Do variations in nasal irrigation recipes and storage effect the risk of bacterial contamination?

OBJECTIVE: Make-at-home nasal irrigation solutions are often recommended for treating chronic rhinosinusitis. Many patients will store pre-made solution for convenient use. This study investigated the microbiological properties of differing recipes and storage temperatures. METHOD: Three irrigation recipes (containing sodium chloride, sodium bicarbonate and sucrose) were stored at 5oC and 22oC. Further samples were inoculated with Staphylococcus aureus and Pseudomonas aeruginosa. Sampling and culturing were conducted at intervals from day 0-12 to examine for bacterial presence or persistence. RESULTS: No significant bacterial growth was detected in any control solution stored at 5oC. Saline solutions remained relatively bacterial free, with poor survival of inoculated bacteria, which may be related to either lower pH or lower osmolality. Storing at room temperature increased the risk of contamination in control samples, particularly from pseudomonas. CONCLUSION: If refrigerated, pre-made nasal irrigation solutions can be stored safely for up to 12 days without risking cross-contamination to irrigation equipment or patients.

Noise-induced hearing loss in small-scale metal industry in Nepal.

BACKGROUND: There has been no previous research to demonstrate the risk of noise-induced hearing loss in industry in Nepal. Limited research on occupational noise-induced hearing loss has been conducted within small-scale industry worldwide, despite it being a substantial and growing cause of deafness in the developing world. METHOD: The study involved a cross-sectional audiometric assessment, with questionnaire-based examinations of noise and occupational history, and workplace noise level assessment. RESULTS: A total of 115 metal workers and 123 hotel workers (control subjects) were recruited. Noise-induced hearing loss prevalence was 30.4 per cent in metal workers and 4.1 per cent in hotel workers, with a significant odds ratio of 10.3. Except for age and time in occupation, none of the demographic factors were significant in predicting outcomes in regression analyses. When adjusted for this finding, and previous noise-exposed occupations, the odds ratio was 13.8. Workplace noise was significantly different between the groups, ranging from 65.3 to 84.7 dBA in metal worker sites, and from 51.4 to 68.6 dBA in the control sites. CONCLUSION: Metal workers appear to have a greater risk of noise-induced hearing loss than controls. Additional research on occupational noise-induced hearing loss in Nepal and small-scale industry globally is needed.

Tunable resonant and nonresonant interactions between a phase qubit and LC resonator.

We use a flux-biased radio frequency superconducting quantum interference device (rf SQUID) with an embedded flux-biased direct current SQUID to generate strong resonant and nonresonant tunable interactions between a phase qubit and a lumped-element resonator. The rf SQUID creates a tunable magnetic susceptibility between the qubit and resonator providing resonant coupling strengths from zero to near the ultrastrong coupling regime. By modulating the magnetic susceptibility, nonresonant parametric coupling achieves rates >100 MHz. Nonlinearity of the magnetic susceptibility also leads to parametric coupling at the subharmonics of the qubit-resonator detuning.

Sideband cooling of micromechanical motion to the quantum ground state.

The advent of laser cooling techniques revolutionized the study of many atomic-scale systems, fuelling progress towards quantum computing with trapped ions and generating new states of matter with Bose-Einstein condensates. Analogous cooling techniques can provide a general and flexible method of preparing macroscopic objects in their motional ground state. Cavity optomechanical or electromechanical systems achieve sideband cooling through the strong interaction between light and motion. However, entering the quantum regime--in which a system has less than a single quantum of motion--has been difficult because sideband cooling has not sufficiently overwhelmed the coupling of low-frequency mechanical systems to their hot environments. Here we demonstrate sideband cooling of an approximately 10-MHz micromechanical oscillator to the quantum ground state. This achievement required a large electromechanical interaction, which was obtained by embedding a micromechanical membrane into a superconducting microwave resonant circuit. To verify the cooling of the membrane motion to a phonon occupation of 0.34 ± 0.05 phonons, we perform a near-Heisenberg-limited position measurement within (5.1 ± 0.4)h/2π, where h is Planck's constant. Furthermore, our device exhibits strong coupling, allowing coherent exchange of microwave photons and mechanical phonons. Simultaneously achieving strong coupling, ground state preparation and efficient measurement sets the stage for rapid advances in the control and detection of non-classical states of motion, possibly even testing quantum theory itself in the unexplored region of larger size and mass. Because mechanical oscillators can couple to light of any frequency, they could also serve as a unique intermediary for transferring quantum information between microwave and optical domains.

Circuit cavity electromechanics in the strong-coupling regime.

