Adaptation and Validation of a Pediatric Sequential Organ Failure Assessment Score and Evaluation of the Sepsis-3 Definitions in Critically Ill Children.

PubMed

Matics, Travis J; Sanchez-Pinto, L Nelson

2017-10-02

The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) uses the Sequential Organ Failure Assessment (SOFA) score to grade organ dysfunction in adult patients with suspected infection. However, the SOFA score is not adjusted for age and therefore not suitable for children. To adapt and validate a pediatric version of the SOFA score (pSOFA) in critically ill children and to evaluate the Sepsis-3 definitions in patients with confirmed or suspected infection. This retrospective observational cohort study included all critically ill children 21 years or younger admitted to a 20-bed, multidisciplinary, tertiary pediatric intensive care unit between January 1, 2009 and August 1, 2016. Data on these children were obtained from an electronic health record database. The pSOFA score was developed by adapting the original SOFA score with age-adjusted cutoffs for the cardiovascular and renal systems and by expanding the respiratory criteria to include noninvasive surrogates of lung injury. Daily pSOFA scores were calculated from admission until day 28 of hospitalization, discharge, or death (whichever came first). Three additional pediatric organ dysfunction scores were calculated for comparison. Organ dysfunction measured by the pSOFA score, and sepsis and septic shock according to the Sepsis-3 definitions. The primary outcome was in-hospital mortality. The daily pSOFA scores and additional pediatric organ dysfunction scores were compared. Performance was evaluated using the area under the curve. The pSOFA score was then used to assess the Sepsis-3 definitions in the subgroup of children with confirmed or suspected infection. In all, 6303 patients with 8711 encounters met inclusion criteria. Each encounter was treated independently. Of the 8482 survivors of hospital encounters, 4644 (54.7%) were male and the median (interquartile range [IQR]) age was 69 (17-156) months. Among the 229 nonsurvivors, 127 (55.4%) were male with a median (IQR) age of 43 (8-144) months. In-hospital mortality was 2.6%. The maximum pSOFA score had excellent discrimination for in-hospital mortality, with an area under the curve of 0.94 (95% CI, 0.92-0.95). The pSOFA score had a similar or better performance than other pediatric organ dysfunction scores. According to the Sepsis-3 definitions, 1231 patients (14.1%) were classified as having sepsis and had a mortality rate of 12.1%, and 347 (4.0%) had septic shock and a mortality rate of 32.3%. Patients with sepsis were more likely to die than patients with confirmed or suspected infection but no sepsis (odds ratio, 18; 95% CI, 11-28). Of the 229 patients who died during their hospitalization, 149 (65.0%) had sepsis or septic shock during their course. The pSOFA score was adapted and validated with age-adjusted variables in critically ill children. Using the pSOFA score, the Sepsis-3 definitions were assessed in children with confirmed or suspected infection. This study is the first assessment, to date, of the Sepsis-3 definitions in critically ill children. Use of these definitions in children is feasible and shows promising results.

Systemic Inflammatory Response Syndrome, Quick Sequential Organ Function Assessment, and Organ Dysfunction: Insights From a Prospective Database of ED Patients With Infection.

PubMed

Williams, Julian M; Greenslade, Jaimi H; McKenzie, Juliet V; Chu, Kevin; Brown, Anthony F T; Lipman, Jeffrey

2017-03-01

A proposed revision of sepsis definitions has abandoned the systemic inflammatory response syndrome (SIRS), defined organ dysfunction as an increase in total Sequential Organ Function Assessment (SOFA) score of ≥ 2, and conceived "qSOFA" (quick SOFA) as a bedside indicator of organ dysfunction. We aimed to (1) determine the prognostic impact of SIRS, (2) compare the diagnostic accuracy of SIRS and qSOFA for organ dysfunction, and (3) compare standard (Sepsis-2) and revised (Sepsis-3) definitions for organ dysfunction in ED patients with infection. Consecutive ED patients admitted with presumed infection were prospectively enrolled over 3 years. Sufficient observational data were collected to calculate SIRS, qSOFA, SOFA, comorbidity, and mortality. We enrolled 8,871 patients, with SIRS present in 4,176 (47.1%). SIRS was associated with increased risk of organ dysfunction (relative risk [RR] 3.5) and mortality in patients without organ dysfunction (OR 3.2). SIRS and qSOFA showed similar discrimination for organ dysfunction (area under the receiver operating characteristic curve, 0.72 vs 0.73). qSOFA was specific but poorly sensitive for organ dysfunction (96.1% and 29.7%, respectively). Mortality for patients with organ dysfunction was similar for Sepsis-2 and Sepsis-3 (12.5% and 11.4%, respectively), although 29% of patients with Sepsis-3 organ dysfunction did not meet Sepsis-2 criteria. Increasing numbers of Sepsis-2 organ system dysfunctions were associated with greater mortality. SIRS was associated with organ dysfunction and mortality, and abandoning the concept appears premature. A qSOFA score ≥ 2 showed high specificity, but poor sensitivity may limit utility as a bedside screening method. Although mortality for organ dysfunction was comparable between Sepsis-2 and Sepsis-3, more prognostic and clinical information is conveyed using Sepsis-2 regarding number and type of organ dysfunctions. The SOFA score may require recalibration. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

76 FR 62894 - Following Procedures When Going Between Rolling Equipment

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-11

... Operations Fatality Analysis (SOFA) Working Group. In October 1999, the Working Group issued a report titled ``Findings and Recommendations of the SOFA Working Group.'' The report can be found on FRA's Web site at http... recommendation reads as follows: \\1\\ More recently, in March 2011, the SOFA Working Group issued a report titled...

The Association Between Sequential Organ Failure Assessment Scores and Mortality in Patients With Sepsis During the First Week: The JSEPTIC DIC Study.

PubMed

Nakashima, Tsuyoshi; Miyamoto, Kyohei; Shimokawa, Toshio; Kato, Seiya; Hayakawa, Mineji

2018-01-01

Predicting prognosis is a complex process, particularly in patients with severe sepsis or septic shock. This study aimed to determine the relationship between the Sequential Organ Failure Assessment (SOFA) scores for individual organs during the first week of admission and the in-hospital mortality in patients with sepsis. This study was a post hoc evaluation of the Japan Septic Disseminated Intravascular Coagulation study and included patients admitted to 42 intensive care units in Japan for severe sepsis or septic shock, between January 2011 and December 2013. We assessed the relationship between the organ and total SOFA scores on days 1, 3, and 7 following admission and the in-hospital mortality using logistic regression analysis. We evaluated 2732 patients and found the in-hospital mortality rate was 29.1%. The mean age of the patients (standard deviation) was 70.5 (14.1) years, and the major primary site of infection was the abdomen (33.6%). The central nervous system (CNS) SOFA score exhibited the strongest relationship with mortality on days 1 (adjusted odds ratio [aOR]: 1.49, 95% confidence interval [CI]: 1.40-1.59), 3 (aOR: 1.75, 95% CI: 1.62-1.89), and 7 (aOR: 1.93, 95% CI: 1.77-2.10). The coagulation SOFA scores showed a weak correlation with mortality on day 1, but a strong correlation with mortality on day 7 (aOR: 2.04, 95% CI: 1.87-2.24). The CNS SOFA scores were associated with mortality in patients with severe sepsis on days 1, 3, and 7 following hospitalization. The coagulation SOFA score was associated with mortality on day 7. In clinical situations, the CNS SOFA scores during the acute phase and the CNS SOFA and coagulation SOFA scores during the subsequent phases should be evaluated in order to determine patient prognosis.

Predictive Value of the Sequential Organ Failure Assessment Score for Mortality in a Contemporary Cardiac Intensive Care Unit Population.

PubMed

Jentzer, Jacob C; Bennett, Courtney; Wiley, Brandon M; Murphree, Dennis H; Keegan, Mark T; Gajic, Ognjen; Wright, R Scott; Barsness, Gregory W

2018-03-10

Optimal methods of mortality risk stratification in patients in the cardiac intensive care unit (CICU) remain uncertain. We evaluated the ability of the Sequential Organ Failure Assessment (SOFA) score to predict mortality in a large cohort of unselected patients in the CICU. Adult patients admitted to the CICU from January 1, 2007, to December 31, 2015, at a single tertiary care hospital were retrospectively reviewed. SOFA scores were calculated daily, and Acute Physiology and Chronic Health Evaluation (APACHE)-III and APACHE-IV scores were calculated on CICU day 1. Discrimination of hospital mortality was assessed using area under the receiver-operator characteristic curve values. We included 9961 patients, with a mean age of 67.5±15.2 years; all-cause hospital mortality was 9.0%. Day 1 SOFA score predicted hospital mortality, with an area under the receiver-operator characteristic curve value of 0.83; area under the receiver-operator characteristic curve values were similar for the APACHE-III score, and APACHE-IV predicted mortality ( P >0.05). Mean and maximum SOFA scores over multiple CICU days had greater discrimination for hospital mortality ( P <0.01). Patients with an increasing SOFA score from day 1 and day 2 had higher mortality. Patients with day 1 SOFA score <2 were at low risk of mortality. Increasing tertiles of day 1 SOFA score predicted higher long-term mortality ( P <0.001 by log-rank test). The day 1 SOFA score has good discrimination for short-term mortality in unselected patients in the CICU, which is comparable to APACHE-III and APACHE-IV. Advantages of the SOFA score over APACHE include simplicity, improved discrimination using serial scores, and prediction of long-term mortality. © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Sofas and Infant Mortality

PubMed Central

Rechtman, Lauren R.; Colvin, Jeffrey D.; Blair, Peter S.

2014-01-01

OBJECTIVE: Sleeping on sofas increases the risk of sudden infant death syndrome and other sleep-related deaths. We sought to describe factors associated with infant deaths on sofas. METHODS: We analyzed data for infant deaths on sofas from 24 states in 2004 to 2012 in the National Center for the Review and Prevention of Child Deaths Case Reporting System database. Demographic and environmental data for deaths on sofas were compared with data for sleep-related infant deaths in other locations, using bivariate and multivariable, multinomial logistic regression analyses. RESULTS: A total of 1024 deaths on sofas made up 12.9% of sleep-related infant deaths. They were more likely than deaths in other locations to be classified as accidental suffocation or strangulation (adjusted odds ratio [aOR] 1.9; 95% confidence interval [CI], 1.6–2.3) or ill-defined cause of death (aOR 1.2; 95% CI, 1.0–1.5). Infants who died on sofas were less likely to be Hispanic (aOR 0.7; 95% CI, 0.6–0.9) compared with non-Hispanic white infants or to have objects in the environment (aOR 0.6; 95% CI, 0.5–0.7) and more likely to be sharing the surface with another person (aOR 2.4; 95% CI, 1.9–3.0), to be found on the side (aOR 1.9; 95% CI, 1.4–2.4), to be found in a new sleep location (aOR 6.5; 95% CI, 5.2–8.2), and to have had prenatal smoke exposure (aOR 1.4; 95% CI, 1.2–1.6). Data on recent parental alcohol and drug consumption were not available. CONCLUSIONS: The sofa is an extremely hazardous sleep surface for infants. Deaths on sofas are associated with surface sharing, being found on the side, changing sleep location, and experiencing prenatal tobacco exposure, which are all risk factors for sudden infant death syndrome and sleep-related deaths. PMID:25311597

Use of the Sequential Organ Failure Assessment score for evaluating outcome among obstetric patients admitted to the intensive care unit.

PubMed

Jain, Shruti; Guleria, Kiran; Suneja, Amita; Vaid, Neelam B; Ahuja, Sharmila

2016-03-01

To evaluate the prognostic value of the Sequential Organ Failure Assessment (SOFA) score among obstetric patients admitted to the intensive care unit (ICU). A prospective study was conducted among 90 consecutive obstetric patients who were admitted to the ICU of Guru Teg Bahadur Hospital, Delhi, India, between October 6, 2010, and December 25, 2011. Maximum SOFA score was calculated for each of the six organ systems. Receiver operating characteristic curves were used to determine critical cutoff values for total, maximum total, and mean total SOFA scores at various time points. Total SOFA score at admission displayed an area under the curve (AUC) of 0.949, a cutoff value of at least 8.5, sensitivity of 86.7%, and specificity of 90.0%. Maximum total SOFA score had an AUC of 0.980, a cutoff value of at least 10.0, sensitivity of 96.7%, and specificity of 90.0%. Mean total SOFA score had an AUC of 0.997, a cutoff value of at least 9.0, sensitivity of 96.7%, and specificity of 96.7%. In terms of discriminatory power for predicting mortality among obstetric patients admitted to the ICU, total SOFA score at admission was the most relevant, simple, and accurate measure. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Solid fat and added sugar intake among U.S. children: The role of stores, schools, and fast food, 1994-2010.

PubMed

Poti, Jennifer M; Slining, Meghan M; Popkin, Barry M

2013-11-01

Little is known about the role of location in U.S. children's excess intake of energy from solid fat and added sugar, collectively referred to as SoFAS. The goal of this study was to compare the SoFAS content of foods consumed by children from stores, schools, and fast-food restaurants and to determine whether trends from 1994 to 2010 differ across these locations. Children aged 2-18 years (N=22,103) from five nationally representative surveys of dietary intake from 1994 to 2010 were studied. SoFAS content was compared across locations for total intake and key foods. Regression models were used to test and compare linear trends across locations. Data were analyzed in 2012. The mean percentage of total energy intake consumed from each location that was provided by SoFAS remained above recommendations, despite significant improvements between 1994 and 2010 at stores (1994, 38.3%; 2004, 33.2%); schools (1994, 38.7%; 2004, 31.2%); and fast-food restaurants (1994, 34.6%; 2004, 34.6%). For each key food, SoFAS content decreased significantly at stores and schools, yet progress at schools was comparatively slower. Milk was higher in SoFAS at schools compared to stores because of shifts toward flavored milk at schools. Schools provided french fries that were higher in solid fat than store-bought versions and pizza that was not significantly different in SoFAS content than fast-food pizza. However, schools made significantly greater progress for sugar-sweetened beverages, as lower-sugar beverages replaced regular sodas. Key fast foods showed little improvement. These findings can inform future strategies targeted to the specific locations and foods where continued progress is needed to reduce children's SoFAS consumption. © 2013 American Journal of Preventive Medicine.

Comparison of QSOFA score and SIRS criteria as screening mechanisms for emergency department sepsis.

PubMed

Haydar, Samir; Spanier, Matthew; Weems, Patricia; Wood, Samantha; Strout, Tania

2017-11-01

The Quick Sequential [Sepsis-related] Organ Failure Assessment (qSOFA) score has been shown to accurately predict mortality in septic patients and is part of recently proposed diagnostic criteria for sepsis. We sought to ascertain the sensitive of the score in diagnosing sepsis, as well as the diagnostic timeliness of the score when compared to traditional systemic inflammatory response syndrome (SIRS) criteria in a population of emergency department (ED) patients treated in the ED, admitted, and subsequently discharged with a diagnosis of sepsis. Electronic health records of 200 patients who were treated for suspected sepsis in our ED and ultimately discharged from our hospital with a diagnosis of sepsis were randomly selected for review from a population of adult ED patients (N=1880). Data extracted included the presence of SIRS criteria and the qSOFA score as well as time required to meet said criteria. In this cohort, 94.5% met SIRS criteria while in the ED whereas only 58.3% met qSOFA. The mean time from arrival to SIRS documentation was 47.1min (95% CI: 36.5-57.8) compared to 84.0min (95% CI: 62.2-105.8) for qSOFA. The median ED "door" to positive SIRS criteria was 12min and 29min for qSOFA. Although qSOFA may be valuable in predicting sepsis-related mortality, it performed poorly as a screening tool for identifying sepsis in the ED. As the time to meet qSOFA criteria was significantly longer than for SIRS, relying on qSOFA alone may delay initiation of evidence-based interventions known to improve sepsis-related outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.

Poor performance of quick-SOFA (qSOFA) score in predicting severe sepsis and mortality - a prospective study of patients admitted with infection to the emergency department.

PubMed

Askim, Åsa; Moser, Florentin; Gustad, Lise T; Stene, Helga; Gundersen, Maren; Åsvold, Bjørn Olav; Dale, Jostein; Bjørnsen, Lars Petter; Damås, Jan Kristian; Solligård, Erik

2017-06-09

We aimed to evaluate the clinical usefulness of qSOFA as a risk stratification tool for patients admitted with infection compared to traditional SIRS criteria or our triage system; the Rapid Emergency Triage and Treatment System (RETTS). The study was an observational cohort study performed at one Emergency Department (ED) in an urban university teaching hospital in Norway, with approximately 20,000 visits per year. All patients >16 years presenting with symptoms or clinical signs suggesting an infection (n = 1535) were prospectively included in the study from January 1 to December 31, 2012. At arrival in the ED, vital signs were recorded and all patients were triaged according to RETTS vital signs, presenting infection, and sepsis symptoms. These admission data were also used to calculate qSOFA and SIRS. Treatment outcome was later retrieved from the patients' electronic records (EPR) and mortality data from the Norwegian population registry. Of the 1535 admitted patients, 108 (7.0%) fulfilled the Sepsis2 criteria for severe sepsis. The qSOFA score ≥2 identified only 33 (sensitivity 0.32, specificity 0.98) of the patients with severe sepsis, whilst the RETTS-alert ≥ orange identified 92 patients (sensitivity 0.85, specificity 0.55). Twenty-six patients died within 7 days of admission; four (15.4%) of them had a qSOFA ≥2, and 16 (61.5%) had RETTS ≥ orange alert. Of the 68 patients that died within 30 days, only eight (11.9%) scored ≥2 on the qSOFA, and 45 (66.1%) had a RETTS ≥ orange alert. In order to achieve timely treatment for sepsis, a sensitive screening tool is more important than a specific one. Our study is the fourth study were qSOFA finds few of the sepsis cases in prehospital or at arrival to the ED. We add information on the RETTS triage system, the two highest acuity levels together had a high sensitivity (85%) for identifying sepsis at arrival to the ED - and thus, RETTS should not be replaced by qSOFA as a screening and trigger tool for sepsis at arrival. In this observational cohort study, qSOFA failed to identify two thirds of the patients admitted to an ED with severe sepsis. Further, qSOFA failed to be a risk stratification tool as the sensitivity to predict 7-day and 30-day mortality was low. The sensitivity was poorer than the other warning scores already in use at the study site, RETTS-triage and the SIRS criteria.

Precise CCD positions of Himalia using Gaia DR1 in 2015-2016

NASA Astrophysics Data System (ADS)

Peng, H. W.; Peng, Q. Y.; Wang, N.

2017-05-01

In order to obtain high-precision CCD positions of Himalia, the sixth Jovian satellite, a total of 598 CCD observations have been obtained during the years 2015-2016. The observations were made by using the 2.4 and 1 m telescopes administered by Yunnan Observatories over 27 nights. Several factors that would influence the positional precision of Himalia were analysed, including the reference star catalogue used, the geometric distortion and the phase effect. By taking advantage of its unprecedented positional precision, the recently released catalogue Gaia Data Release 1 was chosen to match reference stars in the CCD frames of both Himalia and open clusters, which were observed for deriving the geometric distortion. The latest version of sofa library was used to calculate the positions of reference stars. The theoretical positions of Himalia were retrieved from the Jet Propulsion Laboratory Horizons System that includes the satellite ephemeris JUP300, while the positions of Jupiter were based on the planetary ephemeris DE431. Our results showed that the means of observed minus computed (O - C) residuals are 0.071 and -0.001 arcsec in right ascension and declination, respectively. Their standard deviations are estimated at about 0.03 arcsec in each direction.

Accuracy of SOFA score in prediction of 30-day outcome of critically ill patients.

PubMed

Safari, Saeed; Shojaee, Majid; Rahmati, Farhad; Barartloo, Alireza; Hahshemi, Behrooz; Forouzanfar, Mohammad Mehdi; Mohammadi, Elham

2016-12-01

Researchers have attempted to design various scoring systems to determine the severity and predict the outcome of critically ill patients. The present study aimed to evaluate the accuracy of SOFA score in predicting 1-month outcome of these patients in emergency department. The present study is a prospective cross-sectional study of >18 year old non-trauma critically ill patients presented to EDs of 3 hospitals, Tehran, Iran, during October 2014 to October 2015. Baseline characteristics, SOFA score variables, and 1-month outcome of patients were recorded and screening performance characteristics of the score were calculated using STATA 11 software. 140 patients with the mean age of 68.36 ± 18.62 years (18-95) were included (53.5% male). The most common complaints were decrease in level of consciousness (76.43%) and sepsis (60.0%), were the most frequent final diagnoses. Mean SOFA score of the patients was 7.13 ± 2.36 (minimum 2 and maximum 16). 72 (51.43%) patients died during the following 30 days and 16 (11.43%) patients were affected with multiple organ failure. Area under the ROC curve of SOFA score in predicting mortality of studied patients was 0.73 (95%CI: 0.65-0.81) (Fig. 2). Table 2 depicts screening performance characteristics of this scale in prediction of 1-month mortality in the best cut-off point of ≥7. At this cut-off point, sensitivity and specificity of SOFA in predicting 1-month mortality were 75% and 63.23%, respectively. Findings of the present study showed that SOFA scoring system has fair accuracy in predicting 1-month mortality of critically ill patients. However, until a more reliable scoring system is developed, SOFA might be useful for narrative prediction of patient outcome considering its acceptable likelihood ratios.

Prehospital triage of septic patients at the SAMU regulation: Comparison of qSOFA, MRST, MEWS and PRESEP scores.

PubMed

Jouffroy, R; Saade, A; Ellouze, S; Carpentier, A; Michaloux, M; Carli, P; Vivien, B

2018-05-01

A couple of scoring systems have been developed for risk stratification of septic patients. Their performance in the management of out-of-hospital initial care delivery is not documented. This study try to evaluate the predictive ability of Quick Sequential Organ Failure Assessment (qSOFA), Robson Screening Tool (RST), Modified Early Warning Score (MEWS) and Prehospital Early Sepsis Detection (PRESEP) scores on out of-hospital triage of septic patients, to predict intensive care unit (ICU) admission. A retrospective study using call records received by the SAMU 15 regulation call centre including all patients with presumed septic shock was performed. The primary outcome was the admission to the ICU. Among the 47 000 reports received, 37 patients with presumed septic shock were included. Twenty-two patients (59%) were admitted to ICU. AUCs of qSOFA, RST, MEWS and PRESEP scores were respectively 0.40 [0.22-0.59], 0.60 [0.43-0.78], 0.66 [0.47-0.85] and 0.67 [0.51-0.84]. RST outperformed PRESEP, MEWS and qSOFA for sensitivity (1, 0.92, 0.85 and 0.62 respectively). MEWS showed better specificity than PRESEP, MRST and qSOFA (0.33, 0.29, 0.16 and 0.16). MEWS showed comparable positive predictive value than PRESEP and outperformed MRST and qSOFA (0.41, 0.41, 0.39 and 0.29 respectively). Negative predictive value of MRST outperformed PRESEP, MEWS and qSOFA (1, 0.88, 0.80 and 0.44 respectively). Our findings suggest that screening patients at SAMU 15 regulation call centre using qSOFA, MRST, MEWS and PRESEP scores to predict ICU admission is irrelevant. Development of a specific scoring system for out-of-hospital triage of septic patients is needed. Copyright © 2017 Elsevier Inc. All rights reserved.

