Secondary analysis of data from a core outcome set for burns demonstrated the need for involvement of lower income countries.

OBJECTIVE: To compare the views of participants from different income-status countries on outcome selection for a burn care Core Outcome Set (COS). METHODS: A retrospective analysis of data collected during a two round Delphi survey to prioritise the most important outcomes in burn care research. RESULTS: There was considerable agreement between participants from low- and middle-income countries (LMICs) and high-income countries (HICs) across outcomes. The groups agreed on 91% of 88 outcomes in round 1 and 92% of 100 in round 2. In cases of discordance, the consensus of participants from LMICs was to include the outcome and for participants from HICs to exclude. There was also considerable agreement between the groups for the top-ten ranking outcomes. Discordance in outcome prioritisation gives an insight into the different values clinicians from LMICs place on outcomes compared to those from HICs. Limitations of the study were that outcome rankings from international patients were not available. Healthcare professionals from LMICs were not involved in the final consensus meeting. CONCLUSION: COS developers should consider the need for a COS to be global at protocol stage. Global COS should include equal representation from both LMICs and HICs at all stages of development.

Photo-oxidation of tetracycline adsorbed on hydroxyapatite in relation to the light-induced staining of teeth.

In an attempt to understand the chemistry of the light-induced staining of children's teeth by tetracycline, we studied the photo-chemical behavior of tetracycline adsorbed on hydroxyapatite, as a simple model of enamel. Tetracycline was strongly bound by hydroxyapatite to give a pale yellow material which, under ultraviolet light, showed a bright yellow fluorescence (lambda max 525 nm). On exposure of this material to the radiation from a medium-pressure mercury lamp, the fluorescence gradually disappeared, and a red-purple product was formed. Photo-acoustic spectroscopy was employed to follow the disappearance of tetracycline and the concomitant formation of the red-purple product, the spectrum of which (lambda max 530 nm) led to the conclusion that it was 4 alpha, 12 alpha-anhydro-4-oxo-4-dedimethylaminotetracycline (AODTC). This assignment was supported by the observation that 1 mole of oxygen was absorbed per mole of adsorbed tetracycline converted to the red-purple product. It is suggested that the formation of AODTC on hydroxyapatite probably takes place by a mechanism of photo-oxidation similar to that already proposed for solutions of tetracycline, and that the formation of AODTC in children's teeth is responsible for the light-induced staining caused by tetracycline.

British surgical aid to Jordan.

The surgical commitment of No. 2 Field Hospital, R.A.M.C., during its stay in Jordan is presented. The majority of patients that were admitted had sustained war wounds, many of which were infected due to the delay in treatment. The difficulties encountered in their subsequent management are discussed. Special reference is made to the use of ketamine (Ketalar) and mafenide acetate (Sulphamylon) in the treatment of those burns cases under our care. It is the first time for many years that a British field hospital has been employed in an active rôle.

The effect of field of view size on steady-state pupil diameter.

Studies of the relationship between luminance and pupil diameter have produced widely differing results. This research note explores the possibility that this is due, in part, to differences in the size of the adapting fields used by various workers. We present measurements of pupil diameter as a function of luminance for a variety of field subtenses. The results indicate a consistent trend for smaller subtenses to produce less pupil constriction. For field diameters of up to 25 degrees, replotting the data in terms of corneal flux density (i.e. the product of luminance and subtended area) causes an approximate convergence onto a single function described by D = 7.75-5.75 [(F/846)0.41/((F/846)0.41 / 2)] where D is the pupil diameter (mm) and F is the corneal flux density (cdm-2 deg2). This equation should be of some practical use in estimation of natural pupil diameter.

Photochemistry of tetrachlorosalicylanilide and its relevance to the persistent light reactor.

The photochemistry of 3,5,3',4'-tetrachlorosalicylanilide has been studied in solution under carefully controlled conditions. When irradiated in a buffered solution of pH 7.4 (physiological pH), three atoms of chlorine are liberated from the molecule instead of one as suggested by earlier photochemical work. From this observation a mechanism is proposed to explain the long-term photobiological effect of this compound in skin i.e. that of the persistent light reactor.

Exclusion limits on the WIMP-nucleon cross section from the cryogenic dark matter search.

The Cryogenic Dark Matter Search (CDMS) employs Ge and Si detectors to search for weakly interacting massive particles (WIMPs) via their elastic-scattering interactions with nuclei while discriminating against interactions of background particles. CDMS data, accounting for the neutron background, give limits on the spin-independent WIMP-nucleon elastic-scattering cross section that exclude unexplored parameter space above 10 GeV/c2 WIMP mass and, at >75% C.L., the entire 3sigma allowed region for the WIMP signal reported by the DAMA experiment.