): a randomised placebo-controlled trial.

Background
Results of several trials of antioxidant use during pregnancy have not shown a reduction in pre-eclampsia, but the eff ect in women with diabetes is unknown. We aimed to assess whether supplementation with vitamins C and E reduced incidence of pre-eclampsia in women with type 1 diabetes.

Methods
We enrolled women from 25 UK antenatal metabolic clinics in a multicentre randomised placebo-controlled trial. Eligibility criteria were type 1 diabetes preceding pregnancy, presentation between 8 weeks’ and 22 weeks’ gestation, singleton pregnancy, and age 16 years or older. Women were randomly allocated in a 1:1 ratio to receive1000 mg vitamin C and 400 IU vitamin E (a-tocopherol) or matched placebo daily until delivery. The randomisation sequence was stratifi ed by centre with balanced blocks of eight patients. All trial personnel and participants were masked to treatment allocation. The primary endpoint was pre-eclampsia, which we defi ned as gestational hypertension with proteinuria. Analysis was by modifi ed intention to treat. This study is registered, ISRCTN27214045.

Findings
Between April, 2003, and June, 2008, 762 women were randomly allocated to treatment groups (379 vitamin supplementation, 383 placebo). The primary endpoint was assessed for 375 women allocated to receive vitamins, and 374 allocated to placebo. Rates of pre-eclampsia did not differ between vitamin (15%, n=57) and placebo (19%, 70)groups (risk ratio 0·81, 95% CI 0·59–1·12). No adverse maternal or neonatal outcomes were reported.

Interpretation
Supplementation with vitamins C and E did not reduce risk of pre-eclampsia in women with type 1 diabetes. However, the possibility that vitamin supplementation might be benefi cial in women with a low antioxidant status at baseline needs further testing.

Cluster randomised controlled trial of an infection control education and training intervention programme focusing on meticillin-resistant Staphylococcus aureus in nursing homes for older people

The aim of this cluster randomised controlled trial was to test the impact of an infection control education and training programme on meticillin-resistant Staphylococcus aureus (MRSA) prevalence in nursing homes. Nursing homes were randomised to intervention (infection control education and training programme; N¼16) or control (usual practice continued; N¼16). Staff in intervention homes were educated and trained (0, 3 and 6 months) in the principles and implementation of good infection control practice with infection control audits conducted in all sites (0, 3, 6 and 12 months) to assess compliance with good practice. Audit scores were fed back to nursing home managers in intervention homes, together with a written report indicating where practice could be improved. Nasal swabs were taken from all consenting residents and staff at 0, 3, 6 and 12 months. The primary outcome was MRSA prevalence in residents and staff, and the secondary outcome was a change in infection control audit scores. In all, 793 residents and 338 staff were recruited at baseline. MRSA prevalence did not change during the study in residents or staff. The relative risk of a resident being colonised with MRSA in an intervention home compared with a control home at 12 months was 0.99 (95% con?dence interval: 0.69, 1.42) after adjustment for clustering. Mean infection control audit scores were signi?cantly higher in the intervention homes (82%) compared with the control homes (64%) at 12 months (P<0.0001). Consideration should be given to other approaches which may help to reduce MRSA in this setting.

Li-6 in the atmosphere of GJ 117 revisited

Detection of Li-6 has been shown for energetic solar events, one chromospherically active binary, and several dwarf halo stars. We had previously found a Li-6/Li-7 = 0.03 +/- 0.01 for active K dwarf GJ 117 using VLT UVES observations. Here we present high signal-to-noise (> 1000) high spectral resolution observations taken with the McDonald Observatory's 2.7 m and echelle spectrometer of GJ 117. We have used the solar spectrum and template stars to eliminate possible blends, such as Ti I, in the Li-6 spectral region. Our new analysis, using an updated PHOENIX model atmosphere, finds Li-6/Li-7 = 0.05 +/- 0.02. In addition, bisector analysis showed no significant red asymmetries that would affect the lithium line profile. No changes above the statistical uncertainties are found between the VLT and McDonald data. The amount of Li-6 derived for GJ 117 is consistent with creation in spallation reactions on the stellar surface, but we caution that uncertainties in the continuum level may cause additional uncertainty in the Li-6 fraction.

Remote Detection and Identification of Organic Remains: An Assessment of Archaeological Potential

This paper reviews the various methods of using natural or induced light spectra as analytical tools in forensic archaeology. Chemical identi?cation can be made at long range and wide scale (tens of metres) down to short range and very small scale (nanometres). The identi?cation of organic gases and materials has used either chemical capture and chromatography, induced (laser or ultraviolet) light sources or laser Raman microscope spectroscopy. The remote gas detection method relies on the identi?cation of atmospheric gases by their characteristic light spectra. Modern spectroscopes can detect gases down to a few parts per million of an atmosphere. When the light source (wavelength) and direction is controlled, so laser-induced spectroscopy may be used to monitor the emission of gases such methane from buried organic remains. In order to identify the location of buried organic remains, a grid of sample points must be established using a base line or global
positioning system. When matched to base line or ground-positioning systems, such data can be manipulated by geographical information system packages. This would enable pinpointing of anomalies for excavation or avoidance. Microscope-based laser Raman spectroscopy can be used to directly analyse captured gases, swabs and surfaces without the problems of long-path detection. Copyright ? 2002 John Wiley & Sons, Ltd.

Amplitude and Phase Controlled Reflectarray Element Based on an Impedance Transformation Unit

An architecture to simultaneously affect both amplitude and phase control from a reflectarray element using an impedance transformation unit is demonstrated. It is shown that a wide range of control is possible from a single element, removing the conventional necessity for variable sized elements across an array in order to form a desired reflectarray far-field pattern. Parallel plate waveguide measurements for a 2.2 GHz prototype element validate the phase and amplitude variation available from the element. It is demonstrated that there is sufficient control of the element's reflection response to allow Dolph-Tschebyscheff weighting coefficients for major-lobe to side-lobe ratios of up to 36 dB to be implemented.

Preprandial versus postprandial blood glucose monitoring in type 1 diabetic pregnancy: A randomized controlled clinical trial

OBJECTIVE: This study was undertaken to compare preprandial and postprandial capillary glucose monitoring in pregnant women with type 1 diabetes.