Plasma cell-free DNA and qSOFA score predict 7-day mortality in 481 emergency department bacteraemia patients.

PubMed

Rannikko, Juha; Seiskari, Tapio; Huttunen, Reetta; Tarkiainen, Iina; Jylhävä, Juulia; Hurme, Mikko; Syrjänen, Jaana; Aittoniemi, Janne

2018-04-24

A few studies have shown that both quick Sequential Organ Failure Assessment (qSOFA) score and cell-free DNA (cfDNA) have potential use as a prognostic marker in patients with infection. We studied these two markers alone and in combination to identify those emergency department (ED) patients with the highest risk of death. Plasma cfDNA level was studied on days 0 to 4 after admittance to the ED from 481 culture-positive bloodstream infection cases. The qSOFA score was evaluated retrospectively according to Sepsis-3 definitions. The primary outcome was death by day 7. CfDNA on day 0 was significantly higher in non-survivors than in survivors (2.02 μg/ml vs. 1.35 μg/ml, p<0.001). CfDNA level was high (>1.69 μg/ml) in 134 (28%) out of 481 cases and the qSOFA score was ≥2 in 128 (28%) out of 458 cases. High cfDNA and qSOFA score ≥2 had 70% and 77% sensitivity and 76% and 76% specificity in predicting death by day 7, respectively. High cfDNA alone had odds ratio (OR) of 7.7 (95% CI 3.9-15.3) and qSOFA score ≥2 OR of 11.6 (5.5-24.3), but their combination had OR of 20.3 (10.0-41.4) in predicting death by day 7 when compared with those with low cfDNA and qSOFA score <2. Among the five cases with the highest cfDNA levels, there were three patients with severe disseminated intravascular coagulation. CfDNA and qSOFA score can be used independently to identify those bacteraemia patients at high risk of death, and combining these two markers gives additional advantage. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Organ failure and tight glycemic control in the SPRINT study.

PubMed

Chase, J Geoffrey; Pretty, Christopher G; Pfeifer, Leesa; Shaw, Geoffrey M; Preiser, Jean-Charles; Le Compte, Aaron J; Lin, Jessica; Hewett, Darren; Moorhead, Katherine T; Desaive, Thomas

2010-01-01

Intensive care unit mortality is strongly associated with organ failure rate and severity. The sequential organ failure assessment (SOFA) score is used to evaluate the impact of a successful tight glycemic control (TGC) intervention (SPRINT) on organ failure, morbidity, and thus mortality. A retrospective analysis of 371 patients (3,356 days) on SPRINT (August 2005 - April 2007) and 413 retrospective patients (3,211 days) from two years prior, matched by Acute Physiology and Chronic Health Evaluation (APACHE) III. SOFA is calculated daily for each patient. The effect of the SPRINT TGC intervention is assessed by comparing the percentage of patients with SOFA ≤5 each day and its trends over time and cohort/group. Organ-failure free days (all SOFA components ≤2) and number of organ failures (SOFA components >2) are also compared. Cumulative time in 4.0 to 7.0 mmol/L band (cTIB) was evaluated daily to link tightness and consistency of TGC (cTIB ≥0.5) to SOFA ≤5 using conditional and joint probabilities. Admission and maximum SOFA scores were similar (P = 0.20; P = 0.76), with similar time to maximum (median: one day; IQR: 13 days; P = 0.99). Median length of stay was similar (4.1 days SPRINT and 3.8 days Pre-SPRINT; P = 0.94). The percentage of patients with SOFA ≤5 is different over the first 14 days (P = 0.016), rising to approximately 75% for Pre-SPRINT and approximately 85% for SPRINT, with clear separation after two days. Organ-failure-free days were different (SPRINT = 41.6%; Pre-SPRINT = 36.5%; P < 0.0001) as were the percent of total possible organ failures (SPRINT = 16.0%; Pre-SPRINT = 19.0%; P < 0.0001). By Day 3 over 90% of SPRINT patients had cTIB ≥0.5 (37% Pre-SPRINT) reaching 100% by Day 7 (50% Pre-SPRINT). Conditional and joint probabilities indicate tighter, more consistent TGC under SPRINT (cTIB ≥0.5) increased the likelihood SOFA ≤5. SPRINT TGC resolved organ failure faster, and for more patients, from similar admission and maximum SOFA scores, than conventional control. These reductions mirror the reduced mortality with SPRINT. The cTIB ≥0.5 metric provides a first benchmark linking TGC quality to organ failure. These results support other physiological and clinical results indicating the role tight, consistent TGC can play in reducing organ failure, morbidity and mortality, and should be validated on data from randomised trials.

Organ failure and tight glycemic control in the SPRINT study

PubMed Central

2010-01-01

Introduction Intensive care unit mortality is strongly associated with organ failure rate and severity. The sequential organ failure assessment (SOFA) score is used to evaluate the impact of a successful tight glycemic control (TGC) intervention (SPRINT) on organ failure, morbidity, and thus mortality. Methods A retrospective analysis of 371 patients (3,356 days) on SPRINT (August 2005 - April 2007) and 413 retrospective patients (3,211 days) from two years prior, matched by Acute Physiology and Chronic Health Evaluation (APACHE) III. SOFA is calculated daily for each patient. The effect of the SPRINT TGC intervention is assessed by comparing the percentage of patients with SOFA ≤5 each day and its trends over time and cohort/group. Organ-failure free days (all SOFA components ≤2) and number of organ failures (SOFA components >2) are also compared. Cumulative time in 4.0 to 7.0 mmol/L band (cTIB) was evaluated daily to link tightness and consistency of TGC (cTIB ≥0.5) to SOFA ≤5 using conditional and joint probabilities. Results Admission and maximum SOFA scores were similar (P = 0.20; P = 0.76), with similar time to maximum (median: one day; IQR: [1,3] days; P = 0.99). Median length of stay was similar (4.1 days SPRINT and 3.8 days Pre-SPRINT; P = 0.94). The percentage of patients with SOFA ≤5 is different over the first 14 days (P = 0.016), rising to approximately 75% for Pre-SPRINT and approximately 85% for SPRINT, with clear separation after two days. Organ-failure-free days were different (SPRINT = 41.6%; Pre-SPRINT = 36.5%; P < 0.0001) as were the percent of total possible organ failures (SPRINT = 16.0%; Pre-SPRINT = 19.0%; P < 0.0001). By Day 3 over 90% of SPRINT patients had cTIB ≥0.5 (37% Pre-SPRINT) reaching 100% by Day 7 (50% Pre-SPRINT). Conditional and joint probabilities indicate tighter, more consistent TGC under SPRINT (cTIB ≥0.5) increased the likelihood SOFA ≤5. Conclusions SPRINT TGC resolved organ failure faster, and for more patients, from similar admission and maximum SOFA scores, than conventional control. These reductions mirror the reduced mortality with SPRINT. The cTIB ≥0.5 metric provides a first benchmark linking TGC quality to organ failure. These results support other physiological and clinical results indicating the role tight, consistent TGC can play in reducing organ failure, morbidity and mortality, and should be validated on data from randomised trials. PMID:20704712

Association of the Quick Sequential (Sepsis-Related) Organ Failure Assessment (qSOFA) Score With Excess Hospital Mortality in Adults With Suspected Infection in Low- and Middle-Income Countries.

PubMed

Rudd, Kristina E; Seymour, Christopher W; Aluisio, Adam R; Augustin, Marc E; Bagenda, Danstan S; Beane, Abi; Byiringiro, Jean Claude; Chang, Chung-Chou H; Colas, L Nathalie; Day, Nicholas P J; De Silva, A Pubudu; Dondorp, Arjen M; Dünser, Martin W; Faiz, M Abul; Grant, Donald S; Haniffa, Rashan; Van Hao, Nguyen; Kennedy, Jason N; Levine, Adam C; Limmathurotsakul, Direk; Mohanty, Sanjib; Nosten, François; Papali, Alfred; Patterson, Andrew J; Schieffelin, John S; Shaffer, Jeffrey G; Thuy, Duong Bich; Thwaites, C Louise; Urayeneza, Olivier; White, Nicholas J; West, T Eoin; Angus, Derek C

2018-05-20

The quick Sequential (Sepsis-Related) Organ Failure Assessment (qSOFA) score has not been well-evaluated in low- and middle-income countries (LMICs). To assess the association of qSOFA with excess hospital death among patients with suspected infection in LMICs and to compare qSOFA with the systemic inflammatory response syndrome (SIRS) criteria. Retrospective secondary analysis of 8 cohort studies and 1 randomized clinical trial from 2003 to 2017. This study included 6569 hospitalized adults with suspected infection in emergency departments, inpatient wards, and intensive care units of 17 hospitals in 10 LMICs across sub-Saharan Africa, Asia, and the Americas. Low (0), moderate (1), or high (≥2) qSOFA score (range, 0 [best] to 3 [worst]) or SIRS criteria (range, 0 [best] to 4 [worst]) within 24 hours of presentation to study hospital. Predictive validity (measured as incremental hospital mortality beyond that predicted by baseline risk factors, as a marker of sepsis or analogous severe infectious course) of the qSOFA score (primary) and SIRS criteria (secondary). The cohorts were diverse in enrollment criteria, demographics (median ages, 29-54 years; males range, 36%-76%), HIV prevalence (range, 2%-43%), cause of infection, and hospital mortality (range, 1%-39%). Among 6218 patients with nonmissing outcome status in the combined cohort, 643 (10%) died. Compared with a low or moderate score, a high qSOFA score was associated with increased risk of death overall (19% vs 6%; difference, 13% [95% CI, 11%-14%]; odds ratio, 3.6 [95% CI, 3.0-4.2]) and across cohorts (P < .05 for 8 of 9 cohorts). Compared with a low qSOFA score, a moderate qSOFA score was also associated with increased risk of death overall (8% vs 3%; difference, 5% [95% CI, 4%-6%]; odds ratio, 2.8 [95% CI, 2.0-3.9]), but not in every cohort (P < .05 in 2 of 7 cohorts). High, vs low or moderate, SIRS criteria were associated with a smaller increase in risk of death overall (13% vs 8%; difference, 5% [95% CI, 3%-6%]; odds ratio, 1.7 [95% CI, 1.4-2.0]) and across cohorts (P < .05 for 4 of 9 cohorts). qSOFA discrimination (area under the receiver operating characteristic curve [AUROC], 0.70 [95% CI, 0.68-0.72]) was superior to that of both the baseline model (AUROC, 0.56 [95% CI, 0.53-0.58; P < .001) and SIRS (AUROC, 0.59 [95% CI, 0.57-0.62]; P < .001). When assessed among hospitalized adults with suspected infection in 9 LMIC cohorts, the qSOFA score identified infected patients at risk of death beyond that explained by baseline factors. However, the predictive validity varied among cohorts and settings, and further research is needed to better understand potential generalizability.

Assessment of Sepsis-3 criteria and quick SOFA in patients with cirrhosis and bacterial infections.

PubMed

Piano, Salvatore; Bartoletti, Michele; Tonon, Marta; Baldassarre, Maurizio; Chies, Giada; Romano, Antonietta; Viale, Pierluigi; Vettore, Elia; Domenicali, Marco; Stanco, Marialuisa; Pilutti, Chiara; Frigo, Anna Chiara; Brocca, Alessandra; Bernardi, Mauro; Caraceni, Paolo; Angeli, Paolo

2017-08-31

Patients with cirrhosis have a high risk of sepsis, which confers a poor prognosis. The systemic inflammatory response syndrome (SIRS) criteria have several limitations in cirrhosis. Recently, new criteria for sepsis (Sepsis-3) have been suggested in the general population (increase of Sequential Organ Failure Assessment (SOFA) ≥2 points from baseline). Outside the intensive care unit (ICU), the quick SOFA (qSOFA (at least two among alteration in mental status, systolic blood pressure ≤100 mm Hg or respiratory rate ≥22/min)) was suggested to screen for sepsis. These criteria have never been evaluated in patients with cirrhosis. The aim of the study was to assess the ability of Sepsis-3 criteria in predicting in-hospital mortality in patients with cirrhosis and bacterial/fungal infections. 259 consecutive patients with cirrhosis and bacterial/fungal infections were prospectively included. Demographic, laboratory and microbiological data were collected at diagnosis of infection. Baseline SOFA was assessed using preadmission data. Patients were followed up until death, liver transplantation or discharge. Findings were externally validated (197 patients). Sepsis-3 and qSOFA had significantly greater discrimination for in-hospital mortality (area under the receiver operating characteristic (AUROC)=0.784 and 0.732, respectively) than SIRS (AUROC=0.606) (p<0.01 for both). Similar results were observed in the validation cohort. Sepsis-3 (subdistribution HR (sHR)=5.47; p=0.006), qSOFA (sHR=1.99; p=0.020), Chronic Liver Failure Consortium Acute Decompensation score (sHR=1.05; p=0.001) and C reactive protein (sHR=1.01;p=0.034) were found to be independent predictors of in-hospital mortality. Patients with Sepsis-3 had higher incidence of acute-on-chronic liver failure, septic shock and transfer to ICU than those without Sepsis-3. Sepsis-3 criteria are more accurate than SIRS criteria in predicting the severity of infections in patients with cirrhosis. qSOFA is a useful bedside tool to assess risk for worse outcomes in these patients. Patients with Sepsis-3 and positive qSOFA deserve more intensive management and strict surveillance. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

qSOFA, SIRS and NEWS for predicting inhospital mortality and ICU admission in emergency admissions treated as sepsis.

PubMed

Goulden, Robert; Hoyle, Marie-Claire; Monis, Jessie; Railton, Darran; Riley, Victoria; Martin, Paul; Martina, Reynaldo; Nsutebu, Emmanuel

2018-06-01

The third international consensus definition for sepsis recommended use of a new prognostic tool, the quick Sequential Organ Failure Assessment (qSOFA), based on its ability to predict inhospital mortality and prolonged intensive care unit (ICU) stay in patients with suspected infection. While several studies have compared the prognostic accuracy of qSOFA to the Systemic Inflammatory Response Syndrome (SIRS) criteria in suspected sepsis, few have compared qSOFA and SIRS to the widely used National Early Warning Score (NEWS). This was a retrospective cohort study carried out in a UK tertiary centre. The study population comprised emergency admissions in whom sepsis was suspected and treated. The accuracy for predicting inhospital mortality and ICU admission was calculated and compared for qSOFA, SIRS and NEWS. Among 1818 patients, 53 were admitted to ICU (3%) and 265 died in hospital (15%). For predicting inhospital mortality, the area under the receiver operating characteristics curve for NEWS (0.65, 95% CI 0.61 to 0.68) was similar to qSOFA (0.62, 95% CI 0.59 to 0.66) (test for difference, P=0.18) and superior to SIRS (P<0.001), which was not predictive. The sensitivity of NEWS≥5 (74%, 95% CI 68% to 79%) was similar to SIRS≥2 (80%, 95% CI 74% to 84%) and higher than qSOFA≥2 (37%, 95% CI 31% to 43%). The specificity of NEWS≥5 (43%, 95% CI 41% to 46%) was higher than SIRS≥2 (21%, 95% CI 19% to 23%) and lower than qSOFA≥2 (79%, 95% CI 77% to 81%). The negative predictive value was 88% (86%-90%) for qSOFA, 86% (82%-89%) for SIRS and 91% (88%-93%) for NEWS. Results were similar for the secondary outcome of ICU admission. NEWS has equivalent or superior value for most test characteristics relative to SIRS and qSOFA, calling into question the rationale of adopting qSOFA in institutions where NEWS is already in use. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Iterative User Interface Design for Automated Sequential Organ Failure Assessment Score Calculator in Sepsis Detection

PubMed Central

Herasevich, Vitaly

2017-01-01

Background The new sepsis definition has increased the need for frequent sequential organ failure assessment (SOFA) score recalculation and the clerical burden of information retrieval makes this score ideal for automated calculation. Objective The aim of this study was to (1) estimate the clerical workload of manual SOFA score calculation through a time-motion analysis and (2) describe a user-centered design process for an electronic medical record (EMR) integrated, automated SOFA score calculator with subsequent usability evaluation study. Methods First, we performed a time-motion analysis by recording time-to-task-completion for the manual calculation of 35 baseline and 35 current SOFA scores by 14 internal medicine residents over a 2-month period. Next, we used an agile development process to create a user interface for a previously developed automated SOFA score calculator. The final user interface usability was evaluated by clinician end users with the Computer Systems Usability Questionnaire. Results The overall mean (standard deviation, SD) time-to-complete manual SOFA score calculation time was 61.6 s (33). Among the 24% (12/50) usability survey respondents, our user-centered user interface design process resulted in >75% favorability of survey items in the domains of system usability, information quality, and interface quality. Conclusions Early stakeholder engagement in our agile design process resulted in a user interface for an automated SOFA score calculator that reduced clinician workload and met clinicians’ needs at the point of care. Emerging interoperable platforms may facilitate dissemination of similarly useful clinical score calculators and decision support algorithms as “apps.” A user-centered design process and usability evaluation should be considered during creation of these tools. PMID:28526675

Using Statistical and Machine Learning Methods to Evaluate the Prognostic Accuracy of SIRS and qSOFA

PubMed Central

Liu, Tieming; Shepherd, Scott; Paiva, William

2018-01-01

Objectives The objective of this study was to compare the performance of two popularly used early sepsis diagnostic criteria, systemic inflammatory response syndrome (SIRS) and quick Sepsis-related Organ Failure Assessment (qSOFA), using statistical and machine learning approaches. Methods This retrospective study examined patient visits in Emergency Department (ED) with sepsis related diagnosis. The outcome was 28-day in-hospital mortality. Using odds ratio (OR) and modeling methods (decision tree [DT], multivariate logistic regression [LR], and naïve Bayes [NB]), the relationships between diagnostic criteria and mortality were examined. Results Of 132,704 eligible patient visits, 14% died within 28 days of ED admission. The association of qSOFA ≥2 with mortality (OR = 3.06; 95% confidence interval [CI], 2.96–3.17) greater than the association of SIRS ≥2 with mortality (OR = 1.22; 95% CI, 1.18–1.26). The area under the ROC curve for qSOFA (AUROC = 0.70) was significantly greater than for SIRS (AUROC = 0.63). For qSOFA, the sensitivity and specificity were DT = 0.39, LR = 0.64, NB = 0.62 and DT = 0.89, LR = 0.63, NB = 0.66, respectively. For SIRS, the sensitivity and specificity were DT = 0.46, LR = 0.62, NB = 0.62 and DT = 0.70, LR = 0.59, NB = 0.58, respectively. Conclusions The evidences suggest that qSOFA is a better diagnostic criteria than SIRS. The low sensitivity of qSOFA can be improved by carefully selecting the threshold to translate the predicted probabilities into labels. These findings can guide healthcare providers in selecting risk-stratification measures for patients presenting to an ED with sepsis. PMID:29770247

Iterative User Interface Design for Automated Sequential Organ Failure Assessment Score Calculator in Sepsis Detection.

PubMed

Aakre, Christopher Ansel; Kitson, Jaben E; Li, Man; Herasevich, Vitaly

2017-05-18

The new sepsis definition has increased the need for frequent sequential organ failure assessment (SOFA) score recalculation and the clerical burden of information retrieval makes this score ideal for automated calculation. The aim of this study was to (1) estimate the clerical workload of manual SOFA score calculation through a time-motion analysis and (2) describe a user-centered design process for an electronic medical record (EMR) integrated, automated SOFA score calculator with subsequent usability evaluation study. First, we performed a time-motion analysis by recording time-to-task-completion for the manual calculation of 35 baseline and 35 current SOFA scores by 14 internal medicine residents over a 2-month period. Next, we used an agile development process to create a user interface for a previously developed automated SOFA score calculator. The final user interface usability was evaluated by clinician end users with the Computer Systems Usability Questionnaire. The overall mean (standard deviation, SD) time-to-complete manual SOFA score calculation time was 61.6 s (33). Among the 24% (12/50) usability survey respondents, our user-centered user interface design process resulted in >75% favorability of survey items in the domains of system usability, information quality, and interface quality. Early stakeholder engagement in our agile design process resulted in a user interface for an automated SOFA score calculator that reduced clinician workload and met clinicians' needs at the point of care. Emerging interoperable platforms may facilitate dissemination of similarly useful clinical score calculators and decision support algorithms as "apps." A user-centered design process and usability evaluation should be considered during creation of these tools. ©Christopher Ansel Aakre, Jaben E Kitson, Man Li, Vitaly Herasevich. Originally published in JMIR Human Factors (http://humanfactors.jmir.org), 18.05.2017.

Assessment of Clinical Criteria for Sepsis

PubMed Central

Seymour, Christopher W.; Liu, Vincent X.; Iwashyna, Theodore J.; Brunkhorst, Frank M.; Rea, Thomas D.; Scherag, André; Rubenfeld, Gordon; Kahn, Jeremy M.; Shankar-Hari, Manu; Singer, Mervyn; Deutschman, Clifford S.; Escobar, Gabriel J.; Angus, Derek C.

2016-01-01

IMPORTANCE The Third International Consensus Definitions Task Force defined sepsis as “life-threatening organ dysfunction due to a dysregulated host response to infection.” The performance of clinical criteria for this sepsis definition is unknown. OBJECTIVE To evaluate the validity of clinical criteria to identify patients with suspected infection who are at risk of sepsis. DESIGN, SETTINGS, AND POPULATION Among 1.3 million electronic health record encounters from January 1, 2010, to December 31, 2012, at 12 hospitals in southwestern Pennsylvania, we identified those with suspected infection in whom to compare criteria. Confirmatory analyses were performed in 4 data sets of 706 399 out-of-hospital and hospital encounters at 165 US and non-US hospitals ranging from January 1, 2008, until December 31, 2013. EXPOSURES Sequential [Sepsis-related] Organ Failure Assessment (SOFA) score, systemic inflammatory response syndrome (SIRS) criteria, Logistic Organ Dysfunction System (LODS) score, and a new model derived using multivariable logistic regression in a split sample, the quick Sequential [Sepsis-related] Organ Failure Assessment (qSOFA) score (range, 0–3 points, with 1 point each for systolic hypotension [≤100 mm Hg], tachypnea [≥22/min], or altered mentation). MAIN OUTCOMES AND MEASURES For construct validity, pairwise agreement was assessed. For predictive validity, the discrimination for outcomes (primary: in-hospital mortality; secondary: in-hospital mortality or intensive care unit [ICU] length of stay ≥3 days) more common in sepsis than uncomplicated infection was determined. Results were expressed as the fold change in outcome over deciles of baseline risk of death and area under the receiver operating characteristic curve (AUROC). RESULTS In the primary cohort, 148 907 encounters had suspected infection (n = 74 453 derivation; n = 74 454 validation), of whom 6347 (4%) died. Among ICU encounters in the validation cohort (n = 7932 with suspected infection, of whom 1289 [16%] died), the predictive validity for in-hospital mortality was lower for SIRS (AUROC = 0.64; 95% CI, 0.62–0.66) and qSOFA (AUROC = 0.66; 95% CI, 0.64–0.68) vs SOFA (AUROC = 0.74; 95% CI, 0.73–0.76; P < .001 for both) or LODS (AUROC = 0.75; 95% CI, 0.73–0.76; P < .001 for both). Among non-ICU encounters in the validation cohort (n = 66 522 with suspected infection, of whom 1886 [3%] died), qSOFA had predictive validity (AUROC = 0.81; 95% CI, 0.80–0.82) that was greater than SOFA (AUROC = 0.79; 95% CI, 0.78–0.80; P < .001) and SIRS (AUROC = 0.76; 95% CI, 0.75–0.77; P < .001). Relative to qSOFA scores lower than 2, encounters with qSOFA scores of 2 or higher had a 3- to 14-fold increase in hospital mortality across baseline risk deciles. Findings were similar in external data sets and for the secondary outcome. CONCLUSIONS AND RELEVANCE Among ICU encounters with suspected infection, the predictive validity for in-hospital mortality of SOFA was not significantly different than the more complex LODS but was statistically greater than SIRS and qSOFA, supporting its use in clinical criteria for sepsis. Among encounters with suspected infection outside of the ICU, the predictive validity for in-hospital mortality of qSOFA was statistically greater than SOFA and SIRS, supporting its use as a prompt to consider possible sepsis. PMID:26903335

SOFA & astrometry

NASA Astrophysics Data System (ADS)

Hohenkerk, C.