Demonstrating and exploiting the quantum nature of macroscopic mechanical objects would help us to investigate directly the limitations of quantum-based measurements and quantum information protocols, as well as to test long-standing questions about macroscopic quantum coherence. Central to this effort is the necessity of long-lived mechanical states. Previous efforts have witnessed quantum behaviour, but for a low-quality-factor mechanical system. The field of cavity optomechanics and electromechanics, in which a high-quality-factor mechanical oscillator is parametrically coupled to an electromagnetic cavity resonance, provides a practical architecture for cooling, manipulation and detection of motion at the quantum level. One requirement is strong coupling, in which the interaction between the two systems is faster than the dissipation of energy from either system. Here, by incorporating a free-standing, flexible aluminium membrane into a lumped-element superconducting resonant cavity, we have increased the single-photon coupling strength between these two systems by more than two orders of magnitude, compared to previously obtained coupling strengths. A parametric drive tone at the difference frequency between the mechanical oscillator and the cavity resonance dramatically increases the overall coupling strength, allowing us to completely enter the quantum-enabled, strong-coupling regime. This is evidenced by a maximum normal-mode splitting of nearly six bare cavity linewidths. Spectroscopic measurements of these 'dressed states' are in excellent quantitative agreement with recent theoretical predictions. The basic circuit architecture presented here provides a feasible path to ground-state cooling and subsequent coherent control and measurement of long-lived quantum states of mechanical motion.

rf-SQUID-mediated coherent tunable coupling between a superconducting phase qubit and a lumped-element resonator.

We demonstrate coherent tunable coupling between a superconducting phase qubit and a lumped-element resonator. The coupling strength is mediated by a flux-biased rf SQUID operated in the nonhysteretic regime. By tuning the applied flux bias to the rf SQUID we change the effective mutual inductance, and thus the coupling energy, between the phase qubit and resonator. We verify the modulation of coupling strength from 0 to 100 MHz by observing modulation in the size of the splitting in the phase qubit's spectroscopy, as well as coherently by observing modulation in the vacuum Rabi oscillation frequency when on resonance. The measured spectroscopic splittings and vacuum Rabi oscillations agree well with theoretical predictions.

The PEP respiratory monitor: a validation study.

The search for a reliable and accurate respiratory rate monitor for use in non-intubated patients has proved to be a long and fruitless one. A new device fulfilling the criteria for such a monitor has recently been described. The pyroelectric polymer (PEP) device is safe, non-invasive, and cheap. In this study the PEP device, transthoracic impedance, and standard observer counting were all compared with the existing gold standard of capnography in 12 healthy adult volunteers. Using a standard statistical technique it was shown that the PEP device performed as well as a capnograph and was more accurate than the other currently available methods of monitoring respiratory rate.

Emergency intubation of infants: does laryngoscope blade design make any difference?

OBJECTIVE: To compare intubation times and ease of use for a range of infant laryngoscope blades in the hands of accident and emergency (A&E) personnel. METHODS: Seven different blades were compared in terms of intubation times and ease of use scores in the hands of 30 A&E senior house officers (SHOs) and nurses using a standard infant manikin. RESULTS: There was a significant difference in intubation times between the seven blades (p < 0.001). Intubation with two blade designs (Seward and Soper) took almost twice as long as for the other blades (p < 0.05). Subjective ease of use scoring also identified the Seward and Soper blades as being the most difficult to use (p < 0.05). There were no significant differences between SHO and nurse intubation times or ease of use scoring. Successful intubation was achieved within 30 seconds in 90% of attempts. All but two of the subjects used an incorrect levering technique for intubation despite all having previously received training in infant intubation. CONCLUSIONS: No current standard exists regarding the utilisation of infant laryngoscope blades in the A&E department. The first line blade available should be a C shaped blade (Miller, Oxford, Robert-shaw, or Wisconsin). Other blade designs should be kept for use only by more experienced personnel or in difficult intubation situations. Intubation training must focus on correct technique and regular assessment is essential.

An investigation into the effects of British Summer Time on road traffic accident casualties in Cheshire.

OBJECTIVE: To assess the effect of British Summer Time (BST) on road traffic accident casualties and to analyse whether the introduction of year round BST would result in reductions in casualty numbers. DESIGN: A comparative study of road traffic accident data from before and after the onset of BST. SETTING: The county of Cheshire. SUBJECT: Data from a total of 4185 casualties from the period 1983 to 1993. MAIN OUTCOME MEASURES: The effect of BST on both vehicle, cycle, and pedestrian casualties and casualties among schoolchildren. RESULTS: The onset of BST in spring was associated with reductions in casualty numbers of 6% in the morning and 11% in the evening. The anticipated rise in casualties with the darker mornings was not seen and as reductions were maximal in the pedestrian (36%), cyclist (11%), and schoolchild (24%) subgroups they were presumed to be due to an altered reliance on vehicular transport. The change back to Greenwich Mean Time (GMT) in autumn produced an anticipated reduction (6%) in casualties in the lighter mornings. The darker evenings, as predicted, were associated with significant increases in casualties (4%), mainly vehicle (5%) and pedestrian (8%) casualties. There was an overall net reduction in casualty numbers when the analysed periods of BST were compared to those during GMT. CONCLUSIONS: The use of BST in Cheshire over the period studied was associated with reductions in casualty figures. The application of these results nationally may be expected to produce more and less pronounced changes the further north or south, respectively, the area studied. The introduction of year-long BST would result in beneficial effects on road traffic accident casualties.