2015-08-01

The International Astronomical Union's (IAU) Standards of Fundamental Astronomy (SOFA) software library has in the last year introduced a tranche of 32 new routines dealing with the subject area "astrometry". This poster provides a guide to enable users to get to grips easily with the various routines for the transformations between ICRS, ICRS astrometric, GCRS, Celestial Intermediate and observed positions of stars, together with their underlying routines for proper motion, parallax, aberration, light deflection and refraction. A summary of the current status of SOFA is also included.

Resonances and bound states in the continuum on periodic arrays of slightly noncircular cylinders

NASA Astrophysics Data System (ADS)

Hu, Zhen; Lu, Ya Yan

2018-02-01

Optical bound states in the continuum (BICs), especially those on periodic structures, have interesting properties and potentially important applications. Existing theoretical and numerical studies for optical BICs are mostly for idealized structures with simple and perfect geometric features, such as circular holes, rectangular cylinders and spheres. Since small distortions are always present in actual fabricated structures, we perform a high accuracy numerical study for BICs and resonances on a simple periodic structure with small distortions, i.e., periodic arrays of slightly noncircular cylinders. Our numerical results confirm that symmetries are important not only for the so-called symmetry-protected BICs, but also for the majority of propagating BICs which do not have a symmetry mismatch with the outgoing radiation waves. Typically, the BICs continue to exist if the small distortions keep the relevant symmetries, and they become resonant modes with finite quality factors if the small distortions break a required symmetry.

Ergonomic evaluation of processes and products in the manufacture of upholstery.

PubMed

Fialho, Patrícia Bhering; de Souza, Amaury Paulo; Minette, Luciano José; Silva, José de Castro; de Oliveira, Luciana Aparecida

2012-01-01

This study aimed to perform an ergonomic evaluation of industrial processes and products - upholstered sofas - produced in the furniture cluster of Ubá-MG. The used material was collected from two sofas upholstered industries associated with the union of the furniture industries of Ubá region, located in Minas Gerais estate, Brazil. As for the product were evaluated dimensionally 29 upholstered sofas, with 12 being produced by industry "A" and 17 being produced by industry "B". As for the process, were evaluated: the socioeconomic profile of the worker and environmental factors of lighting and noise. The main results of this study showed that the upholstered sofas produced by industries, in general, fulfilled to the recommendations set out in the work in relation to the backrest height and useful seat depth. All the sofas, however, proved to be inadequate in relation to the seat height to the floor and the dimensions of the armrests Regarding environmental aspects, it was observed that in both industries, the activities in most jobs are performed under adverse conditions to the health and safety of workers and nonconformity with the limits set by Brazilian regulatory standard used in this work.

Prospective validation of a near real-time EHR-integrated automated SOFA score calculator.

PubMed

Aakre, Christopher; Franco, Pablo Moreno; Ferreyra, Micaela; Kitson, Jaben; Li, Man; Herasevich, Vitaly

2017-07-01

We created an algorithm for automated Sequential Organ Failure Assessment (SOFA) score calculation within the Electronic Health Record (EHR) to facilitate detection of sepsis based on the Third International Consensus Definitions for Sepsis and Septic Shock (SEPSIS-3) clinical definition. We evaluated the accuracy of near real-time and daily automated SOFA score calculation compared with manual score calculation. Automated SOFA scoring computer programs were developed using available EHR data sources and integrated into a critical care focused patient care dashboard at Mayo Clinic in Rochester, Minnesota. We prospectively compared the accuracy of automated versus manual calculation for a sample of patients admitted to the medical intensive care unit at Mayo Clinic Hospitals in Rochester, Minnesota and Jacksonville, Florida. Agreement was calculated with Cohen's kappa statistic. Reason for discrepancy was tabulated during manual review. Random spot check comparisons were performed 134 times on 27 unique patients, and daily SOFA score comparisons were performed for 215 patients over a total of 1206 patient days. Agreement between automatically scored and manually scored SOFA components for both random spot checks (696 pairs, κ=0.89) and daily calculation (5972 pairs, κ=0.89) was high. The most common discrepancies were in the respiratory component (inaccurate fraction of inspired oxygen retrieval; 200/1206) and creatinine (normal creatinine in patients with no urine output on dialysis; 128/1094). 147 patients were at risk of developing sepsis after intensive care unit admission, 10 later developed sepsis confirmed by chart review. All were identified before onset of sepsis with the ΔSOFA≥2 point criterion and 46 patients were false-positives. Near real-time automated SOFA scoring was found to have strong agreement with manual score calculation and may be useful for the detection of sepsis utilizing the new SEPSIS-3 definition. Copyright © 2017 Elsevier B.V. All rights reserved.

16 CFR 1632.8 - Glossary of terms.

Code of Federal Regulations, 2012 CFR

2012-01-01

... prevent or assist in the healing of decubitus ulcers (bed sores). Flat decubitus pads are covered by the... pressure is exerted on the back of the sofa, it becomes a bed. When the back is lifted, it becomes a sofa...

16 CFR § 1632.8 - Glossary of terms.

Code of Federal Regulations, 2013 CFR

2013-01-01

... pad. Designed to prevent or assist in the healing of decubitus ulcers (bed sores). Flat decubitus pads... sofa. When pressure is exerted on the back of the sofa, it becomes a bed. When the back is lifted, it...

16 CFR 1632.8 - Glossary of terms.

Code of Federal Regulations, 2011 CFR

2011-01-01

... prevent or assist in the healing of decubitus ulcers (bed sores). Flat decubitus pads are covered by the... pressure is exerted on the back of the sofa, it becomes a bed. When the back is lifted, it becomes a sofa...

16 CFR 1632.8 - Glossary of terms.

Code of Federal Regulations, 2014 CFR

2014-01-01

... prevent or assist in the healing of decubitus ulcers (bed sores). Flat decubitus pads are covered by the... pressure is exerted on the back of the sofa, it becomes a bed. When the back is lifted, it becomes a sofa...

Reducing NOx Emissions for a 600 MWe Down-Fired Pulverized-Coal Utility Boiler by Applying a Novel Combustion System.

PubMed

Ma, Lun; Fang, Qingyan; Lv, Dangzhen; Zhang, Cheng; Chen, Yiping; Chen, Gang; Duan, Xuenong; Wang, Xihuan

2015-11-03

A novel combustion system was applied to a 600 MWe Foster Wheeler (FW) down-fired pulverized-coal utility boiler to solve high NOx emissions, without causing an obvious increase in the carbon content of fly ash. The unit included moving fuel-lean nozzles from the arches to the front/rear walls and rearranging staged air as well as introducing separated overfire air (SOFA). Numerical simulations were carried out under the original and novel combustion systems to evaluate the performance of combustion and NOx emissions in the furnace. The simulated results were found to be in good agreement with the in situ measurements. The novel combustion system enlarged the recirculation zones below the arches, thereby strengthening the combustion stability considerably. The coal/air downward penetration depth was markedly extended, and the pulverized-coal travel path in the lower furnace significantly increased, which contributed to the burnout degree. The introduction of SOFA resulted in a low-oxygen and strong-reducing atmosphere in the lower furnace region to reduce NOx emissions evidently. The industrial measurements showed that NOx emissions at full load decreased significantly by 50%, from 1501 mg/m3 (O2 at 6%) to 751 mg/m3 (O2 at 6%). The carbon content in the fly ash increased only slightly, from 4.13 to 4.30%.

[The correlation between procalcitonin, C-reactive protein and severity scores in patients with sepsis and their value in assessment of prognosis].

PubMed

Wang, Shengyun; Chen, Dechang

2015-02-01

To investigate the correlation between procalcitonin (PCT), C-reactive protein (CRP) and acute physiology and chronic health evaluation II (APACHE II) score and sequential organ failure assessment (SOFA) score, and to investigate the value in assessment of PCT and CRP in prognosis in patients with sepsis. Clinical data of patients admitted to intensive care unit (ICU) of Changzheng Hospital Affiliated to the Second Military Medical University from January 2011 to June 2014 were retrospectively analyzed. 201 sepsis patients who received PCT and CRP tests, and evaluation of APACHE II score and SOFA score were enrolled. The values of PCT, CRP, APACHE II score and SOFA score between survivals (n = 136) and non-survivals (n = 65) were compared. The values of PCT and CRP among groups with different APACHE II scores and SOFA scores were compared. The relationships between PCT, CRP and APACHE II score and SOFA score were analyzed by Spearman correlation analysis. Receiver operating characteristic (ROC) curve was plotted to assess the prognostic value of PCT and CRP for prognosis of patients with sepsis. Compared with survival group, the values of PCT [μg/L: 11.03 (19.17) vs. 1.39 (2.61), Z = -4.572, P < 0.001], APACHE II score (19.16±5.32 vs. 10.01±3.88, t = -13.807, P < 0.001) and SOFA score (9.66±4.28 vs. 4.27±3.19, t = -9.993, P < 0.001) in non-survival group were significantly increased, but the value of CRP was not significantly different between non-survival group and survival group [mg/L: 75.22 (110.94) vs. 56.93 (100.75), Z = -0.731, P = 0.665]. The values of PCT were significantly correlated with APACHE II score and SOFA score (r1 = 0.373, r2 = 0.392, both P < 0.001), but the values of CRP were not significantly correlated with APACHE II score and SOFA score (r1 = -0.073, P1 = 0.411; r2 = -0.106, P2 = 0.282). The values of PCT rose significantly as the APACHE II score and SOFA score became higher, but the value of CRP was not significantly increased. When APACHE II score was 0-10, 11-20, and > 20, the value of PCT was 1.45 (2.62), 1.96 (9.04), and 7.41 (28.9) μg/L, respectively, and the value of CRP was 57.50 (83.40), 59.00 (119.70), and 77.60 (120.00) mg/L, respectively. When SOFA score was 0-5, 6-10, and > 10, the value of PCT was respectively 1.43 (3.09), 3.41 (9.75), and 5.43 (29.60) μg/L, and the value of CRP was 49.30 (86.20), 76.00 (108.70), and 75.60 (118.10) mg/L, respectively. There was significant difference in PCT between any two groups with different APACHE II and SOFA scores (P < 0.05 or P < 0.01), but no significant differences in CRP were found. The area under the ROC curve (AUC) of PCT for prognosis was significantly greater than that of CRP [0.872 (95% confidence interval 0.811-0.943) vs. 0.512 (95% confidence interval 0.427-0.612), P < 0.001]. When the cut-off value of PCT was 3.36 μg/L, the sensitivity was 66.8%, and the specificity was 45.4%. When the cut-off value of CRP was 44.50 mg/L, the sensitivity was 82.2%, and the specificity was 80.3%. Compared with CRP, PCT was more significantly correlated with APACHE II score and SOFA score. PCT can be a better indicator for evaluation of degree of severity, and also prognosis in sepsis patients.

Switching operations fatality analysis : findings and recommendations of the SOFA working group

DOT National Transportation Integrated Search

1999-10-01

On February 1998, a Switching Operations Fatality Analysis (SOFA) Working Group (WG) was formed at the request of the Federal Railroad Administration (FRA) to review recent fatal incidents and develop recommendations for reducing fatalities in switch...

Better prognostic marker in ICU - APACHE II, SOFA or SAP II!

PubMed

Naqvi, Iftikhar Haider; Mahmood, Khalid; Ziaullaha, Syed; Kashif, Syed Mohammad; Sharif, Asim

2016-01-01

This study was designed to determine the comparative efficacy of different scoring system in assessing the prognosis of critically ill patients. This was a retrospective study conducted in medical intensive care unit (MICU) and high dependency unit (HDU) Medical Unit III, Civil Hospital, from April 2012 to August 2012. All patients over age 16 years old who have fulfilled the criteria for MICU admission were included. Predictive mortality of APACHE II, SAP II and SOFA were calculated. Calibration and discrimination were used for validity of each scoring model. A total of 96 patients with equal gender distribution were enrolled. The average APACHE II score in non-survivors (27.97+8.53) was higher than survivors (15.82+8.79) with statistically significant p value (<0.001). The average SOFA score in non-survivors (9.68+4.88) was higher than survivors (5.63+3.63) with statistically significant p value (<0.001). SAP II average score in non-survivors (53.71+19.05) was higher than survivors (30.18+16.24) with statistically significant p value (<0.001). All three tested scoring models (APACHE II, SAP II and SOFA) would be accurate enough for a general description of our ICU patients. APACHE II has showed better calibration and discrimination power than SAP II and SOFA.

Using Extended Huckel Theory as a Platform to Introduce Jahn-Teller Distortion: The Spontaneous Distortion of 1,3,5,7-Cyclooctatetraene from a Perfect Octagon

ERIC Educational Resources Information Center

Sohlberg, Karl; Liu, Xiang

2013-01-01

Herein, a slightly enhanced version of extended Huckel molecular orbital theory is applied to demonstrate the spontaneous distortion of 1,3,5,7-cyclooctatetraene from a perfect octagon, a consequence of the Jahn-Teller effect. The exercise is accessible to students who have been introduced to basic quantum mechanics and extended Huckel molecular…

[Evaluation of coagulation disorders with thrombelastography in patients with sepsis].

PubMed

Zhong, Shengjian; Zhang, Chunbao; Hu, Juntao; Tang, Zhanhong

2016-02-01

To compare the results of thrombelastography (TEG) and the conventional coagulability test in patients with sepsis, and to discuss the value of TEG in monitoring blood coagulation dysfunction in patients with sepsis. The clinical data of 92 adult patients with sepsis admitted to Department of Critical Care Medicine of the First Affiliated Hospital of Guangxi Medical University were retrospectively analyzed. The patients were divided into sequential organ failure assessment (SOFA) score ≥ 12 group (n = 47) and SOFA < 12 group (n = 45). Thirty-five non-sepsis adult patients with normal coagulation function served as control group. The venous blood was collected for conventional blood coagulation test and routine examination of blood, D-dimer, procalcitonin (PCT), and TEG, and the differences were compared among three groups. Correlations between SOFA and various indexes of patients with sepsis were analyzed by Spearman rank correlation method. As shown in the results of the conventional blood coagulation test, D-dimer was gradually increased with the aggravation of the disease, the values in non-sepsis, SOFA < 12, and SOFA ≥ 12 groups were 0.523 (0.273, 0.928), 0.863 (0.673, 4.221), and 4.118 (2.420, 5.653) mg/L respectively (Z = 25.163, P = 0.000). Platelet count (PLT) in SOFA ≥ 12 group was significantly lower than that of the SOFA < 12 group and non-sepsis group [×10(9)/L: 28.6 (12.8, 48.9) vs. 257.3 (152.6, 339.8), 182.0 (118.0, 229.0), both P < 0.01]. There was no significant difference in prothrombin time (PT) and international normalized ratio (INR) among three groups, and it indicated that the conventional blood coagulation test might not respond quickly to the change in coagulation status of sepsis patients. As shown in the results of TEG, the values of reaction time (R value) and kinetics time (K value) in SOFA < 12 group were lower than those of the non-sepsis group [R value (minutes): 4.4 (3.6, 6.1) vs. 6.3 (6.0, 6.7), P < 0.01; K value (minutes): 1.1 (1.0, 1.5) vs. 1.5 (1.3, 1.8), P < 0.05], while they were higher in SOFA ≥ 12 group than those of the non-sepsis group [R value (minutes): 7.0 (5.7, 8.7) vs. 6.3 (6.0, 6.7), P > 0.05; K value (minutes): 4.2 (3.4, 7.1) vs. 1.5 (1.3, 1.8), P < 0.01]. The α angle, maximum amplitude (MA) and coagulation index (CI) in SOFA < 12 group were higher than those of the non-sepsis group [α angle (degree angle): 73.3 (68.5, 74.7) vs. 66.8 (62.2, 69.0), P < 0.01; MA (mm): 71.7 (61.9, 73.3) vs. 60.3 (58.2, 63.8), P < 0.01; CI: 3.1 (-0.1, 3.9) vs. 0.9 (-0.4, 1.3), P < 0.05], while they were lower in SOFA ≥ 12 group than those of the non-sepsis group [α angle (degree angle): 48.1 (36.6, 53.0) vs. 66.8 (62.2, 69.0), P < 0.01; MA (mm): 37.8 (30.0, 45.7) vs. 60.3 (58.2, 63.8), P < 0.01; CI: -5.6 (-8.4, -3.6) vs. 0.9 (-0.4, 1.3), P < 0.01]. The above results indicated that TEG could distinguish quickly the hypercoagulability and hypocoagulability status in septic patients. PCT in non-sepsis, SOFA < 12, and SOFA ≥ 12 groups were 0.27 (0.05, 1.80), 0.68 (0.10, 10.00), 41.10 (4.24, 100.00) μg/L respectively (Z = 195.475, P = 0.000), which indicate the severity of infectious disease. Correlation analysis results showed that SOFA score was negatively correlated with PLT, α angle, MA, and CI (r value was -0.853, -0.833, -0.881, and -0.859, respectively, all P = 0.000), and it was positively correlated with activated partial thromboplastin time (APTT), D-dimer, R value, K value, and PCT (r value was 0.381, 0.561, 0.587, 0.831, 0.775, respectively, P < 0.05 or P < 0.01), and non correlations was founded with PT, fibrinogen (FBG), and INR (r1 = 0.211, P1 = 0.233; r2 = -0.252, P2 = 0.142; r3 = 0.248, P3 = 0.148). TEG can effectively monitor the change in coagulation in patients with sepsis, and distinguish the hypercoagulable and hypocoagulable state. TEG may be a valuable tool to evaluate degree and risk of sepsis objectively.

Epidemiology and outcome analysis of sepsis and organ dysfunction/failure after burns.

PubMed

Belba, Monika Kristaq; Petrela, Elizana Ylber; Belba, Amy Gjergji

2017-09-01

The aim of this prospective study in adult population is to give frequency data (prevalence, incidence) of burn wound sepsis and its consequences (organ dysfunction/failure); to analyze the evolution of the SOFA cumulative score during the disease and relationship between the SOFA score in the 3rd, 7th, 14th and 21th day after burn with mortality. A prospective cohort study was performed among adult patients (age ≥20 years) admitted in the ICU, with major and moderate burns. Sepsis, organ dysfunction, organ failure and mortality were calculated as Cumulative Incidence (CI) and as Incidence rate (IR). Data from patients with sepsis were compared with those without sepsis. Evaluation of SOFA evolution was done with delta score and the influence of the SOFA score in mortality was calculated with AUC of the ROC curve. Period prevalence of sepsis in our adult burned population was 26%. Incidence proportion as CI was 0.3 or 30 patients per 100 adults. Incidence rate (IR) was 6 patients with sepsis per 100 patient-years. Overall morbidity was 88.1% while overall mortality was 11.9%. Mortality in patients with sepsis was 34.4%. Incidence of MOD was 63% while incidence of MOF was 37%. Respective mortality as CI was 7% and 81% while mortality rate as IR was 1.4 per 100 patient-years in patients with MOD and 16.2 per 100 patient-years in patients with MOF. SOFA-3 should be considered a "reliable indicator" at separating survivors from non survivors and SOFA 7, 14, and 21 should be considered excellent in predicting mortality. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

Hyperproteic hypocaloric enteral nutrition in the critically ill patient: A randomized controlled clinical trial

PubMed Central

Rugeles, Saúl-Javier; Rueda, Juan-David; Díaz, Carlos-Eduardo; Rosselli, Diego

2013-01-01

Introduction: Our aim was to evaluate the impact of hyperproteic hypocaloric enteral feeding on clinical outcomes in critically ill patients, particularly on severity of organic failure measured with the Sequential Organ Failure Assessment (SOFA). Materials and Methods: In a double blind clinical trial, 80 critically ill adult patients were randomized to hyperproteic hypocaloric or to isocaloric enteral nutrition; all patients completed follow-up of at least 4 days. Prescribed caloric intake was: Hyperproteic hypocaloric enteral nutrition (15 kcal/kg with 1.7 g/kg of protein) or isocaloric enteral nutrition (25 kcal/kg with 20% of the calories as protein). The main outcome was the differences in delta SOFA at 48 h. Secondary outcomes were intensive care unit (ICU) length of stay, days on ventilator, hyperglycemic events, and insulin requirements. Results: There were no differences in SOFA score at baseline (7.5 (standard deviation (SD) 2.9) vs 6.7 (SD 2.5) P = 0.17). The total amount of calories delivered was similarly low in both groups (12 kcal/kg in intervention group vs 14 kcal/kg in controls), but proteic delivery was significantly different (1.4 vs 0.76 g/kg, respectively P ≤ 0.0001). The intervention group showed an improvement in SOFA score at 48 h (delta SOFA 1.7 (SD 1.9) vs 0.7 (SD 2.8) P = 0.04) and less hyperglycemic episodes per day (1.0 (SD 1.3) vs 1.7 (SD 2.5) P = 0.017). Discussion: Enteral hyperproteic hypocaloric nutrition therapy could be associated with a decrease in multiple organ failure measured with SOFA score. We also found decreased hyperglycemia and a trend towards less mechanical ventilation days and ICU length of stay. PMID:24501485

Prognostic scores in cirrhotic patients admitted to a gastroenterology intensive care unit.

PubMed

Freire, Paulo; Romãozinho, José M; Amaro, Pedro; Ferreira, Manuela; Sofia, Carlos

2011-04-01

prognostic scores have been validated in cirrhotic patients admitted to general Intensive Care Units. No assessment of these scores was performed in cirrhotics admitted to specialized Gastroenterology Intensive Care Units (GICUs). to assess the prognostic accuracy of Acute Physiology and Chronic Health Evaluation (APACHE) II, Simplified Acute Physiology Score (SAPS) II, Sequential Organ Failure Assessment (SOFA), Model for End-stage Liver Disease (MELD) and Child-Pugh-Turcotte (CPT) in predicting GICU mortality in cirrhotic patients. the study involved 124 consecutive cirrhotic admissions to a GICU. Clinical data, prognostic scores and mortality were recorded. Discrimination was evaluated with area under receiver operating characteristic curves (AUC). Calibration was assessed with Hosmer-Lemeshow goodness-of-fit test. GICU mortality was 9.7%. Mean APACHE II, SAPS II, SOFA, MELD and CPT scores for survivors (13.6, 25.4, 3.5,18.0 and 8.6, respectively) were found to be significantly lower than those of non-survivors (22.0, 47.5, 10.1, 30.7 and 12.5,respectively) (p < 0.001). All the prognostic systems showed good discrimination, with AUC = 0.860, 0.911, 0.868, 0.897 and 0.914 for APACHE II, SAPS II, SOFA, MELD and CPT, respectively. Similarly, APACHE II, SAPS II, SOFA, MELD and CPT scores achieved good calibration, with p = 0.146, 0.120, 0.686,0.267 and 0.120, respectively. The overall correctness of prediction was 81.9%, 86.1%, 93.3%, 90.7% and 87.7% for the APA-CHE II, SAPS II, SOFA, MELD and CPT scores, respectively. in cirrhotics admitted to a GICU, all the tested scores have good prognostic accuracy, with SOFA and MELD showing the greatest overall correctness of prediction.

Frequency modulation television analysis: Distortion analysis

NASA Technical Reports Server (NTRS)

Hodge, W. H.; Wong, W. H.

1973-01-01

Computer simulation is used to calculate the time-domain waveform of standard T-pulse-and-bar test signal distorted in passing through an FM television system. The simulator includes flat or preemphasized systems and requires specification of the RF predetection filter characteristics. The predetection filters are modeled with frequency-symmetric Chebyshev (0.1-db ripple) and Butterworth filters. The computer was used to calculate distorted output signals for sixty-four different specified systems, and the output waveforms are plotted for all sixty-four. Comparison of the plotted graphs indicates that a Chebyshev predetection filter of four poles causes slightly more signal distortion than a corresponding Butterworth filter and the signal distortion increases as the number of poles increases. An increase in the peak deviation also increases signal distortion. Distortion also increases with the addition of preemphasis.

High-protein hypocaloric vs normocaloric enteral nutrition in critically ill patients: A randomized clinical trial.

PubMed

Rugeles, Saúl; Villarraga-Angulo, Luis Gabriel; Ariza-Gutiérrez, Aníbal; Chaverra-Kornerup, Santiago; Lasalvia, Pieralessandro; Rosselli, Diego

2016-10-01

Appropriate caloric intake in critically ill patients receiving enteral nutrition is controversial. This study evaluates the impact of different caloric regimens on severity of organ failure measured with Sequential Organ Failure Assessment (SOFA). We conducted a randomized prospective controlled trial. Study population included adult intensive care unit (ICU) patients expected to require enteral nutrition for more than 96 hours. Goals in the intervention group were hypocaloric (15 kcal/kg per day) enteral nutrition compared to normocaloric (25 kcal/kg per day) enteral nutrition, both with hyperproteic intake (1.7 g of protein/kg per day). Primary end point was change in SOFA score (ΔSOFA) from baseline at 48 hours. Secondary end points were ΔSOFA at 96 hours, insulin requirements, hyperglycemia or hypoglycemic episodes, length of ICU stay, days on ventilator, and 28-day mortality. After screening 443 patients, 120 patients were analyzed. There were no differences between groups in baseline characteristics. We did not find a statistically significant difference in ΔSOFA at 48 hours. Patients in the hypocaloric group showed lower average daily insulin requirements and percentage of patients requiring any insulin. Hyperproteic, hypocaloric nutrition did not show different outcomes compared to normocaloric nutrition, except lower insulin requirements. Hypocaloric nutrition could provide a more physiologic approach with lower need for care and metabolic impact. Copyright © 2016 Elsevier Inc. All rights reserved.

Muscular contractions in the zebrafish embryo are necessary to reveal thiuram-induced notochord distortions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Teraoka, Hiroki; Urakawa, Satsuki; Nanba, Satomi

2006-04-01

Dithiocarbamates form a large group of chemicals that have numerous uses in agriculture and medicine. It has been reported that dithiocarbamates, including thiuram (tetramethylthiuram disulfide), cause wavy distortions of the notochord in zebrafish and other fish embryos. In the present study, we investigated the mechanism underlying the toxicity of thiuram in zebrafish embryos. When embryos were exposed to thiuram (2-1000 nM: 0.48-240 {mu}g/L) from 3 h post fertilization (hpf) (30% epiboly) until 24 hpf (Prim-5), all embryos develop wavy notochords, disorganized somites, and have shortened yolk sac extensions. The thiuram response was specific and did not cause growth retardation ormore » mortality at 24 hpf. The thiuram-dependent responses showed the same concentration dependence with a waterborne EC{sub 5} values of approximately 7 nM. Morphometric measurements revealed that thiuram does not affect the rate of notochord lengthening. However, the rate of overall body lengthening was significantly reduced in thiuram-exposed animals. Other dithiocarbamates, such as ziram, caused similar malformations to thiuram. While expression of genes involved in somitogenesis was not affected, the levels of notochord-specific transcripts were altered after the onset of malformations. Distortion of the notochord started precisely at 18 hpf, which is concomitant with onset of spontaneous rhythmic trunk contractions. Abolishment of spontaneous contractions using tricaine, {alpha}-bungarotoxin, and a paralytic mutant sofa potato, resulted in normal notochord morphology in the presence of thiuram. These results indicate that muscle activity is necessary to reveal the underlying functional deficit and suggest that the developmental target of dithiocarbamates impairs trunk plasticity through an unknown mechanism.« less

75 FR 12730 - Foreign-Trade Zone 158-Vicksburg/Jackson, MS; Amendment to Application for Subzone; Max Home, LLC...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-17

...-purpose subzone status for the upholstered furniture manufacturing facilities of Max Home, LLC (Max Home... additional manufacturing plant and warehouse (100 employees/ 26 acres/160,000 sq. ft.) are located at 1313... finished upholstered furniture (chairs, seats, sofas, sleep sofas, and sectionals). The additional...

A comparison of three organ dysfunction scores: MODS, SOFA and LOD for predicting ICU mortality in critically ill patients.

PubMed

Khwannimit, Bodin

2007-06-01

To compare the validity of the Multiple Organ Dysfunction Score (MODS), Sequential Organ Failure Assessment (SOFA), and Logistic Organ Dysfunction Score (LOD) for predicting ICU mortality of Thai critically ill patients. A retrospective study was made of prospective data collected between the 1st July 2004 and 31st March 2006 at Songklanagarind Hospital. One thousand seven hundred and eighty two patients were enrolled in the present study. Two hundred and ninety three (16.4%) deaths were recorded in the ICU. The areas under the Receiver Operating Curves (A UC) for the prediction of ICU mortality the results were 0.861 for MODS, 0.879 for SOFA and 0.880 for LOD. The AUC of SOFA and LOD showed a statistical significance higher than the MODS score (p = 0.014 and p = 0.042, respectively). Of all the models, the neurological failure score showed the best correlation with ICU mortality. All three organ dysfunction scores satisfactorily predicted ICU mortality. The LOD and neurological failure had the best correlation with ICU outcome.

Prognostic value of Sequential Organ Failure Assessment and Simplified Acute Physiology II Score compared with trauma scores in the outcome of multiple-trauma patients.

PubMed

Fueglistaler, Philipp; Amsler, Felix; Schüepp, Marcel; Fueglistaler-Montali, Ida; Attenberger, Corinna; Pargger, Hans; Jacob, Augustinus Ludwig; Gross, Thomas

2010-08-01

Prospective data regarding the prognostic value of the Sequential Organ Failure Assessment (SOFA) score in comparison with the Simplified Acute Physiology Score (SAPS II) and trauma scores on the outcome of multiple-trauma patients are lacking. Single-center evaluation (n = 237, Injury Severity Score [ISS] >16; mean ISS = 29). Uni- and multivariate analysis of SAPS II, SOFA, revised trauma, polytrauma, and trauma and ISS scores (TRISS) was performed. The 30-day mortality was 22.8% (n = 54). SOFA day 1 was significantly higher in nonsurvivors compared with survivors (P < .001) and correlated well with the length of intensive care unit stay (r = .50, P < .001). Logistic regression revealed SAPS II to have the best predictive value of 30-day mortality (area under the receiver operating characteristic = .86 +/- .03). The SOFA score significantly added prognostic information with regard to mortality to both SAPS II and TRISS. The combination of critically ill and trauma scores may increase the accuracy of mortality prediction in multiple-trauma patients. 2010 Elsevier Inc. All rights reserved.

Sequential organ failure assessment (SOFA) scores differ between genders in a sepsis cohort: cause or effect?

PubMed

Jacobson, Sofie; Liedgren, Eva; Johansson, Göran; Ferm, Martin; Winsö, Ola

2012-11-01

Controversy exists regarding the influence of gender on sepsis events and outcome. Epidemiological data from other countries may not always apply to local circumstances. The aim of this study was to identify gender differences in patient characteristics, treatment, and outcome related to the occurrence of sepsis at admission to the ICU. A prospective observational cohort study on patients admitted to the ICU over a 3-year period fulfilling sepsis criteria during the first 24 hours. Demographic data, APACHE II score, SOFA score, TISS 76, aetiology, length of stay (LOS), mortality rate, and aspects of treatment were collected and then analysed with respect to gender differences. There were no gender-related differences in mortality or length of stay. Early organ dysfunction assessed as SOFA score at admission was a stronger risk factor for hospital mortality for women than for men. This discrepancy was mainly associated with the coagulation sub-score. CRP levels differed between genders in relation to hospital mortality. Infection from the abdominopelvic region was more common among women, whereas infection from skin or skin structures were more common in men. In this cohort, gender was not associated with increased mortality during a 2-year follow-up period. SOFA score at ICU admission was a stronger risk factor for hospital mortality for women than for men. The discrepancy was mainly related to the coagulation SOFA sub-score. Together with differences in CRP levels this may suggest differences in inflammatory response patterns between genders.

Acute Kidney Injury Enhances Outcome Prediction Ability of Sequential Organ Failure Assessment Score in Critically Ill Patients

PubMed Central

Chang, Chih-Hsiang; Fan, Pei-Chun; Chang, Ming-Yang; Tian, Ya-Chung; Hung, Cheng-Chieh; Fang, Ji-Tseng; Yang, Chih-Wei; Chen, Yung-Chang

2014-01-01

Introduction Acute kidney injury (AKI) is a common and serious complication in intensive care unit (ICU) patients and also often part of a multiple organ failure syndrome. The sequential organ failure assessment (SOFA) score is an excellent tool for assessing the extent of organ dysfunction in critically ill patients. This study aimed to evaluate the outcome prediction ability of SOFA and Acute Physiology and Chronic Health Evaluation (APACHE) III score in ICU patients with AKI. Methods A total of 543 critically ill patients were admitted to the medical ICU of a tertiary-care hospital from July 2007 to June 2008. Demographic, clinical and laboratory variables were prospectively recorded for post hoc analysis as predictors of survival on the first day of ICU admission. Results One hundred and eighty-seven (34.4%) patients presented with AKI on the first day of ICU admission based on the risk of renal failure, injury to kidney, failure of kidney function, loss of kidney function, and end-stage renal failure (RIFLE) classification. Major causes of the ICU admissions involved respiratory failure (58%). Overall in-ICU mortality was 37.9% and the hospital mortality was 44.7%. The predictive accuracy for ICU mortality of SOFA (areas under the receiver operating characteristic curves: 0.815±0.032) was as good as APACHE III in the AKI group. However, cumulative survival rates at 6-month follow-up following hospital discharge differed significantly (p<0.001) for SOFA score ≤10 vs. ≥11 in these ICU patients with AKI. Conclusions For patients coexisting with AKI admitted to ICU, this work recommends application of SOFA by physicians to assess ICU mortality because of its practicality and low cost. A SOFA score of ≥ “11” on ICU day 1 should be considered an indicator of negative short-term outcome. PMID:25279844

Comparison of PIRO, SOFA, and MEDS scores for predicting mortality in emergency department patients with severe sepsis and septic shock.

PubMed

Macdonald, Stephen P J; Arendts, Glenn; Fatovich, Daniel M; Brown, Simon G A

2014-11-01

The Predisposition Insult Response and Organ failure (PIRO) scoring system has been developed for use in the emergency department (ED) to risk stratify sepsis cases, but has not been well studied among high-risk patients with severe sepsis and septic shock. The PIRO score was compared with the Sequential Organ Failure Assessment (SOFA) and Mortality in ED Sepsis (MEDS) scores to predict mortality in ED patients with features suggesting severe sepsis or septic shock in the ED. This was an analysis of sepsis patients enrolled in a prospective observational ED study of patients presenting with evidence of shock, hypoxemia, or other organ failure. PIRO, MEDS, and SOFA scores were calculated from ED data. Analysis compared areas under the receiver operator characteristic (ROC) curves for 30-day mortality. Of 240 enrolled patients, final diagnoses were septic shock in 128 (53%), severe sepsis without shock in 70 (29%), and infection with no organ dysfunction in 42 (18%). Forty-eight (20%) patients died within 30 days of presentation. Area under the ROC curve (AUC) for mortality was 0.86 (95% confidence interval [CI] = 0.80 to 0.92) for PIRO, 0.81 (95% CI = 0.74 to 0.88) for MEDS, and 0.78 (95% CI = 0.71 to 0.87) for SOFA scores. Pairwise comparisons of the AUC were as follows: PIRO versus SOFA, p = 0.01; PIRO versus MEDS, p = 0.064; and MEDS versus SOFA; p = 0.37. Mortality increased with increasing PIRO scores: PIRO < 5, 0%; PIRO 5 to 9, 5%; PIRO 10 to 14, 5%; PIRO 15 to 19, 37%; and PIRO ≥ 20, 80% (p < 0.001). The MEDS score also showed increasing mortality with higher scores: MEDS < 5, 0%; MEDS 5 to 7, 12%; MEDS 8 to 11, 15%; MEDS 12 to 14, 48%; and MEDS > 15, 65% (p < 0.001). The PIRO model, taking into account comorbidities and septic source as well as physiologic status, performed better than the SOFA score and similarly to the MEDS score for predicting mortality in ED patients with severe sepsis and septic shock. These findings have implications for identifying and managing high-risk patients and for the design of clinical trials in sepsis. © 2014 by the Society for Academic Emergency Medicine.

Associations between flame retardant applications in furniture foam, house dust levels, and residents' serum levels.

PubMed

Hammel, Stephanie C; Hoffman, Kate; Lorenzo, Amelia M; Chen, Albert; Phillips, Allison L; Butt, Craig M; Sosa, Julie Ann; Webster, Thomas F; Stapleton, Heather M

2017-10-01

Polyurethane foam (PUF) in upholstered furniture frequently is treated with flame retardant chemicals (FRs) to reduce its flammability and adhere to rigorous flammability standards. For decades, a commercial mixture of polybrominated diphenyl ethers (PBDEs) called PentaBDE was commonly applied to foam to fulfill these regulations; however, concerns over toxicity, bioaccumulation, and persistence led to a global phase-out in the mid-2000s. Although PentaBDE is still detected in older furniture, other FR compounds such as tris(1,3-dichloroisopropyl) phosphate (TDCIPP) and Firemaster® 550 (FM550) have been increasingly used as replacements. While biomonitoring studies suggest exposure is widespread, the primary sources of exposure are not clearly known. Here, we investigated the relationships between specific FR applications in furniture foam and human exposure. Paired samples of furniture foam, house dust and serum samples were collected from a cohort in North Carolina, USA and analyzed for FRs typically used in PUF. In general, the presence of a specific FR in the sofa of a home was associated with an increase in the concentration of that FR in house dust. For example, the presence of PentaBDE in sofas was associated with significantly higher levels of BDE-47, a major component of PentaBDE, in house dust (10 β =6.4, p<0.001). A similar association was observed with a component of FM550, 2-ethylhexyl-2,3,4,5-tetrabromobenzoate (EH-TBB), with levels that were approximately 3 times higher in house dust when FM550 was identified in the sofa foam (p<0.01). These relationships were modified by dust loading rates in the living room and the ratio of sofa size to room size. Interestingly, levels of TDCIPP and tris(1-chloro-2-isopropyl) phosphate (TCIPP) were also higher in dust with detections in sofa foam; however, these associations were not statistically significant and may suggest there are other prominent sources of these compounds in the home. In addition, the presence of PentaBDE in sofa foam was associated with significantly higher levels of BDE-47 in serum (p<0.01). These results suggest that FR applications in sofas are likely major sources of exposure to these compounds in the home. Copyright © 2017 Elsevier Ltd. All rights reserved.

Low sensitivity of qSOFA, SIRS criteria and sepsis definition to identify infected patients at risk of complication in the prehospital setting and at the emergency department triage.

PubMed

Tusgul, Selin; Carron, Pierre-Nicolas; Yersin, Bertrand; Calandra, Thierry; Dami, Fabrice

2017-11-03

Sepsis is defined as life-threatening organ dysfunction caused by a host response to infection. The quick SOFA (qSOFA) score has been recently proposed as a new bedside clinical score to identify patients with suspected infection at risk of complication (intensive care unit (ICU) admission, in-hospital mortality). The aim of this study was to measure the sensitivity of the qSOFA score, SIRS criteria and sepsis definitions to identify the most serious sepsis cases in the prehospital setting and at the emergency department (ED) triage. We performed a retrospective study of all patients transported by emergency medical services (EMS) to the Lausanne University Hospital (CHUV) over twelve months. All patients with a suspected or proven infection after the ED workup were included. We retrospectively analysed the sensitivity of the qSOFA score (≥2 criteria), SIRS criteria (≥2 clinical criteria) and sepsis definition (SIRS criteria + one sign of organ dysfunction or hypoperfusion) in the pre-hospital setting and at the ED triage as predictors of ICU admission, ICU stay of ≥3 days and early (i.e. 48 h) mortality. No direct comparison between the three tools was attempted. Among 11,411 patients transported to the University hospital, 886 (7.8%) were included. In the pre-hospital setting, the sensitivity of qSOFA reached 36.3% for ICU admission, 17.4% for ICU stay of three days or more and 68.0% for 48 h mortality. The sensitivity of SIRS criteria reached 68.8% for ICU admission, 74.6% for ICU stay of three days or more and 64.0% for 48 h mortality. The sensitivity of sepsis definition did not reach 60% for any outcome. At ED triage, the sensitivity of qSOFA reached 31.2% for ICU admission, 30.5% for ICU stay of ≥3 days and 60.0% for mortality at 48 h. The sensitivity of SIRS criteria reached 58.8% for ICU admission, 57.6% for ICU stay of ≥3 days 80.0% for mortality at 48 h. The sensitivity of sepsis definition reached 60.0% for 48 h mortality. Incidence of sepsis in the ED among patients transported by ambulance was 3.8 percent. This rate, associated to the mortality of sepsis, confirms the necessity to dispose of a test to early identify those patients. The sensitivity performance of all three tools was suboptimal. The qSOFA score, SIRS criteria and sepsis definition have low identification sensitivity in selecting septic patients in the pre-hospital setting or upon arrival in the ED at risk of complication.

Some observations of the effects of radial distortions on performance of a transonic rotating blade row

NASA Technical Reports Server (NTRS)

Sandercock, D. M.; Sanger, N. L.

1974-01-01

A single rotating blade row was tested with two magnitudes of tip radial distortion and two magnitudes of hub radial distortion imposed on the inlet flow. The rotor was about 50 centimeters (20 in.) in diameter and had a design operating tip speed of approximately 420 meters per second (1380 ft/sec). Overall performance at 60, 80, and 100 percent of equivalent design speed generally showed a decrease (compared to undistorted flow) in rotor stall margin with tip radial distortion but no change, or a slight increase, in rotor stall margin with hub radial distortion. At design speed there was a decrease in rotor overall total pressure ratio and choke flow with all inlet flow distortions. Radial distributions of blade element parameters are presented for selected operating conditions at design speed.

Sequential Organ Failure Assessment (SOFA) scores differ between genders in a sepsis cohort: Cause or effect?

PubMed Central

Liedgren, Eva; Johansson, Göran; Ferm, Martin; Winsö, Ola

2012-01-01

Background. Controversy exists regarding the influence of gender on sepsis events and outcome. Epidemiological data from other countries may not always apply to local circumstances. The aim of this study was to identify gender differences in patient characteristics, treatment, and outcome related to the occurrence of sepsis at admission to the ICU. Methods. A prospective observational cohort study on patients admitted to the ICU over a 3-year period fulfilling sepsis criteria during the first 24 hours. Demographic data, APACHE II score, SOFA score, TISS 76, aetiology, length of stay (LOS), mortality rate, and aspects of treatment were collected and then analysed with respect to gender differences. Results. There were no gender-related differences in mortality or length of stay. Early organ dysfunction assessed as SOFA score at admission was a stronger risk factor for hospital mortality for women than for men. This discrepancy was mainly associated with the coagulation sub-score. CRP levels differed between genders in relation to hospital mortality. Infection from the abdominopelvic region was more common among women, whereas infection from skin or skin structures were more common in men. Conclusion. In this cohort, gender was not associated with increased mortality during a 2-year follow-up period. SOFA score at ICU admission was a stronger risk factor for hospital mortality for women than for men. The discrepancy was mainly related to the coagulation SOFA sub-score. Together with differences in CRP levels this may suggest differences in inflammatory response patterns between genders. PMID:22793786

NICE guidance on sepsis is of limited value in postoperative colorectal patients: the scores that cry 'wolf!'

PubMed

Herrod, Pjj; Cox, M; Keevil, H; Smith, Kje; Lund, J N

2018-04-01

Background and aims Late recognition of sepsis and consequent death remains a problem. To address this, the National Institute for Health and Care Excellence has published updated guidance recommending the use of the Quick Sequential Organ Failure Assessment (Q-SOFA) score when assessing patients at risk of sepsis following the publication of the Third International Consensus Definitions for Sepsis and Septic Shock. The trauma from major surgery produces a systemic inflammatory response syndrome (SIRS) postoperatively as part of its natural history, which may falsely trigger scoring systems. We aimed to assess the accuracy of Q-SOFA and SIRS criteria as recommended scores for early detection of sepsis and septic complications in the first 48hrs after colorectal cancer surgery. Methods We reviewed all elective major colorectal operations in a single centre during a 12-month period from prospectively maintained electronic records. Results One hundred and thirty nine patients were included in this study. In all, 29 patients developed postoperative infective complications in hospital. Nineteen patients triggered on SIRS without developing infective complications, while 42 patients triggered on Q-SOFA with no infective complications. The area under the ROC curve was 0.52 for Q-SOFA and 0.67 for SIRS. Discussion Q-SOFA appears to perform little better than a coin toss at identifying postoperative sepsis after colorectal cancer resection and is inferior to the SIRS criteria. More work is required to assess whether a combination of scoring criteria, biochemical markers and automated tools could increase accurate detection of postoperative infection and trigger early intervention.

Contour sensitive saliency and depth application in image retargeting

NASA Astrophysics Data System (ADS)

Lu, Hongju; Yue, Pengfei; Zhao, Yanhui; Liu, Rui; Fu, Yuanbin; Zheng, Yuanjie; Cui, Jia

2018-04-01

Image retargeting technique requires important information preservation and less edge distortion during increasing/decreasing image size. The major existed content-aware methods perform well. However, there are two problems should be improved: the slight distortion appeared at the object edges and the structure distortion in the nonsalient area. According to psychological theories, people evaluate image quality based on multi-level judgments and comparison between different areas, both image content and image structure. The paper proposes a new standard: the structure preserving in non-salient area. After observation and image analysis, blur (slight blur) is generally existed at the edge of objects. The blur feature is used to estimate the depth cue, named blur depth descriptor. It can be used in the process of saliency computation for balanced image retargeting result. In order to keep the structure information in nonsalient area, the salient edge map is presented in Seam Carving process, instead of field-based saliency computation. The derivative saliency from x- and y-direction can avoid the redundant energy seam around salient objects causing structure distortion. After the comparison experiments between classical approaches and ours, the feasibility of our algorithm is proved.

Counterfactuals in Action: An fMRI Study of Counterfactual Sentences Describing Physical Effort

ERIC Educational Resources Information Center

Urrutia, Mabel; Gennari, Silvia P.; de Vega, Manuel

2012-01-01

Counterfactual statements such as "if Mary had cleaned the room, she would have moved the sofa" convey both actual and hypothetical actions, namely, that Mary did not clean the room or move the sofa, but she would have done so in some possible past situation. Such statements are ubiquitous in daily life and are involved in critical cognitive…

Serial evaluation of the MODS, SOFA and LOD scores to predict ICU mortality in mixed critically ill patients.

PubMed

Khwannimit, Bodin

2008-09-01

To perform a serial assessment and compare ability in predicting the intensive care unit (ICU) mortality of the multiple organ dysfunction score (MODS), sequential organ failure assessment (SOFA) and logistic organ dysfunction (LOD) score. The data were collected prospectively on consecutive ICU admissions over a 24-month period at a tertiary referral university hospital. The MODS, SOFA, and LOD scores were calculated on initial and repeated every 24 hrs. Two thousand fifty four patients were enrolled in the present study. The maximum and delta-scores of all the organ dysfunction scores correlated with ICU mortality. The maximum score of all models had better ability for predicting ICU mortality than initial or delta score. The areas under the receiver operating characteristic curve (AUC) for maximum scores was 0.892 for the MODS, 0.907 for the SOFA, and 0.92for the LOD. No statistical difference existed between all maximum scores and Acute Physiology and Chronic Health Evaluation II (APACHE II) score. Serial assessment of organ dysfunction during the ICU stay is reliable with ICU mortality. The maximum scores is the best discrimination comparable with APACHE II score in predicting ICU mortality.

Computer modeling of fan-exit-splitter spacing effects on F100 response to distortion

NASA Technical Reports Server (NTRS)

Shaw, M.; Murdoch, R. W.

1982-01-01

The distortion response of the F100(3) engine was effected by the fan exit splitter configuration. The sensitivity for a proximate splitter fan is calculated to be slightly greater than a remote splitter configuration with identical airfoils. Predicted response was based upon a multiple segment parallel compressor Model modified to include a bypass ratio representation that effects the performance characteristics of the last rotor and intermediate case struts. The predicted distortion response required an accurate definition of row pre- and post-stall undistorted operation.

Recognition Memory for Movement in Photographs: A Developmental Study.

ERIC Educational Resources Information Center

Futterweit, Lorelle R.; Beilin, Harry

1994-01-01

Investigated whether children's recognition memory for movement in photographs is distorted forward in the direction of implied motion. When asked whether the second photograph was the same as or different from the first, subjects made more errors for test photographs showing the action slightly forward in time, compared with slightly backward in…

Getting the invite list right: a discussion of sepsis severity scoring systems in severe complicated intra-abdominal sepsis and randomized trial inclusion criteria.

PubMed

Tolonen, Matti; Coccolini, Federico; Ansaloni, Luca; Sartelli, Massimo; Roberts, Derek J; McKee, Jessica L; Leppaniemi, Ari; Doig, Christopher J; Catena, Fausto; Fabian, Timothy; Jenne, Craig N; Chiara, Osvaldo; Kubes, Paul; Kluger, Yoram; Fraga, Gustavo P; Pereira, Bruno M; Diaz, Jose J; Sugrue, Michael; Moore, Ernest E; Ren, Jianan; Ball, Chad G; Coimbra, Raul; Dixon, Elijah; Biffl, Walter; MacLean, Anthony; McBeth, Paul B; Posadas-Calleja, Juan G; Di Saverio, Salomone; Xiao, Jimmy; Kirkpatrick, Andrew W

2018-01-01

Severe complicated intra-abdominal sepsis (SCIAS) is a worldwide challenge with increasing incidence. Open abdomen management with enhanced clearance of fluid and biomediators from the peritoneum is a potential therapy requiring prospective evaluation. Given the complexity of powering multi-center trials, it is essential to recruit an inception cohort sick enough to benefit from the intervention; otherwise, no effect of a potentially beneficial therapy may be apparent. An evaluation of abilities of recognized predictive systems to recognize SCIAS patients was conducted using an existing intra-abdominal sepsis (IAS) database. All consecutive adult patients with a diffuse secondary peritonitis between 2012 and 2013 were collected from a quaternary care hospital in Finland, excluding appendicitis/cholecystitis. From this retrospectively collected database, a target population (93) of those with either ICU admission or mortality were selected. The performance metrics of the Third Consensus Definitions for Sepsis and Septic Shock based on both SOFA and quick SOFA, the World Society of Emergency Surgery Sepsis Severity Score (WSESSSS), the APACHE II score, Manheim Peritonitis Index (MPI), and the Calgary Predisposition, Infection, Response, and Organ dysfunction (CPIRO) score were all tested for their discriminant ability to identify this subgroup with SCIAS and to predict mortality. Predictive systems with an area under-the-receiving-operating characteristic (AUC) curve > 0.8 included SOFA, Sepsis-3 definitions, APACHE II, WSESSSS, and CPIRO scores with the overall best for CPIRO. The highest identification rates were SOFA score ≥ 2 (78.4%), followed by the WSESSSS score ≥ 8 (73.1%), SOFA ≥ 3 (75.2%), and APACHE II ≥ 14 (68.8%) identification. Combining the Sepsis-3 septic-shock definition and WSESSS ≥ 8 increased detection to 80%. Including CPIRO score ≥ 3 increased this to 82.8% (Sensitivity-SN; 83% Specificity-SP; 74%. Comparatively, SOFA ≥ 4 and WSESSSS ≥ 8 with or without septic-shock had 83.9% detection (SN; 84%, SP; 75%, 25% mortality). No one scoring system behaves perfectly, and all are largely dominated by organ dysfunction. Utilizing combinations of SOFA, CPIRO, and WSESSSS scores in addition to the Sepsis-3 septic shock definition appears to offer the widest "inclusion-criteria" to recognize patients with a high chance of mortality and ICU admission. https://clinicaltrials.gov/ct2/show/NCT03163095; Registered on May 22, 2017.

75 FR 71671 - Draft Report on the Technical Study of the Sofa Super Store Fire-South Carolina, June 18, 2007.

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-24

...-0532-01] Draft Report on the Technical Study of the Sofa Super Store Fire--South Carolina, June 18..., which took place on June 18, 2007. DATES: Comments must be received on or before 12 noon EST, December 2...-6868. SUPPLEMENTARY INFORMATION: Following a fire in Charleston, SC on June 18, 2007, NIST conducted a...

Implications of the new sepsis definition on research and practice.

PubMed

Peach, Brian C

2017-04-01

The Society of Critical-Care Medicine and the European Society of Intensive Care Medicine recently announced a marked change in the sepsis definition. A task force of 19 sepsis clinicians and researchers made the change based on advances in the pathobiological understanding of the septic process. The task force determined that there were numerous justifications for a revision of the sepsis definition, which are outlined in this article. The systemic inflammatory response criteria have been replaced by the Sequential Organ Failure Assessment (SOFA) score in the newly operationalized definition (Singer et al., 2016). In addition to the definition change, the task force recommended using the new quick SOFA (qSOFA) score in non-ICU settings, as a risk stratification tool to identify patients who may be septic or be at risk of developing sepsis. The change in definition will likely have a negative impact on sepsis research in the short-term as hospitals adjust their coding for the new definition, but may result in less misclassification bias and improved research data in the long-term. While the intent of the SCCM/ESICM task force was to better define sepsis for coding and epidemiological research purposes, there is the potential for improved patient outcomes if clinicians are better able to differentiate between sepsis and inflammatory events. The qSOFA tool may also aid clinicians in recognizing sepsis in a quicker manner, leading to more timely treatment, and potentially better outcomes. While the new operationalized Sepsis-3 definition appears on the surface to be an improvement over the previous iterations, it remains to be seen if research data will be more robust using the new criteria. There is the potential for better patient outcomes if clinicians are better able to differentiate sepsis from inflammatory events with the new definition, and if sepsis cases are recognized sooner with qSOFA. Future research on the impact of this definition change on research and practice will be essential, to determine if the Sepsis 3 definition, its associated clinical criteria, and the qSOFA need further revision. Copyright © 2016 Elsevier Inc. All rights reserved.

Development of the SoFAS (solid fats and added sugars) concept: the 2010 Dietary Guidelines for Americans.

PubMed

Nicklas, Theresa A; O'Neil, Carol E

2015-05-01

The diets of most US children and adults are poor, as reflected by low diet quality scores, when compared with the recommendations of the Dietary Guidelines for Americans (DGAs). Contributing to these low scores is that most Americans overconsume solid fats, which may contain saturated fatty acids and added sugars; although alcohol consumption was generally modest, it provided few nutrients. Thus, the 2005 DGAs generated a new recommendation: to reduce intakes of solid fats, alcohol, and added sugars (SoFAAS). What precipitated the emergence of the new SoFAAS terminology was the concept of discretionary calories (a "calorie" is defined as the amount of energy needed to increase the temperature of 1 kg of water by 1°C), which were defined as calories consumed after an individual had met his or her recommended nutrient intakes while consuming fewer calories than the daily recommendation. A limitation with this concept was that additional amounts of nutrient-dense foods consumed beyond the recommended amount were also considered discretionary calories. The rationale for this was that if nutrient-dense foods were consumed beyond recommended amounts, after total energy intake was met then this constituted excess energy intake. In the 2010 DGAs, the terminology was changed to solid fats and added sugars (SoFAS); thus, alcohol was excluded because it made a minor contribution to overall intake and did not apply to children. The SoFAS terminology also negated nutrient-dense foods that were consumed in amounts above the recommendations for the specific food groups in the food patterns. The ambiguous SoFAS terminology was later changed to "empty calories" to reflect only those calories from solid fats and added sugars (and alcohol if consumed beyond moderate amounts). The purpose of this review is to provide an historical perspective on how the dietary recommendations went from SoFAAS to SoFAS and how discretionary calories went to empty calories between the 2005 and 2010 DGAs. This information will provide practitioners, as well as the public, with valuable information to better understand the evolution of SoFAS over time. © 2015 American Society for Nutrition.

Development of the SoFAS (Solid Fats and Added Sugars) Concept: The 2010 Dietary Guidelines for Americans123

PubMed Central

Nicklas, Theresa A; O’Neil, Carol E

2015-01-01

The diets of most US children and adults are poor, as reflected by low diet quality scores, when compared with the recommendations of the Dietary Guidelines for Americans (DGAs). Contributing to these low scores is that most Americans overconsume solid fats, which may contain saturated fatty acids and added sugars; although alcohol consumption was generally modest, it provided few nutrients. Thus, the 2005 DGAs generated a new recommendation: to reduce intakes of solid fats, alcohol, and added sugars (SoFAAS). What precipitated the emergence of the new SoFAAS terminology was the concept of discretionary calories (a “calorie” is defined as the amount of energy needed to increase the temperature of 1 kg of water by 1°C), which were defined as calories consumed after an individual had met his or her recommended nutrient intakes while consuming fewer calories than the daily recommendation. A limitation with this concept was that additional amounts of nutrient-dense foods consumed beyond the recommended amount were also considered discretionary calories. The rationale for this was that if nutrient-dense foods were consumed beyond recommended amounts, after total energy intake was met then this constituted excess energy intake. In the 2010 DGAs, the terminology was changed to solid fats and added sugars (SoFAS); thus, alcohol was excluded because it made a minor contribution to overall intake and did not apply to children. The SoFAS terminology also negated nutrient-dense foods that were consumed in amounts above the recommendations for the specific food groups in the food patterns. The ambiguous SoFAS terminology was later changed to “empty calories” to reflect only those calories from solid fats and added sugars (and alcohol if consumed beyond moderate amounts). The purpose of this review is to provide an historical perspective on how the dietary recommendations went from SoFAAS to SoFAS and how discretionary calories went to empty calories between the 2005 and 2010 DGAs. This information will provide practitioners, as well as the public, with valuable information to better understand the evolution of SoFAS over time. PMID:25979510

Associations among depression severity, painful physical symptoms, and social and occupational functioning impairment in patients with major depressive disorder: a 3-month, prospective, observational study.

PubMed

Harada, Eiji; Satoi, Yoichi; Kuga, Atsushi; Tokuoka, Hirofumi; Kikuchi, Toshiaki; Watanabe, Koichiro; Alev, Levent; Mimura, Masaru

2017-01-01

To investigate associations among depression severity, painful physical symptoms (PPS), and social and occupational functioning impairment in patients with major depressive disorder (MDD) who had achieved complete remission (CR) or partial remission (PR) after acute treatment. This was a 12-week, multicenter, prospective, observational study. Patients with MDD treated with an antidepressant medication for the previous 12 weeks (±3 weeks) who had achieved CR (defined as a 17-item Hamilton Rating Scale for Depression [HAM-D17] score ≤7) or PR (HAM-D17 score ≥8 and ≤18) were enrolled. Depression severity, PPS, and impairment in social and occupational functioning were assessed using the HAM-D17, the Brief Pain Inventory (Short Form) (BPI-SF), and the Social and Occupational Functioning Assessment Scale (SOFAS), respectively, at enrollment (Week 12) and after 12 weeks (Week 24). Overall, 323 Japanese patients with MDD were enrolled (CR n=158, PR n=165) and 288 patients completed the study (CR n=139, PR n=149). HAM-D17 and SOFAS scores were strongly and negatively correlated at enrollment (Week 12; P <0.0001) and Week 24 ( P <0.0001). A weak negative correlation between the BPI-SF and SOFAS was observed at Week 24 ( P =0.0011), but not at enrollment ( P =0.164). Remission status at enrollment (CR or PR) was associated with achieving normal social and occupational functioning (SOFAS score ≥80) at Week 24 in patients who had not achieved normal social and occupational functioning (SOFAS score <80) at enrollment (CR vs PR, OR=0.05 [95% CIs 0.01-0.18], P <0.0001). A greater proportion of patients with CR and no PPS at enrollment achieved SOFAS scores ≥80 at Week 24 than those with CR and PPS. Our results suggest that treating both depressive symptoms and PPS is important for achieving a normal level of functioning on a long-term basis in patients with MDD.

PAL: A Positional Astronomy Library

NASA Astrophysics Data System (ADS)

Jenness, T.; Berry, D. S.

2013-10-01

PAL is a new positional astronomy library written in C that attempts to retain the SLALIB API but is distributed with an open source GPL license. The library depends on the IAU SOFA library wherever a SOFA routine exists and uses the most recent nutation and precession models. Currently about 100 of the 200 SLALIB routines are available. Interfaces are also available from Perl and Python. PAL is freely available via github.

Validation of Computerized Automatic Calculation of the Sequential Organ Failure Assessment Score

PubMed Central

Harrison, Andrew M.; Pickering, Brian W.; Herasevich, Vitaly

2013-01-01

Purpose. To validate the use of a computer program for the automatic calculation of the sequential organ failure assessment (SOFA) score, as compared to the gold standard of manual chart review. Materials and Methods. Adult admissions (age > 18 years) to the medical ICU with a length of stay greater than 24 hours were studied in the setting of an academic tertiary referral center. A retrospective cross-sectional analysis was performed using a derivation cohort to compare automatic calculation of the SOFA score to the gold standard of manual chart review. After critical appraisal of sources of disagreement, another analysis was performed using an independent validation cohort. Then, a prospective observational analysis was performed using an implementation of this computer program in AWARE Dashboard, which is an existing real-time patient EMR system for use in the ICU. Results. Good agreement between the manual and automatic SOFA calculations was observed for both the derivation (N=94) and validation (N=268) cohorts: 0.02 ± 2.33 and 0.29 ± 1.75 points, respectively. These results were validated in AWARE (N=60). Conclusion. This EMR-based automatic tool accurately calculates SOFA scores and can facilitate ICU decisions without the need for manual data collection. This tool can also be employed in a real-time electronic environment. PMID:23936639

Predictive value of the APACHE II, SAPS II, SOFA and GCS scoring systems in patients with severe purulent bacterial meningitis.

PubMed

Pietraszek-Grzywaczewska, Iwona; Bernas, Szymon; Łojko, Piotr; Piechota, Anna; Piechota, Mariusz

2016-01-01

Scoring systems in critical care patients are essential for predicting of the patient outcome and evaluating the therapy. In this study, we determined the value of the Acute Physiology and Chronic Health Evaluation II (APACHE II), Simplified Acute Physiology Score II (SAPS II), Sequential Organ Failure Assessment (SOFA) and Glasgow Coma Scale (GCS) scoring systems in the prediction of mortality in adult patients admitted to the intensive care unit (ICU) with severe purulent bacterial meningitis. We retrospectively analysed data from 98 adult patients with severe purulent bacterial meningitis who were admitted to the single ICU between March 2006 and September 2015. Univariate logistic regression identified the following risk factors of death in patients with severe purulent bacterial meningitis: APACHE II, SAPS II, SOFA, and GCS scores, and the lengths of ICU stay and hospital stay. The independent risk factors of patient death in multivariate analysis were the SAPS II score, the length of ICU stay and the length of hospital stay. In the prediction of mortality according to the area under the curve, the SAPS II score had the highest accuracy followed by the APACHE II, GCS and SOFA scores. For the prediction of mortality in a patient with severe purulent bacterial meningitis, SAPS II had the highest accuracy.

Structure of the Fusarium oxysporum endoglucanase I with a nonhydrolyzable substrate analogue: substrate distortion gives rise to the preferred axial orientation for the leaving group.

PubMed

Sulzenbacher, G; Driguez, H; Henrissat, B; Schülein, M; Davies, G J

1996-12-03

Endoglucanase I (EG I) is a cellulase, from glycosyl hydrolase family 7, which cleaves the beta-1,4 linkages of cellulose with overall retention of configuration. The structure of the EG I from Fusarium oxysproum, complexed to a nonhydrolyzable thiooligosaccharide substrate analogue, has been determined by X-ray crystallography at a resolution of 2.7 A utilizing the 4-fold noncrystallographic symmetry present in the asymmetric unit. The electron density map clearly reveals the presence of three glucosyl units of the inhibitor, consistent with the known number of sugar-binding subsites, located at the active site of the enzyme in the -2, -1, and +1 subsites, i.e., actually spanning the point of enzymatic cleavage. The pyranose ring at the point of potential enzymatic cleavage is clearly distorted from the standard 4C1 chair as was originally suggested for beta-retaining enzymes by Phillips [Ford, L.O., Johnson, L.N., Machin, P. A., Phillips, D.C., & Tijan, T. (1974) J. Mol. Biol, 88, 349-371]. The distortion observed goes beyond the "sofa" conformation observed in previous studies and results in a conformation whose salient feature is the resulting quasi-axial orientation for the glycosidic bond and leaving group, as predicted by stereoelectronic theory. An almost identical conformation has recently been observed in a complex of chitobiase with its unhydrolyzed substrate [Tews, I., Perrakis, A., Oppenheim, A., Dauter, Z., Wilson, K. S., & Vorgias, C. E. (1996) Nat. Struct. Biol. 3, 638-648]. The striking similarity between these two complexes extends beyond the almost identical pyranose ring distortion. The overlap of the two respective sugars places the enzymatic nucleophile of endoglucanase I in coincidence with the C2 acetamido oxygen of N-acetylglucosamine in the catalytic site of the chitobiase, substantiating the involvement of this group in the catalytic mechanism of chitobiase and related chitinolytic enzymes. The endoglucanase I complex with the thiosaccharide substrate analogue clearly illustrates the potential of nonhydrolyzable sulfur-linked oligosaccharides in the elucidation of substrate binding and catalysis by glycosyl hydrolases.

Internal flow characteristics of a multistage compressor with inlet pressure distortion. [J85-13 turbojet engine studies

NASA Technical Reports Server (NTRS)

Debogdan, C. E.; Moss, J. E., Jr.; Braithwaite, W. M.

1977-01-01

The measured distribution of compressor interstage pressures and temperatures resulting from a 180 deg inlet-total-pressure distortion for a J85-13 turbojet engine is reported. Extensive inner stage instrumentation combined with stepwise rotation of the inlet distortion gave data of high circumferential resolution. The steady-state pressures and temperatures along with the amplitude, extent, and location of the distorted areas are given. Data for 80, 90, and 100 percent of rotor design speed are compared with clean (undistorted) inlet flow conditions to show pressure and temperature behavior within the compressor. Both overall and stagewise compressor performances vary only slightly when clean and distorted inlet conditions are compared. Total and static pressure distortions increase in amplitude in the first few stages of the compressor and then attenuate fairly uniformly to zero at the discharge. Total-temperature distortion induced by the pressure distortion reached a maximum amplitude by the first two stages and decayed only a little through the rest of the compressor. Distortion amplitude tended to peak in line with the screen edges, and, except for total and static pressure in the tip zone, there was little swirl in the axial direction.

Sofa dermatitis.

PubMed

Schad, Karin; Nobbe, Stephan; French, Lars E; Ballmer-Weber, Barbara

2010-11-01

Furniture components can cause contact allergies. In the last years several cases of eczema after sofa contact have been reported. Typically the skin lesions develop on the back, the buttocks, the dorsal aspects of the thighs and arms and are often very resistant to topical corticoid therapy. Dimethylfumarate (DMF) is postulated to be the causative agent for this Type IV hypersensitivity reaction. DMF is an antimicrobial substance, which is used in asian upholstered furniture industry amongst others. We report the case of a 65-year old patient with generalised severely itching maculopapular, partly eczematous skin lesions on the buttocks, back, abdomen and arms. The resistance to therapy, several relapses after discharge from hospital as well as the detailed history lead us to the tentative diagnosis. The sofa dermatitis was proven by positive patch testing with furniture material and dimethylfumarate. © The Authors • Journal compilation © Blackwell Verlag GmbH, Berlin.

Association between trends in clinical variables and outcome in intensive care patients with faecal peritonitis: analysis of the GenOSept cohort.

PubMed

Tridente, Ascanio; Clarke, Geraldine M; Walden, Andrew; Gordon, Anthony C; Hutton, Paula; Chiche, Jean-Daniel; Holloway, Paul A H; Mills, Gary H; Bion, Julian; Stüber, Frank; Garrard, Christopher; Hinds, Charles

2015-05-05

Patients admitted to intensive care following surgery for faecal peritonitis present particular challenges in terms of clinical management and risk assessment. Collaborating surgical and intensive care teams need shared perspectives on prognosis. We aimed to determine the relationship between dynamic assessment of trends in selected variables and outcomes. We analysed trends in physiological and laboratory variables during the first week of intensive care unit (ICU) stay in 977 patients at 102 centres across 16 European countries. The primary outcome was 6-month mortality. Secondary endpoints were ICU, hospital and 28-day mortality. For each trend, Cox proportional hazards (PH) regression analyses, adjusted for age and sex, were performed for each endpoint. Trends over the first 7 days of the ICU stay independently associated with 6-month mortality were worsening thrombocytopaenia (mortality: hazard ratio (HR) = 1.02; 95% confidence interval (CI), 1.01 to 1.03; P < 0.001) and renal function (total daily urine output: HR =1.02; 95% CI, 1.01 to 1.03; P < 0.001; Sequential Organ Failure Assessment (SOFA) renal subscore: HR = 0.87; 95% CI, 0.75 to 0.99; P = 0.047), maximum bilirubin level (HR = 0.99; 95% CI, 0.99 to 0.99; P = 0.02) and Glasgow Coma Scale (GCS) SOFA subscore (HR = 0.81; 95% CI, 0.68 to 0.98; P = 0.028). Changes in renal function (total daily urine output and renal component of the SOFA score), GCS component of the SOFA score, total SOFA score and worsening thrombocytopaenia were also independently associated with secondary outcomes (ICU, hospital and 28-day mortality). We detected the same pattern when we analysed trends on days 2, 3 and 5. Dynamic trends in all other measured laboratory and physiological variables, and in radiological findings, changes in respiratory support, renal replacement therapy and inotrope and/or vasopressor requirements failed to be retained as independently associated with outcome in multivariate analysis. Only deterioration in renal function, thrombocytopaenia and SOFA score over the first 2, 3, 5 and 7 days of the ICU stay were consistently associated with mortality at all endpoints. These findings may help to inform clinical decision making in patients with this common cause of critical illness.

The Role of Configural Processing in Face Classification by Race: An ERP Study

PubMed Central

Lv, Jing; Yan, Tianyi; Tao, Luyang; Zhao, Lun

2015-01-01

The current study investigated the time course of the other-race classification advantage (ORCA) in the subordinate classification of normally configured faces and distorted faces by race. Slightly distorting the face configuration delayed the categorization of own-race faces and had no conspicuous effects on other-race faces. The N170 was sensitive neither to configural distortions nor to faces' races. The P3 was enhanced for other-race than own-race faces and reduced by configural manipulation only for own-race faces. We suggest that the source of ORCA is the configural analysis applied by default while processing own-race faces. PMID:26733850

Comparison of the sequential organ failure assessment score with the King's College Hospital criteria and the model for end-stage liver disease score for the prognosis of acetaminophen-induced acute liver failure.

PubMed

Cholongitas, Evangelos; Theocharidou, Eleni; Vasianopoulou, Panayota; Betrosian, Alex; Shaw, Steve; Patch, David; O'Beirne, James; Agarwal, Banwari; Burroughs, Andrew K

2012-04-01

Acetaminophen-induced acute liver failure (ALF) is a complex multiorgan illness. An assessment of the prognosis is essential for the accurate identification of patients for whom survival without liver transplantation (LT) is unlikely. The aims of this study were the comparison of prognostic models [King's College Hospital (KCH), Model for End-Stage Liver Disease, Sequential Organ Failure Assessment (SOFA), and Acute Physiology and Chronic Health Evaluation II (APACHE II)] and the identification of independent prognostic indicators of outcome. We evaluated consecutive patients with severe acetaminophen-induced ALF who were admitted to the intensive care unit. At admission, demographic, clinical, and laboratory parameters were recorded. The discriminative ability of each prognostic score at the baseline was evaluated with the area under the receiver operating characteristic curve (AUC). In addition, using a multiple logistic regression, we assessed independent factors associated with outcome. In all, 125 consecutive patients with acetaminophen-induced ALF were evaluated: 67 patients (54%) survived with conservative medical management (group 1), and 58 patients (46%) either died without LT (28%) or underwent LT (18%; group 2). Group 1 patients had significantly lower median APACHE II (10 versus 14) and SOFA scores (9 versus 12) than group 2 patients (P < 0.001). The independent indicators associated with death or LT were a longer prothrombin time (P = 0.007), the inspiratory oxygen concentration (P = 0.005), and the lactate level at 12 hours (P < 0.001). The KCH criteria had the highest specificity (83%) but the lowest sensitivity (47%), and the SOFA score had the best discriminative ability (AUC = 0.79). In conclusion, for patients with acetaminophen-induced ALF, the SOFA score performed better than the other prognostic scores, and this reflected the presence of multiorgan dysfunction. A further evaluation of SOFA with the KCH criteria is warranted. Copyright © 2012 American Association for the Study of Liver Diseases.

Low energy intake during the first week in an emergency intensive care unit is associated with reduced duration of mechanical ventilation in critically ill, underweight patients: a single-center retrospective chart review.

PubMed

Ichimaru, Satomi; Fujiwara, Hidetoshi; Amagai, Teruyoshi; Atsumi, Takahiro

2014-06-01

Although nutrition support is essential in intensive care units, optimal energy intake remains unclear. Here, we assessed the influence of energy intake on outcomes of critically ill, underweight patients. A retrospective chart review was conducted in patients with body mass index (BMI) of <20.0 kg/m(2) in an emergency intensive care unit (EICU). Patients were categorized into 4 groups by initial Sequential Organ Failure Assessment score (I-SOFA) and average daily energy intake during the first week: group M-1, I-SOFA ≤8 and <16 kcal/kg/d; group M-2, I-SOFA ≤8 and ≥16 kcal/kg/d; group S-1, I-SOFA >8 and <16 kcal/kg/d; and group S-2, I-SOFA >8 and ≥16 kcal/kg/d. The study included 51 patients with a median age of 69 years. No significant differences were noted in all-cause mortality and length of stay in the EICU and hospital between groups M-1 and M-2 or groups S-1 and S-2. The mechanical ventilation duration (MVD) was significantly shorter in group M-1 than M-2 (2.7 [1.0-5.7] vs 9.2 [4.2-17.4] days; P = .040) and in group S-1 than S-2 (3.1 [0.7-6.0] vs 8.8 [6.1-23.1] days; P = .006). The number of patients who underwent tracheostomy in hospital was significantly lower in group S-1 than in S-2 (20% vs 32%; P = .002). Multivariable analyses to adjust for confounders revealed that average energy intake during the first week in EICU was a significant factor independently associated with MVD but not with the requirement of tracheostomy. Reduced energy intake during the first week in EICU was associated with a reduced MVD in clinically ill patients with BMI <20.0 kg/m(2).

Investigation on centrifugal impeller in an axial-radial combined compressor with inlet distortion

NASA Astrophysics Data System (ADS)

Li, Du; Yang, Ce; Zhao, Ben; Zhou, Mi; Qi, Mingxu; Zhang, Jizhong

2011-12-01

Assembling an axial rotor and a stator at centrifugal compressor upstream to build an axial-radial combined compressor could achieve high pressure ratio and efficiency by appropriate size augment. Then upstream potential flow and wake effect appear at centrifugal impeller inlet. In this paper, the axial-radial compressor is unsteadily simulated by three-dimensional Reynolds averaged Navier-Stokes equations with uniform and circumferential distorted total pressure inlet condition to investigate upstream effect on radial rotor. The results show that span-wise nonuniform total pressure distribution is generated and radial and circumferential combined distortion is formed at centrifugal rotor inlet. The upstream stator wake deflects to rotor rotation direction and decreases with blade span increases. Circumferential distortion causes different separated flow formations at different pitch positions. The tip leakage vortex is suppressed in centrifugal blade passages. Under distorted inlet condition, flow direction of centrifugal impeller leading edge upstream varies evidently near hub and shroud but varies slightly at mid-span. In addition, compressor stage inlet distortion produces remarkable effect on blade loading of centrifugal blade both along chordwise and pitchwise.

Out-of-hospital characteristics and care of patients with severe sepsis: a cohort study

PubMed Central

Seymour, Christopher W.; Band, Roger A.; Cooke, Colin R.; Mikkelsen, Mark E.; Hylton, Julie; Rea, Tom D.; Goss, Christopher H.; Gaieski, David F.

2010-01-01

Purpose Early recognition and treatment in severe sepsis improves outcomes. Yet, out-of-hospital patient characteristics and emergency medical services (EMS) care in severe sepsis is understudied. Our goal was to describe out-of-hospital characteristics and EMS care in patients with severe sepsis, and evaluate associations between out-of-hospital characteristics and severity of organ dysfunction in the emergency department (ED). Materials & Methods We performed a secondary data analysis of existing data from patients with severe sepsis transported by EMS to an academic medical center. We constructed multivariable linear regression models to determine if out-of-hospital factors are associated with serum lactate and SOFA in the ED. Results Two hundred sixteen patients with severe sepsis arrived by EMS. Median serum lactate in the ED was 3.0 mmol/L (IQR:2.0-5.0) and median SOFA score was 4 (IQR:2-6). Sixty-three percent (135) of patients were transported by advanced life support providers and 30% (62) received IV fluid. Lower out-of-hospital Glasgow coma scale (GCS) was independently associated with elevated serum lactate (p<0.01). Out-of-hospital hypotension, greater respiratory rate, and lower GCS were associated with greater SOFA (p<0.01). Conclusions Out-of-hospital fluid resuscitation occurred in less than one-third of patients with severe sepsis, and routinely measured out-of-hospital variables were associated with greater serum lactate and SOFA in the ED. PMID:20381301

Hyperglycemia and glycemic variability are associated with the severity of sepsis in nondiabetic subjects.

PubMed

Preechasuk, Lukana; Suwansaksri, Nattakarn; Ipichart, Nantawan; Vannasaeng, Sathit; Permpikul, Chairat; Sriwijitkamol, Apiradee

2017-04-01

The purpose was to compare glucose variability (GV) obtained via continuous glucose monitoring between nondiabetic sepsis patients and healthy subjects and to seek associations between GV and sepsis severity in nondiabetic sepsis patients. Nondiabetic sepsis inpatients and healthy controls received a 72-hour continuous glucose monitoring (iPro2, Medtronic) postadmission and post-oral glucose tolerance test, respectively. The mean glucose level (MGL) along with GV represented by standard deviation (SD) and the mean amplitude of glycemic excursion (MAGE) were calculated at 24 and 72 hours. Sepsis severity was evaluated with the Sepsis-related Organ Failure Assessment Score (SOFA). MGL and GV in patients with SOFA ≥9 and <9 were compared. Thirty nondiabetic sepsis and 10 healthy subjects were recruited. No differences were found between groups except for higher patient age in sepsis patients. The MGL and MAGE 72h of sepsis patients were significantly higher than those of healthy subjects. MGL and GV 24h were higher in patients with SOFA ≥9 than in patients with SOFA <9 (MGL 24h 195±17 vs 139±27, P<.001; SD 24h 32 [28, 36] vs 19 [5, 58], P=.02; and MAGE 24h 94 [58, 153] vs 54 [16, 179], P=.01). Nondiabetic sepsis patients had higher MGL and GV values than healthy subjects. MGL and GV 24h were associated with sepsis severity. Copyright © 2016 Elsevier Inc. All rights reserved.

Importance of vital signs to the early diagnosis and severity of sepsis: association between vital signs and sequential organ failure assessment score in patients with sepsis.

PubMed

Kenzaka, Tsuneaki; Okayama, Masanobu; Kuroki, Shigehiro; Fukui, Miho; Yahata, Shinsuke; Hayashi, Hiroki; Kitao, Akihito; Sugiyama, Daisuke; Kajii, Eiji; Hashimoto, Masayoshi

2012-01-01

While much attention is given to the fifth vital sign, the utility of the 4 classic vital signs (blood pressure, respiratory rate, body temperature, and heart rate) has been neglected. The aim of this study was to assess a possible association between vital signs and the Sequential Organ Failure Assessment (SOFA) score in patients with sepsis. We performed a prospective, observational study of 206 patients with sepsis. Blood pressure, respiratory rate, body temperature, and heart rate were measured on arrival at the hospital. The SOFA score was also determined on the day of admission. Bivariate correlation analysis showed that all of the vital signs were correlated with the SOFA score. Multiple regression analysis indicated that decreased values of systolic blood pressure (multivariate regression coefficient [Coef] = -0.030, 95% confidence interval [CI] = -0.046 to -0.013) and diastolic blood pressure (Coef = -0.045, 95% CI = -0.070 to -0.019), increased respiratory rate (Coef = 0.176, 95% CI = 0.112 to 0.240), and increased shock index (Coef = 4.232, 95% CI = 2.401 to 6.062) significantly influenced the SOFA score. Increased respiratory rate and shock index were significantly correlated with disease severity in patients with sepsis. Evaluation of these signs may therefore improve early identification of severely ill patients at triage, allowing more aggressive and timely interventions to improve the prognosis of these patients.

Retrospective evaluation of prognostic score performances in cirrhotic patients admitted to an intermediate care unit.

PubMed

Dupont, Benoît; Delvincourt, Maxime; Koné, Mamadou; du Cheyron, Damien; Ollivier-Hourmand, Isabelle; Piquet, Marie-Astrid; Terzi, Nicolas; Dao, Thông

2015-08-01

The prognosis of cirrhotic patients in the Intensive Care Unit requires the development of predictive tools for mortality. We aimed to evaluate the ability of different prognostic scores to predict hospital mortality in these patients. A single-centre retrospective analysis was conducted of 281 hospital stays of cirrhotic patients at an Intermediate Care Unit between June 2009 and December 2010. The performance of the Simplified Acute Physiology Score (SOFA), the Simplified Acute Physiology Score (SAPS) II or III, Child-Pugh, Model for End-Stage Liver Disease (MELD), MELD-Na and the Chronic Liver Failure-Consortium Acute-on-Chronic Liver Failure score (CLIF-C ACLF) in predicting hospital mortality were compared. Mean age was 58.2±12.1 years; 77% were male. The main cause of admission was acute gastrointestinal bleeding (47%). The in-hospital mortality rate was 25.3%. Receiver operating characteristic curve analyses demonstrated that SOFA (0.82) MELD-Na (0.82) or MELD (0.81) scores at admission predicted in-hospital mortality better than Child-Pugh (0.76), SAPS II (0.77), SAPS III (0.75) or CLIF-C ACLF (0.75). We then developed the cirrhosis prognostic score (Ci-Pro), which performed better (0.89) than SOFA. SOFA, MELD and especially the Ci-Pro score show the best performance in predicting hospital mortality of cirrhotic patients admitted to an Intermediate Care Unit. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Review article: scoring systems for assessing prognosis in critically ill adult cirrhotics.

PubMed

Cholongitas, E; Senzolo, M; Patch, D; Shaw, S; Hui, C; Burroughs, A K

2006-08-01

Cirrhotic patients admitted to intensive care units (ICU) still have poor outcomes. Some current ICU prognostic models [Acute Physiology and Chronic Health Evaluation (APACHE), Organ System Failure (OSF) and Sequential Organ Failure Assessment (SOFA)] were used to stratify cirrhotics into risk categories, but few cirrhotics were included in the original model development. Liver-specific scores [Child-Turcotte-Pugh (CTP) and model for end-stage liver disease (MELD)] could be useful in this setting. To evaluate whether ICU prognostic models perform better compared with liver-disease specific ones in cirrhotics admitted to ICU. We performed a structured literature review identifying clinical studies focusing on prognosis and risk factors for mortality in adult cirrhotics admitted to ICU. We found 21 studies (five solely dealing with gastrointestinal bleeding) published during the last 20 years (54-420 patients in each). APACHE II and III, SOFA and OSF had better discrimination for correctly predicting death compared with the CTP score. The MELD score was evaluated only in one study and had good predictive accuracy [receiver operator characteristic (ROC) curve: 0.81). Organ dysfunction models (OSF, SOFA) were superior compared with APACHE II and III (ROC curve: range 0.83-0.94 vs. 0.66-0.88 respectively). Cardiovascular, liver and renal system dysfunction were more frequently independently associated with mortality. General-ICU models had better performance in cirrhotic populations compared with CTP score; OSF and SOFA had the best predictive ability. Further prospective and validation studies are needed.

Predictors of outcome in myxoedema coma: a study from a tertiary care centre.

PubMed

Dutta, Pinaki; Bhansali, Anil; Masoodi, Shriq Rashid; Bhadada, Sanjay; Sharma, Navneet; Rajput, Rajesh

2008-01-01

With the easy availability of thyroid hormone assays, thyroid disorders are now recognised even in a subclinical state. However, patients are still seen with advanced manifestations of the disease, particularly in developing countries. This observational study analysed the predictors of outcome in patients with myxoedema coma and tested the validity of different modules to define morbidity and mortality in these patients. Twenty-three consecutive patients with myxoedema coma who presented from January 1999 to August 2006 were studied. The thyroid function test and random serum cortisol were measured in all patients at the time of admission. Patients were given oral or intravenous (i.v.) thyroxine with intention to treat with the latter according to availability. Various modules that predict outcome, including Glasgow Coma Scale (GCS), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and Sequential Organ Failure Assessment (SOFA) score, were analysed. SOFA score was repeated every 2 days until the time of discharge or demise. Twenty-three patients (20 women; 87%) of 59.5 +/- 14.4 years of age (range, 30 to 89 years) were seen during the study period. Nine (39%) patients were diagnosed with hypothyroidism for the first time at the time of presentation of myxoedema coma, whereas 14 (70%) were diagnosed with hypothyroidism previously. However, the treatment defaulters presented early to the hospital and had more severe manifestations than de novo subjects. Nineteen (82%) had thyroprivic (primary) and 4 (17%) had trophoprivic (secondary) hypothyroidism. Fifteen (65%) patients presented in the winter and in 17 (74%) sepsis was the major accompanying comorbidity. Twelve (52%) had a history of diuretic use, thereby delaying the initial diagnosis. Patients who received oral L-thyroxine had no difference in outcome from those receiving i.v. thyroxine. Twelve (52%) subjects died and sepsis was the predominant cause of death. Various predictors of mortality included hypotension (p = 0.01) and bradycardia (p = 0.03) at presentation, need for mechanical ventilation (p = 0.00), hypothermia unresponsive to treatment (p = 0.01), sepsis (p = 0.01), intake of sedative drugs (p = 0.02), lower GCS (p = 0.03), high APACHE II score (p = 0.04), and high SOFA score (p = 0.00). However, SOFA score was more effective than other predictive models as baseline and day 3 SOFA scores of more than 6 were highly predictive of poor outcome. L-Thyroxine treatment defaulters had more severe manifestations compared with de novo subjects. Outcome was not influenced by either aetiology or route of administration of L-thyroxine, and SOFA score was the best outcome predictor model.

[Prediction of mortality in patients with acute hepatic failure].

PubMed

Eremeeva, L F; Berdnikov, A P; Musaeva, T S; Zabolotskikh, I B

2013-01-01

The article deals with a study of 243 patients (from 18 to 65 years old) with acute hepatic failure. Purpose of the study was to evaluate the predictive capability of severity scales APACHE III, SOFA, MODS, Child-Pugh and to identify mortality predictors in patients with acute hepatic failure. Results; The best predictive ability in patients with acute hepatic failure and multiple organ failure had APACHE III and SOFA scales. The strongest mortality predictors were: serum creatinine > 132 mmol/L, fibrinogen < 1.4 g/L, Na < 129 mmol/L.

The deformation of flux tubes in the solar wind with applications to the structure of magnetic clouds and CMEs

NASA Technical Reports Server (NTRS)

Cargill, Peter J.; Chen, James; Spicer, D. S.; Zalesak, S. T.

1994-01-01

Two dimensional magnetohydrodynamic simulations of the distortion of a magnetic flux tube, accelerated through ambient solar wind plasma, are presented. Vortices form on the trailing edge of the flux tube, and couple strongly to its interior. If the flux tube azimuthal field is weak, it deforms into an elongated banana-like shape after a few Alfven transit times. A significant azimuthal field component inhibits this distortion. In the case of magnetic clouds in the solar wind, it is suggested that the shape observed at 1 AU was determined by distortion of the cloud in the inner heliosphere. Distortion of the cloud beyond 1 AU takes many days. It is estimated that effective drag coefficients slightly greater than unity are appropriate for modeling flux tube propagation. Synthetic magnetic field profiles as would be seen by a spacecraft traversing the cloud are presented.

Development and evaluation of an influenza pandemic intensive care unit triage protocol.

PubMed

Cheung, Winston; Myburgh, John; Seppelt, Ian M; Parr, Michael J; Blackwell, Nikki; Demonte, Shannon; Gandhi, Kalpesh; Hoyling, Larissa; Nair, Priya; Passer, Melissa; Reynolds, Claire; Saunders, Nicholas M; Saxena, Manoj K; Thanakrishnan, Govindasamy

2012-09-01

To develop an influenza pandemic ICU triage (iPIT) protocol that excludes patients with the highest and lowest predicted mortality rates, and to determine the increase in ICU bed availability that would result. Post-hoc analysis of a study evaluating two triage protocols, designed to determine which patients should be excluded from access to ICU resources during an influenza pandemic. ICU mortality rates were determined for the individual triage criteria in the protocols and included criteria based on the Sequential Organ Failure Assessment (SOFA) score. Criteria resulting in mortality rates outside the 25th and 75th percentiles were used as exclusion criteria in a new iPIT-1 protocol. The SOFA threshold component was modified further and reported as iPIT-2 and iPIT-3. Increase in ICU bed availability. The 25th and 75th percentiles for ICU mortality were 8.3% and 35.2%, respectively. Applying the iPIT-1 protocol resulted in an increase in ICU bed availability at admission of 71.7% ± 0.6%. Decreasing the lower SOFA score exclusion criteria to ≤6 (iPIT-2) and ≤4 (iPIT-3) resulted in an increase in ICU bed availability at admission of 66.9% ± 0.6% and 59.4 ± 0.7%, respectively (P < 0.001). The iPIT protocol excludes patients with the lowest and highest ICU mortality, and provides increases in ICU bed availability. Adjusting the lower SOFA score exclusion limit provides a method of escalation or de- escalation to cope with demand.

Risk factors, sequential organ failure assessment and model for end-stage liver disease scores for predicting short term mortality in cirrhotic patients admitted to intensive care unit.

PubMed

Cholongitas, E; Senzolo, M; Patch, D; Kwong, K; Nikolopoulou, V; Leandro, G; Shaw, S; Burroughs, A K

2006-04-01

Prognostic scores in an intensive care unit (ICU) evaluate outcomes, but derive from cohorts containing few cirrhotic patients. To evaluate 6-week mortality in cirrhotic patients admitted to an ICU, and to compare general and liver-specific prognostic scores. A total of 312 consecutive cirrhotic patients (65% alcoholic; mean age 49.6 years). Multivariable logistic regression to evaluate admission factors associated with survival. Child-Pugh, Model for End-stage Liver Disease (MELD), Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores were compared by receiver operating characteristic curves. Major indication for admission was respiratory failure (35.6%). Median (range) Child-Pugh, APACHE II, MELD and SOFA scores were 11 (5-15), 18 (0-44), 24 (6-40) and 11 (0-21), respectively; 65% (n = 203) died. Survival improved over time (P = 0.005). Multivariate model factors: more organs failing (FOS) (<3 = 49.5%, > or =3 = 90%), higher FiO(2), lactate, urea and bilirubin; resulting in good discrimination [area under receiver operating characteristic curve (AUC) = 0.83], similar to SOFA and MELD (AUC = 0.83 and 0.81, respectively) and superior to APACHE II and Child-Pugh (AUC = 0.78 and 0.72, respectively). Cirrhotics admitted to ICU with > or =3 failing organ systems have 90% mortality. The Royal Free model discriminated well and contained key variables of organ function. SOFA and MELD were better predictors than APACHE II or Child-Pugh scores.

Examination of the Positive and Negative Syndrome Scale factor structure and longitudinal relationships with functioning in early psychosis.

PubMed

Best, Michael W; Grossman, Michael; Oyewumi, L Kola; Bowie, Christopher R

2016-04-01

We examined the factor structure of the Positive and Negative Syndrome Scale (PANSS) in early-episode psychosis and its relationships with functioning at baseline and follow-up. A total of 240 consecutive admissions to an early intervention in psychosis clinic were assessed at intake to the program with the PANSS, Global Assessment of Functioning (GAF) and Social and Occupational Functioning Assessment Scale (SOFAS). Seventy individuals were reassessed at follow-up. A maximum likelihood factor analysis was conducted on baseline PANSS scores and the ability of each factor to predict baseline and follow-up GAF and SOFAS was examined. A five-factor model with varimax rotation was the best fit to our data and was largely congruent with factors found previously. The negative symptom factor was the best predictor of GAF and SOFAS at baseline and follow-up. Negative symptoms are the best symptomatic predictor of functioning in individuals with early psychosis and are an important treatment target to improve recovery. © 2014 Wiley Publishing Asia Pty Ltd.

The non-contact heart rate measurement system for monitoring HRV.

PubMed

Huang, Ji-Jer; Yu, Sheng-I; Syu, Hao-Yi; See, Aaron Raymond

2013-01-01

A noncontact ECG monitoring and analysis system was developed using capacitive-coupled device integrated to a home sofa. Electrodes were placed on the backrest of a sofa separated from the body with only the chair covering and the user's clothing. The study also incorporates measurements using different fabric materials, and a pure cotton material was chosen to cover the chair's backrest. The material was chosen to improve the signal to noise ratio. The system is initially implemented on a home sofa and is able to measure non-contact ECG through thin cotton clothing and perform heart rate analysis to calculate the heart rate variability (HRV) parameters. It was also tested under different conditions and results from reading and sleeping exhibited a stable ECG. Subsequently, results from our calculated HRV were found to be identical to those of a commercially available HRV analyzer. However, HRV parameters are easily affected by motion artifacts generated during drinking or eating with the latter producing a more severe disturbance. Lastly, parameters measured are saved on a cloud database, providing users with a long-term monitoring and recording for physiological information.

Predictors of outcome in myxoedema coma: a study from a tertiary care centre

PubMed Central

Dutta, Pinaki; Bhansali, Anil; Masoodi, Shriq Rashid; Bhadada, Sanjay; Sharma, Navneet; Rajput, Rajesh

2008-01-01

Background With the easy availability of thyroid hormone assays, thyroid disorders are now recognised even in a subclinical state. However, patients are still seen with advanced manifestations of the disease, particularly in developing countries. This observational study analysed the predictors of outcome in patients with myxoedema coma and tested the validity of different modules to define morbidity and mortality in these patients. Methods Twenty-three consecutive patients with myxoedema coma who presented from January 1999 to August 2006 were studied. The thyroid function test and random serum cortisol were measured in all patients at the time of admission. Patients were given oral or intravenous (IV) thyroxine with intention to treat with the latter according to availability. Various modules that predict outcome, including Glasgow Coma Scale (GCS), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and Sequential Organ Failure Assessment (SOFA) score, were analysed. SOFA score was repeated every 2 days until the time of discharge or demise. Results Twenty-three patients (20 women; 87%) of 59.5 ± 14.4 years of age (range, 30 to 89 years) were seen during the study period. Nine (39%) patients were diagnosed with hypothyroidism for the first time at the time of presentation of myxoedema coma, whereas 14 (70%) were diagnosed with hypothyroidism previously. However, the treatment defaulters presented early to the hospital and had more severe manifestations than de novo subjects. Nineteen (82%) had thyroprivic (primary) and 4 (17%) had trophoprivic (secondary) hypothyroidism. Fifteen (65%) patients presented in the winter and in 17 (74%) sepsis was the major accompanying comorbidity. Twelve (52%) had a history of diuretic use, thereby delaying the initial diagnosis. Patients who received oral L-thyroxine had no difference in outcome from those receiving IV thyroxine. Twelve (52%) subjects died and sepsis was the predominant cause of death. Various predictors of mortality included hypotension (p = 0.01) and bradycardia (p = 0.03) at presentation, need for mechanical ventilation (p = 0.00), hypothermia unresponsive to treatment (p = 0.01), sepsis (p = 0.01), intake of sedative drugs (p = 0.02), lower GCS (p = 0.03), high APACHE II score (p = 0.04), and high SOFA score (p = 0.00). However, SOFA score was more effective than other predictive models as baseline and day 3 SOFA scores of more than 6 were highly predictive of poor outcome. Conclusion L-Thyroxine treatment defaulters had more severe manifestations compared with de novo subjects. Outcome was not influenced by either aetiology or route of administration of L-thyroxine, and SOFA score was the best outcome predictor model. PMID:18173846

Detailed intermolecular structure of molecular liquids containing slightly distorted tetrahedral molecules with C(3v) symmetry: chloroform, bromoform, and methyl-iodide.

PubMed

Pothoczki, Szilvia; Temleitner, László; Pusztai, László

2011-01-28

Analyses of the intermolecular structure of molecular liquids containing slightly distorted tetrahedral molecules of the CXY(3)-type are described. The process is composed of the determination of several different distance-dependent orientational correlation functions, including ones that are introduced here. As a result, a complete structure classification could be provided for CXY(3) molecular liquids, namely for liquid chloroform, bromoform, and methyl-iodide. In the present work, the calculations have been conducted on particle configurations resulting from reverse Monte Carlo computer modeling: these particle arrangements have the advantage that they are fully consistent with structure factors from neutron and x-ray diffraction measurements. It has been established that as the separation between neighboring molecules increases, the dominant mutual orientations change from face-to-face to edge-to-edge, via the edge-to-face arrangements. Depending on the actual liquid, these geometrical elements (edges and faces of the distorted tetrahedra) were found to contain different atoms. From the set of liquids studied here, the structure of methyl-iodide was found to be easiest to describe on the basis of pure steric effects (molecular shape, size, and density) and the structure of liquid chloroform seems to be the furthest away from the corresponding "flexible fused hard spheres" like reference system.

Anisotropic crystal structure distortion of the monoclinic polymorph of acetaminophen at high hydrostatic pressures.

PubMed

Boldyreva, E V; Shakhtshneider, T P; Vasilchenko, M A; Ahsbahs, H; Uchtmann, H

2000-04-01

The anisotropy of structural distortion of the monoclinic polymorph of acetaminophen induced by hydrostatic pressure up to 4.0 GPa was studied by single-crystal X-ray diffraction in a Merrill-Bassett diamond anvil cell (DAC). The space group (P2(1)/n) and the general structural pattern remained unchanged with pressure. Despite the overall decrease in the molar volume with pressure, the structure expanded in particular crystallographic directions. One of the linear cell parameters (c) passed through a minimum as the pressure increased. The intramolecular bond lengths changed only slightly with pressure, but the changes in the dihedral and torsion angles were very large. The compressibility of the intermolecular hydrogen bonds NH...O and OH...O was measured. NH...O bonds were shown to be slightly more compressible than OH...O bonds. The anisotropy of structural distortion was analysed in detail in relation to the pressure-induced changes in the molecular conformations, to the compression of the hydrogen-bond network, and to the changes in the orientation of molecules with respect to each other in the pleated sheets in the structure. Dirichlet domains were calculated in order to analyse the relative shifts of the centroids of the hydrogen-bonded cycles and of the centroids of the benzene rings with pressure.

Pediatric CLIF-SOFA score is the best predictor of 28-day mortality in children with decompensated chronic liver disease.

PubMed

Bolia, Rishi; Srivastava, Anshu; Yachha, Surender Kumar; Poddar, Ujjal

2018-03-01

Early identification of children with decompensated chronic liver disease (DCLD) at risk of short-term mortality helps improve outcome. We aimed to evaluate the predictors of outcome and role of Child-Pugh, pediatric end-stage liver disease (PELD) and pediatric chronic liver failure sequential organ failure assessment (pCLIF-SOFA) score for prognosticating 28-day mortality in children with DCLD. DCLD children were prospectively evaluated with a clinico-laboratory proforma and followed for 28 days to determine outcome. Child-Pugh, PELD and pCLIF-SOFA were calculated at admission. Univariate and multivariate analysis was performed to identify the best predictors of outcome. A total of 110 children (74 boys, 96 [4-204] months) were enrolled and 37 (33.6%) died at 28 days. Significant risk factors for mortality were a higher international normalized ratio (hazard ratio [HR] 1.17; 95% CI 1.04-1.31; p <0.001) and bilirubin (HR 1.04; 95% CI 1.01-1.08; p <0.001), lower albumin (HR 0.46; 95% CI 0.27-0.77; p = 0.03) and sodium (HR 0.93; 95% CI 0.89-0.98; p = 0.01), absence of treatable etiology (HR 2.00; 95% CI 1.40-2.87; p = 0.001) and presence of organ failure (HR 3.22; 95% CI 1.98-10.58; p <0.001). Organ failure and serum sodium were independent predictors of poor outcome on multivariate analysis. pCLIF-SOFA (16 [9-22] vs. 9 [5-15]), Child-Pugh (11 [9-15] vs. 10 [8-14]) and PELD (22.2 [7.5-45.3] vs. 15.3 [4.5-23.9]) scores were significantly higher in non-survivors. The area under the curve was 0.977 for pCLIF-SOFA, 0.815 for Child-Pugh score, and 0.741 for PELD score. A pCLIF-SOFA score of ≥11 identified 28-day mortality with a sensitivity and specificity of 94.9% and 91.5%, respectively. Thirty-four percent of children with DCLD have a poor short-term outcome. Organ failure and low serum sodium are independent predictors of outcome. pCLIF-SOFA performs better than Child-Pugh and PELD in prognostication of 28-day mortality. Our study supports the use of scores based on organ failure in prognosticating children with DCLD. The ability to predict the course of a disease is an important part of the assessment, enabling timely interventions that improve outcomes. We evaluated the outcome (death vs. survival) and compared three different scoring systems for their ability to predict mortality within 28 days in children with decompensated chronic liver disease (DCLD). One-third of children with DCLD died within 28 days and the pediatric chronic liver failure sequential organ failure assessment score, which considers the main organ systems of the body (lungs, liver, brain, kidney, blood and cardiac) fared better for identification of children with a poor outcome than the Child-Pugh and pediatric end-stage liver disease score which comprise of only liver-related parameters. Our study supports the use of scores based on organ failure in prognosticating children with DCLD. Copyright © 2017 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Building a Sustainable Global Surgery Nonprofit Organization at an Academic Institution.

PubMed

Frisella, Margaret M

Surgical Outreach for the Americas is a 501(c)3 nonprofit organization providing surgical care to those in need in developing countries of the Western Hemisphere. Every year since its inception in 2008, teams of surgeons, nurses, and allied health professionals have traveled to areas of need and performed primarily hernia repair surgeries for those without access to affordable health care. Surgical Outreach for the Americas (SOfA) began as a general concept based on World Health Organization statistics claiming that 11% of the global burden of disease can be resolved via surgery. Armed with this information, a group of compassionate and selfless health care professionals planned the first trip, to the Dominican Republic, in January 2009. Building on what was first just an ambition to help others, we now also train surgeons, surgery residents, and nurses in the countries we serve. To date, SOfA has successfully treated 734 patients, with 899 total surgical procedures performed (693 of these under general anesthesia). These procedures include inguinal hernia, umbilical hernia, testicular masses, orchiectomies, and various general surgical procedures. Through the efforts of a great many talented individuals and robust fundraising efforts, the SOfA message continues to gain momentum. SOfA not only considers the health and well-being of the disadvantaged through capacity-building efforts but strives to educate and improve the skills of health care professionals in the countries we visit. Our goal is to increase the number of missions each year and begin a 2-fold educational program that (a) provides surgical resident education through participation in mission work and (b) provides local surgeon education in the areas served. Copyright © 2016. Published by Elsevier Inc.

Survival predictor in patients with acute respiratory distress syndrome and diffuse alveolar damage undergoing open lung biopsy

PubMed Central

Chang, Chih-Hao; Hung, Chen-Yiu; Chiu, Li-Chung; Huang, Chung-Chi; Hu, Han-Chung

2017-01-01

Background Diffuse alveolar damage (DAD) is a typical pathological finding of open lung biopsies in patients with acute respiratory distress syndrome (ARDS). Patients with ARDS and DAD have been reported to have a poorer prognosis than those without DAD. The aim of this study was to investigate the survival predictors in patients with ARDS and DAD. Methods We retrospectively reviewed all ARDS patients who underwent an open lung biopsy which showed evidence of DAD from January 2006 to June 2015 at Chang Gung Memorial Hospital. Clinical data including baseline characteristics, medication, and survival outcomes were analyzed. Results A total of 64 ARDS patients with DAD were eligible for analysis and divided into known etiology (n = 17, 26.6%) and unknown etiology groups (n = 47, 73.4%). There was no significant difference in hospital mortality rate between the two groups (71.9% vs. 70.6%, p = 0.890). Univariate logistic regression analysis revealed that sequential organ failure assessment (SOFA) score at the time of a diagnosis of ARDS, and SOFA score, PaO2/FiO2 ratio, and positive end expiratory pressure level when the biopsy was performed were associated with hospital mortality. Multivariate analysis showed that the SOFA score on the day of the biopsy was an independent predictor of hospital mortality (odds ratio 1.413, 95% confidence interval 1.127–1.772; p = 0.03). There were no significant differences in the use, dose, duration and timing from ARDS to glucocorticoid therapy between the survivors and nonsurvivors. Conclusion For selected ARDS patients who underwent an open lung biopsy with pathological DAD, SOFA score was an independent predictor of hospital mortality. PMID:28678876

Outcome and prognostic factors of malaria-associated acute kidney injury requiring hemodialysis: A single center experience

PubMed Central

Kute, V. B.; Shah, P. R.; Munjappa, B. C.; Gumber, M. R.; Patel, H. V.; Jain, S. H.; Engineer, D. P.; Naresh, V. V. Sai; Vanikar, A. V.; Trivedi, H. L.

2012-01-01

Acute kidney injury (AKI) is one of the most dreaded complications of severe malaria. We carried out prospective study in 2010, to describe clinical characteristics, laboratory parameters, prognostic factors, and outcome in 59 (44 males, 15 females) smear-positive malaria patients with AKI. The severity of illness was assessed using Acute Physiology and Chronic Health Evaluation (APACHE) II, Sequential Organ Failure Assessment (SOFA) score, Multiple Organ Dysfunction Score (MODS), and Glasgow Coma Scale (GCS) scores. All patients received artesunate and hemodialysis (HD). Mean age of patients was 33.63 ± 14 years. Plasmodium falciparum malaria was seen in 76.3% (n = 45), Plasmodium vivax in 16.9% (n = 10), and mixed infection in 6.8% (n = 4) patients. Presenting clinical features were fever (100%), nausea-vomiting (85%), oliguria (61%), abdominal pain/tenderness (50.8%), and jaundice (74.5%). Mean APACHE II, SOFA, MODS, and GCS scores were 18.1 ± 3, 10.16 ± 3.09, 9.71 ± 2.69, and 14.15 ± 1.67, respectively, all were higher among patients who died than among those who survived. APACHE II ≥20, SOFA and MODS scores ≥12 were associated with higher mortality (P < 0.05). 34% patients received blood component transfusion and exchange transfusion was done in 15%. Mean number of HD sessions required was 4.59 ± 3.03. Renal biopsies were performed in five patients (three with patchy cortical necrosis and two with acute tubular necrosis). 81.3% of patients had complete renal recovery and 11.8% succumbed to malaria. Prompt diagnosis, timely HD, and supportive therapy were associated with improved survival and recovery of kidney functions in malarial with AKI. Mortality was associated with higher APACHE II, SOFA, MODS, GCS scores, requirement of inotrope, and ventilator support. PMID:22279340

Lactate clearance in septic shock is not a surrogate for improved microcirculatory flow

PubMed Central

Puskarich, Michael A.; Shapiro, Nathan I.; Massey, Michael J.; Kline, Jeffrey A.; Jones, Alan E.

2016-01-01

Introduction Failure to normalize lactate is associated with poor outcomes in septic shock. It has been suggested that persistently elevated lactate may result from regional ischemia due to disturbed and/or heterogenous microcirculatory blood flow. Objectives The goal of this study was to determine if lactate clearance may serve as a surrogate marker for changes in microcirculatory blood flow in patients with septic shock. Methods This was a prospective observational study performed within a previously published clinical trial of L-carnitine for the treatment of vasopressor-dependent septic shock. Intravital video microscopy was performed at enrollment and 12 hours later, and microcirculatory flow index (MFI) was assessed. Associations between enrollment MFI, lactate, and SOFA score were determined, in addition to associations between ΔMFI, lactate clearance, and ΔSOFA. A preplanned subgroup analysis of only patients with an elevated initial lactate was performed. Results We enrolled a total of 31 patients, 23 with survival to and sufficient quality videos both at enrollment and 12 hours. ΔMFI, lactate clearance, and ΔSOFA were 0.1 (IQR 0, 0.3), 18% (IQR −10%, 46%), and −2 (IQR −4, 0). Both ΔMFI and lactate clearance were associated with ΔSOFA (β = −5.3, p = 0.01 and β = −3.5, 0.047), but not with each other, even in the subgroup of patients with an initially elevated lactate. Conclusion We observed no association between degree of lactate clearance and change in microcirculatory blood flow in patients with septic shock. These data suggest against the hypothesis that lactate clearance may be used as a surrogate marker of microcirculatory blood flow. PMID:26825368

Single-centre validation of the EASL-CLIF consortium definition of acute-on-chronic liver failure and CLIF-SOFA for prediction of mortality in cirrhosis.

PubMed

Silva, Pedro E Soares E; Fayad, Leonardo; Lazzarotto, César; Ronsoni, Marcelo F; Bazzo, Maria L; Colombo, Bruno S; Dantas-Correa, Esther B; Narciso-Schiavon, Janaína L; Schiavon, Leonardo L

2015-05-01

The idea of acute-on-chronic liver failure (ACLF) has emerged to identify those subjects with organ failure and high mortality rates. However, the absence of a precise definition has limited the clinical application and research related to the ACLF concept. We sought to validate the ACLF definition and the CLIF-SOFA Score recently proposed by the EASL-CLIF Consortium in a cohort of patients admitted for acute decompensation (AD) of cirrhosis. In this prospective cohort study, patients were followed during their hospital stay and thirty and 90-day mortality was evaluated by phone call, in case of hospital discharge. All subjects underwent laboratory evaluation at admission. Between December 2010 and November 2013, 192 cirrhotic patients were included. At enrollment, 46 patients (24%) met the criteria for ACLF (Grades 1, 2 and 3 in 18%, 4% and 2% respectively). The 30-day mortality was 65% in ACLF group and 12% in the remaining subjects (P < 0.001). Logistic regression analysis showed that 30-day mortality was independently associated with ascites and ACLF at admission. The Kaplan-Meier survival probability at 90-day was 92% in patients without ascites or ACLF and only 22% for patients with both ascites and ACLF. The AUROC of CLIF-SOFA in predicting 30-day mortality was 0.847 ± 0.034, with sensitivity of 64%, specificity of 90% and positive likelihood ratio of 6.61 for values ≥9. In our single-centre experience the CLIF-SOFA and the EASL-CLIF Consortium definition of ACLF proved to be strong predictors of short-term mortality in cirrhotic patients admitted for AD. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Development of a prognostic nomogram for cirrhotic patients with upper gastrointestinal bleeding.

PubMed

Zhou, Yu-Jie; Zheng, Ji-Na; Zhou, Yi-Fan; Han, Yi-Jing; Zou, Tian-Tian; Liu, Wen-Yue; Braddock, Martin; Shi, Ke-Qing; Wang, Xiao-Dong; Zheng, Ming-Hua

2017-10-01

Upper gastrointestinal bleeding (UGIB) is a complication with a high mortality rate in critically ill patients presenting with cirrhosis. Today, there exist few accurate scoring models specifically designed for mortality risk assessment in critically ill cirrhotic patients with upper gastrointestinal bleeding (CICGIB). Our aim was to develop and evaluate a novel nomogram-based model specific for CICGIB. Overall, 540 consecutive CICGIB patients were enrolled. On the basis of Cox regression analyses, the nomogram was constructed to estimate the probability of 30-day, 90-day, 270-day, and 1-year survival. An upper gastrointestinal bleeding-chronic liver failure-sequential organ failure assessment (UGIB-CLIF-SOFA) score was derived from the nomogram. Performance assessment and internal validation of the model were performed using Harrell's concordance index (C-index), calibration plot, and bootstrap sample procedures. UGIB-CLIF-SOFA was also compared with other prognostic models, such as CLIF-SOFA and model for end-stage liver disease, using C-indices. Eight independent factors derived from Cox analysis (including bilirubin, creatinine, international normalized ratio, sodium, albumin, mean artery pressure, vasopressin used, and hematocrit decrease>10%) were assembled into the nomogram and the UGIB-CLIF-SOFA score. The calibration plots showed optimal agreement between nomogram prediction and actual observation. The C-index of the nomogram using bootstrap (0.729; 95% confidence interval: 0.689-0.766) was higher than that of the other models for predicting survival of CICGIB. We have developed and internally validated a novel nomogram and an easy-to-use scoring system that accurately predicts the mortality probability of CICGIB on the basis of eight easy-to-obtain parameters. External validation is now warranted in future clinical studies.

Speaking out on safe sleep: evidence-based infant sleep recommendations.

PubMed

Bartick, Melissa; Smith, Linda J

2014-11-01

The American Academy of Pediatrics (AAP) issued recommendations in 2005 and 2011 to reduce sleep-related infant death, which advise against all bedsharing for sleep. These recommendations overemphasize the risks of bedsharing, and this overemphasis has serious unintended consequences. It may result in increased deaths on sofas as tired parents try to avoid feeding their infants in bed. Current evidence shows that other risks are far more potent, such as smoking, shared sleep on sofas, sleeping next to impaired caregivers, and formula feeding. The emphasis on separate sleep is diverting resources away from addressing these critical risk factors. Recommendations to avoid bedsharing may also interfere with breastfeeding. We examine both the evidence behind the AAP recommendations and the evidence omitted from those recommendations. We conclude that the only evidence-based universal advice to date is that sofas are hazardous places for adults to sleep with infants; that exposure to smoke, both prenatal and postnatal, increases the risk of death; and that sleeping next to an impaired caregiver increases the risk of death. No sleep environment is completely safe. Public health efforts must address the reality that tired parents must feed their infants at night somewhere and that sofas are highly risky places for parents to fall asleep with their infants, especially if parents are smokers or under the influence of alcohol or drugs. All messaging must be crafted and reevaluated to avoid unintended negative consequences, including impact on breastfeeding rates, or falling asleep in more dangerous situations than parental beds. We must realign our resources to focus on the greater risk factors, and that may include greater investment in smoking cessation and doing away with aggressive formula marketing. This includes eliminating conflicts of interest between formula marketing companies and organizations dedicated to the health of children.

Unexpected Huge Dimerization Ratio in One-Dimensional Carbon Atomic Chains.

PubMed

Lin, Yung-Chang; Morishita, Shigeyuki; Koshino, Masanori; Yeh, Chao-Hui; Teng, Po-Yuan; Chiu, Po-Wen; Sawada, Hidetaka; Suenaga, Kazutomo

2017-01-11

Peierls theory predicted atomic distortion in one-dimensional (1D) crystal due to its intrinsic instability in 1930. Free-standing carbon atomic chains created in situ in transmission electron microscope (TEM)1-3 are an ideal example to experimentally observe the dimerization behavior of carbon atomic chain within a finite length. We report here a surprisingly huge distortion found in the free-standing carbon atomic chains at 773 K, which is 10 times larger than the value expected in the system. Such an abnormally distorted phase only dominates at the elevated temperatures, while two distinct phases, distorted and undistorted, coexist at lower or ambient temperatures. Atom-by-atom spectroscopy indeed shows considerable variations in the carbon 1s spectra at each atomic site but commonly observes a slightly downshifted π* peak, which proves its sp 1 bonding feature. These results suggest that the simple model, relaxed and straight, is not fully adequate to describe the realistic 1D structure, which is extremely sensitive to perturbations such as external force or boundary conditions.

Real-Time Correction By Optical Tracking with Integrated Geometric Distortion Correction for Reducing Motion Artifacts in fMRI

NASA Astrophysics Data System (ADS)

Rotenberg, David J.

Artifacts caused by head motion are a substantial source of error in fMRI that limits its use in neuroscience research and clinical settings. Real-time scan-plane correction by optical tracking has been shown to correct slice misalignment and non-linear spin-history artifacts, however residual artifacts due to dynamic magnetic field non-uniformity may remain in the data. A recently developed correction technique, PLACE, can correct for absolute geometric distortion using the complex image data from two EPI images, with slightly shifted k-space trajectories. We present a correction approach that integrates PLACE into a real-time scan-plane update system by optical tracking, applied to a tissue-equivalent phantom undergoing complex motion and an fMRI finger tapping experiment with overt head motion to induce dynamic field non-uniformity. Experiments suggest that including volume by volume geometric distortion correction by PLACE can suppress dynamic geometric distortion artifacts in a phantom and in vivo and provide more robust activation maps.

Centrifugal distortion and the ring puckering vibration in the microwave spectrum of 2,3-dihydrofuran

NASA Astrophysics Data System (ADS)

Cervellati, R.; Degli Esposti, A.; Lister, D. G.; Lopez, J. C.; Alonso, J. L.

1986-10-01

The microwave spectrum of 2,3-dihydrofuran has been reinvestigated and measurements for the ground and first five excited states of the ring puckering vibration have been extended to higher frequencies and rotational quantum numbers in order to study the vibrational dependence of the rotational and centrifugal distortion constants. The ring puckering potential function derived by Green from the far infrared spectrum does not reproduce the vibrational dependence of the rotational constants well. A slightly different potential function is derived which gives a reasonable fit both to the far infrared spectrum and the rotational constants. This changes the barrier to ring inversion from 1.00 kJ mol -1 to 1.12 kJ mol -1. The vibrational dependence of the centrifugal distortion constants is accounted for satisfactorily by the theory developed by Creswell and Mills. An attempt to reproduce the vibrational dependence of the rotational and centrifugal distortion constants using the ring puckering potential function and a simple model for this vibration has very limited success.

Double-spin-echo diffusion weighting with a modified eddy current adjustment.

PubMed

Finsterbusch, Jürgen

2010-04-01

Magnetic field inhomogeneities like eddy current-related gradient fields cause geometric distortions in echo-planar imaging (EPI). This in particular affects diffusion-weighted imaging where these distortions vary with the direction of the diffusion weighting and hamper the accurate determination of diffusion parameters. The double-spin-echo preparation often used aims to reduce the cumulative eddy current effect by adjusting the diffusion-weighting gradient pulse durations to the time constant of the dominant eddy current contribution. However, eddy currents with a variety of time constants may be present and cause residual distortions. Here, a modification is proposed where the two bipolar gradient pairs of the preparation are adjusted independently to different time constants. At the expense of a slightly prolonged echo time, residual geometric distortions and correspondingly increased values of the diffusion anisotropy can be reduced as is demonstrated in phantoms and the human brain. Thus, it may help to improve the reliability of diffusion-weighted EPI. Copyright 2010 Elsevier Inc. All rights reserved.

Does the achievement of an intermediate glycemic target reduce organ failure and mortality? A post hoc analysis of the Glucontrol trial.

PubMed

Penning, Sophie; Chase, J Geoffrey; Preiser, Jean-Charles; Pretty, Christopher G; Signal, Matthew; Mélot, Christian; Desaive, Thomas

2014-06-01

This research evaluates the impact of the achievement of an intermediate target glycemic band on the severity of organ failure and mortality. Daily Sequential Organ Failure Assessment (SOFA) score and the cumulative time in a 4.0 to 7.0 mmol/L band (cTIB) were evaluated daily up to 14 days in 704 participants of the multicentre Glucontrol trial (16 centers) that randomized patients to intensive group A (blood glucose [BG] target: 4.4-6.1 mmol/L) or conventional group B (BG target: 7.8-10.0 mmol/L). Sequential Organ Failure Assessment evolution was measured by percentage of patients with SOFA less than or equal to 5 on each day, percentage of individual organ failures, and percentage of organ failure-free days. Conditional and joint probability analysis of SOFA and cTIB 0.5 or more assessed the impact of achieving 4.0 to 7.0 mmol/L target glycemic range on organ failure. Odds ratios (OR) compare the odds risk of death for cTIB 0.5 or more vs cTIB less than 0.5, where a ratio greater than 1.0 indicates an improvement for achieving cTIB 0.5 or more independent of SOFA or glycemic target. Groups A and B were matched for demographic and severity of illness data. Blood glucose differed between groups A and B (P<.05), as expected. There was no difference in the percentage of patients with SOFA less than or equal to 5, individual organ failures, and organ failure-free days between groups A and B over days 1 to 14. However, 20% to 30% of group A patients failed to achieve cTIB 0.5 or more for all days, and significant crossover confounds interpretation. Mortality OR was greater than 1.0 for patients with cTIB 0.5 or more in both groups but much higher for group A on all days. There was no difference in organ failure in the Glucontrol study based on intention to treat to different glycemic targets. Actual outcomes and significant crossover indicate that this result may not be due to the difference in target or treatment. Odds ratios-associated achieving an intermediate 4.0 to 7.0 mmol/L range improved outcome. Copyright © 2014 Elsevier Inc. All rights reserved.

Sepsis patients in the emergency department: stratification using the Clinical Impression Score, Predisposition, Infection, Response and Organ dysfunction score or quick Sequential Organ Failure Assessment score?

PubMed

Quinten, Vincent M; van Meurs, Matijs; Wolffensperger, Anna E; Ter Maaten, Jan C; Ligtenberg, Jack J M

2017-05-08

The aim of this study was to compare the stratification of sepsis patients in the emergency department (ED) for ICU admission and mortality using the Predisposition, Infection, Response and Organ dysfunction (PIRO) and quick Sequential Organ Failure Assessment (qSOFA) scores with clinical judgement assessed by the ED staff. This was a prospective observational study in the ED of a tertiary care teaching hospital. Adult nontrauma patients with suspected infection and at least two Systemic Inflammatory Response Syndrome criteria were included. The primary outcome was direct ED to ICU admission. The secondary outcomes were in-hospital, 28-day and 6-month mortality, indirect ICU admission and length of stay. Clinical judgement was recorded using the Clinical Impression Scores (CIS), appraised by a nurse and the attending physician. The PIRO and qSOFA scores were calculated from medical records. We included 193 patients: 103 presented with sepsis, 81 with severe sepsis and nine with septic shock. Fifteen patients required direct ICU admission. The CIS scores of nurse [area under the curve (AUC)=0.896] and the attending physician (AUC=0.861), in conjunction with PIRO (AUC=0.876) and qSOFA scores (AUC=0.849), predicted direct ICU admission. The CIS scores did not predict any of the mortality endpoints. The PIRO predicted in-hospital (AUC=0.764), 28-day (AUC=0.784) and 6-month mortality (AUC=0.695). The qSOFA score also predicted in-hospital (AUC=0.823), 28-day (AUC=0.848) and 6-month mortality (AUC=0.620). Clinical judgement is a fast and reliable method to stratify between ICU and general ward admission in ED patients with sepsis. The PIRO and qSOFA scores do not add value to this stratification, but perform better on the prediction of mortality. In sepsis patients, therefore, the principle of 'treat first what kills first' can be supplemented with 'judge first and calculate later'.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/.

Tidal disruption of dissipative planetesimals

NASA Technical Reports Server (NTRS)

Mizuno, H.; Boss, A. P.

1985-01-01

A self-consistent numerical model is developed for the tidal disruption of a solid planetesimal. The planetesimal is treated as a highly viscous, slightly compressible fluid whose disturbed parts are an inviscid, pressureless fluid undergoing distortion and disruption. The distortions were constrained to being symmetrical above and below the equatorial plane. The tidal potential is expanded in terms of Legendre polynomials, which eliminates the center of mass acceleration effects, permitting definition of equations of motion in a noninertial frame. Consideration is given to viscous dissipation and to characteristics of the solid-atmosphere boundary. The model is applied to sample cases in one, two and three dimensions.

Combined approach to the Hubble Space Telescope wave-front distortion analysis

NASA Astrophysics Data System (ADS)

Roddier, Claude; Roddier, Francois

1993-06-01

Stellar images taken by the HST at various focus positions have been analyzed to estimate wave-front distortion. Rather than using a single algorithm, we found that better results were obtained by combining the advantages of various algorithms. For the planetary camera, the most accurate algorithms consistently gave a spherical aberration of -0.290-micron rms with a maximum deviation of 0.005 micron. Evidence was found that the spherical aberration is essentially produced by the primary mirror. The illumination in the telescope pupil plane was reconstructed and evidence was found for a slight camera misalignment.

Frequency shifts in distortion-product otoacoustic emissions evoked by swept tones

PubMed Central

Shera, Christopher A.; Abdala, Carolina

2016-01-01

When distortion-product otoacoustic emissions (DPOAEs) are evoked using stimuli whose instantaneous frequencies change rapidly and continuously with time (swept tones), the oscillatory interference pattern known as distortion-product fine structure shifts slightly along the frequency axis in the same direction as the sweep. By analogy with the temporal mechanisms thought to underlie the differing efficacies of up- and down-swept stimuli as perceptual maskers (e.g., Schroeder-phase complexes), fine-structure shifts have been ascribed to the phase distortion associated with dispersive wave propagation in the cochlea. This paper tests an alternative hypothesis and finds that the observed shifts arise predominantly as a methodological side effect of the analysis procedures commonly used to extract delayed emissions from the measured time waveform. Approximate expressions for the frequency shifts of DPOAE distortion and reflection components are derived, validated with computer simulations, and applied to account for DPOAE fine-structure shifts measured in human subjects. Component magnitudes are shown to shift twice as much as component phases. Procedures for compensating swept-tone measurements to obtain estimates of the total DPOAE and its components measured at other sweep rates or in the sinusoidal steady state are presented. PMID:27586726

Beyond face value: does involuntary emotional anticipation shape the perception of dynamic facial expressions?

PubMed

Palumbo, Letizia; Jellema, Tjeerd

2013-01-01

Emotional facial expressions are immediate indicators of the affective dispositions of others. Recently it has been shown that early stages of social perception can already be influenced by (implicit) attributions made by the observer about the agent's mental state and intentions. In the current study possible mechanisms underpinning distortions in the perception of dynamic, ecologically-valid, facial expressions were explored. In four experiments we examined to what extent basic perceptual processes such as contrast/context effects, adaptation and representational momentum underpinned the perceptual distortions, and to what extent 'emotional anticipation', i.e. the involuntary anticipation of the other's emotional state of mind on the basis of the immediate perceptual history, might have played a role. Neutral facial expressions displayed at the end of short video-clips, in which an initial facial expression of joy or anger gradually morphed into a neutral expression, were misjudged as being slightly angry or slightly happy, respectively (Experiment 1). This response bias disappeared when the actor's identity changed in the final neutral expression (Experiment 2). Videos depicting neutral-to-joy-to-neutral and neutral-to-anger-to-neutral sequences again produced biases but in opposite direction (Experiment 3). The bias survived insertion of a 400 ms blank (Experiment 4). These results suggested that the perceptual distortions were not caused by any of the low-level perceptual mechanisms (adaptation, representational momentum and contrast effects). We speculate that especially when presented with dynamic, facial expressions, perceptual distortions occur that reflect 'emotional anticipation' (a low-level mindreading mechanism), which overrules low-level visual mechanisms. Underpinning neural mechanisms are discussed in relation to the current debate on action and emotion understanding.

Beyond Face Value: Does Involuntary Emotional Anticipation Shape the Perception of Dynamic Facial Expressions?

PubMed Central

Palumbo, Letizia; Jellema, Tjeerd

2013-01-01

Emotional facial expressions are immediate indicators of the affective dispositions of others. Recently it has been shown that early stages of social perception can already be influenced by (implicit) attributions made by the observer about the agent’s mental state and intentions. In the current study possible mechanisms underpinning distortions in the perception of dynamic, ecologically-valid, facial expressions were explored. In four experiments we examined to what extent basic perceptual processes such as contrast/context effects, adaptation and representational momentum underpinned the perceptual distortions, and to what extent ‘emotional anticipation’, i.e. the involuntary anticipation of the other’s emotional state of mind on the basis of the immediate perceptual history, might have played a role. Neutral facial expressions displayed at the end of short video-clips, in which an initial facial expression of joy or anger gradually morphed into a neutral expression, were misjudged as being slightly angry or slightly happy, respectively (Experiment 1). This response bias disappeared when the actor’s identity changed in the final neutral expression (Experiment 2). Videos depicting neutral-to-joy-to-neutral and neutral-to-anger-to-neutral sequences again produced biases but in opposite direction (Experiment 3). The bias survived insertion of a 400 ms blank (Experiment 4). These results suggested that the perceptual distortions were not caused by any of the low-level perceptual mechanisms (adaptation, representational momentum and contrast effects). We speculate that especially when presented with dynamic, facial expressions, perceptual distortions occur that reflect ‘emotional anticipation’ (a low-level mindreading mechanism), which overrules low-level visual mechanisms. Underpinning neural mechanisms are discussed in relation to the current debate on action and emotion understanding. PMID:23409112

Geometric calibration of lens and filter distortions for multispectral filter-wheel cameras.

PubMed

Brauers, Johannes; Aach, Til

2011-02-01

High-fidelity color image acquisition with a multispectral camera utilizes optical filters to separate the visible electromagnetic spectrum into several passbands. This is often realized with a computer-controlled filter wheel, where each position is equipped with an optical bandpass filter. For each filter wheel position, a grayscale image is acquired and the passbands are finally combined to a multispectral image. However, the different optical properties and non-coplanar alignment of the filters cause image aberrations since the optical path is slightly different for each filter wheel position. As in a normal camera system, the lens causes additional wavelength-dependent image distortions called chromatic aberrations. When transforming the multispectral image with these aberrations into an RGB image, color fringes appear, and the image exhibits a pincushion or barrel distortion. In this paper, we address both the distortions caused by the lens and by the filters. Based on a physical model of the bandpass filters, we show that the aberrations caused by the filters can be modeled by displaced image planes. The lens distortions are modeled by an extended pinhole camera model, which results in a remaining mean calibration error of only 0.07 pixels. Using an absolute calibration target, we then geometrically calibrate each passband and compensate for both lens and filter distortions simultaneously. We show that both types of aberrations can be compensated and present detailed results on the remaining calibration errors.

Magneto-structural correlation in Co0.8Cu0.2Cr2O4 cubic spinel

NASA Astrophysics Data System (ADS)

Kumar, Ram; Rayaprol, S.; Siruguri, V.; Xiao, Y.; Ji, W.; Pal, D.

2018-05-01

Neutron and X-ray diffraction, magnetic susceptibility, and specific heat measurements have been used to investigate the magneto-structural phase transitions in 20% Cu substituted multiferroic CoCr2O4 spinel. The Jahn-Teller active Cu2+ ion in the tetrahedral A-site of the spinel configuration induces the Jahn-Teller distortion slightly above the Néel temperature. In this compound, we observe a Jahn-Teller distortion of the crystal structure at 90 K. It was further observed that the high temperature cubic (Fd 3 ‾ m) structure coexists with the low temperature orthorhombic (Fddd) structure till the lowest temperature of measurement.

Observing the contour profile of a Kerr-Sen black hole

NASA Astrophysics Data System (ADS)

Lan, X. G.; Pu, J.

2018-06-01

In this paper, the shadow and the corresponding naked singularity cast by a Kerr-Sen black hole are studied. It is found that the shadow of a rotating black hole would be a dark zone surrounded by a deformed circle, and the shadow is distorted more away from a circle when the black hole approaches the extremal case. Besides, it is shown that the mean radius of the shadow decreases and distortion parameter increases with the increasing of charge, respectively. However, the mean radius and the distortion parameter vary complicatedly with the change of spin parameter. In the beginning, both observables decrease rapidly with the increasing of specific angular momentum, nevertheless, they increase slightly in the latter part. These results show that there would be a significant effect of the spin on the shadows, which would be of great importance for probing the nature of the black hole.

[Prevalence of severe sepsis in intensive care units. A national multicentric study].

PubMed

Dougnac, Alberto L; Mercado, Marcelo F; Cornejo, Rodrigo R; Cariaga, Mario V; Hernández, Glenn P; Andresen, Max H; Bugedo, Guillermo T; Castillo, Luis F

2007-05-01

Severe sepsis (SS) is the leading cause of death in the Intensive Care Units (ICU). To study the prevalence of SS in Chilean ICUs. An observational, cross-sectional study using a predesigned written survey was done in all ICUs of Chile on April 21st, 2004. General hospital and ICU data and the number of hospitalized patients in the hospital and in the ICU at the survey day, were recorded. Patients were followed for 28 days. Ninety four percent of ICUs participated in the survey. The ICU occupation index was 66%. Mean age of patients was 57.7+/-18 years and 59% were male, APACHE II score was 15+/-7.5 and SOFA score was 6+/-4. SS was the admission diagnosis of 94 of the 283 patients (33%) and 38 patients presented SS after admission. On the survey day, 112 patients fulfilled SS criteria (40%). APACHE II and SOFA scores were significantly higher in SS patients than in non SS patients. Global case-fatality ratio at 28 days was 15.9% (45/283). Case-fatality ratio in patients with or without SS at the moment of the survey was 26.7% (30/112) and 8.7% (17/171), respectively p <0.05. Thirteen percent of patients who developed SS after admission, died. Case-fatality ratios for patients with SS from Santiago and the other cities were similar, but APACHE II score was significantly higher in patients from Santiago. In SS patients, the independent predictors of mortality were SS as cause of hospital admission, APACHE II and SOFA scores. Ninety nine percent of SS patients had a known sepsis focus (48% respiratory and 30% abdominal). Eighty five patients that presented SS after admission, had a respiratory focus. SS is highly prevalent in Chilean ICUs and represents the leading diagnosis at admission. SS as cause of hospitalization, APACHE II and SOFA scores were independent predictors of mortality.

Predictive relevance of clinical scores and inflammatory parameters in secondary peritonitis.

PubMed

Zügel, Nikolaus P; Kox, Martin; Lichtwark-Aschoff, Michael; Gippner-Steppert, Cornelia; Jochum, Marianne

2011-01-01

To measure and evaluate clinical scores and various inflammation parameters for providing a better outcome assessment of patients with secondary peritonitis. Prospective study. ICU of a university and a university affiliated hospital. Fifty-six patients with severe secondary peritonitis were enrolled in this study executed within 4 years. Blood samples were taken preoperatively and 2, 6, 8, 12, 18, 24, 30, 36, 42 and 48 hours post operation, thereafter every 12th hour until day 5 respectively once daily until day 14. Etiology of peritonitis, clinical score systems (APACHE II, MOF and SOFA), and 27 mainly with activity tests or enzyme-immunoassays measurable inflammation parameters were simultaneously analyzed and stratified into lethal outcome (n = 11) or survival (n = 45), respectively. The etiological distribution of peritonitis was identical among both groups. Proportion of intraperitoneal fungi, E. coli, and bacteroids was substantially higher during the primary operation in the group with lethal outcome. With increasing significance initial and follow-up APACHE II, MOF and SOFA scores provided higher values in this group. Various plasma/serum parameters of hemostasis, leukocyte proteolytic system, acute phase reaction, cytokine system, cell adhesion, opsonization, and main organ functions showed significantly different values between both groups at the preoperative stage and/or during observation period I (day 0-4). Logistic regression analysis revealed the SOFA score and neopterin concentration as the combination with the best sensitivity (63.6%) and specificity (93.2%) for predicting the patients' survival even at the preoperative stage. For the observation period I, the combination of SOFA score and TNF receptor II showed the highest predictive sensitivity (72.7%) and specificity (95.6%). Evaluation of the severity of secondary peritonitis using a scoring system with high prognostic relevance could conceivably result in an earlier and adequate application of intensive care such as hemofiltration, administration of immunoglobulins and serial abdominal lavage to improve successful outcome.

Soluble RAGE as a severity marker in community acquired pneumonia associated sepsis

PubMed Central

2012-01-01

Background Community-acquired pneumonia (CAP) is considered the most important cause of death from infectious disease in developed countries. Severity assessment scores partially address the difficulties in identifying high-risk patients. A lack of specific and valid pathophysiologic severity markers affect early and effective sepsis therapy. HMGB-1, sRAGE and RAGE have been involved in sepsis and their potential as severity markers has been proposed. The aim of this study was to evaluate HMGB-1, RAGE and sRAGE levels in patients with CAP-associated sepsis and determine their possible association with clinical outcome. Method We evaluated 33 patients with CAP-associated sepsis admitted to the emergency room and followed in the medical wards. Severity assessment scores (CURB-65, PSI, APACHE II, SOFA) and serologic markers (HMGB-1, RAGE, sRAGE) were evaluated on admission. Results Thirty patients with a diagnosis of CAP-associated sepsis were enrolled in the study within 24 hours after admission. Fourteen (46.6%) had pandemic (H1N1) influenza A virus, 2 (6.6%) had seasonal influenza A and 14 other diagnoses. Of the patients in the study group, 16 (53.3%) had a fatal outcome. ARDS was observed in 17 (56.6%) and a total of 22 patients had severe sepsis on admission (73%). The SOFA score showed the greatest difference between surviving and non-surviving groups (P = .003) with similar results in ARDS patients (P = .005). sRAGE levels tended to be higher in non-surviving (P = .058) and ARDS patients (P = .058). Logistic regression modeling demonstrated that SOFA (P = .013) and sRAGE (P = .05) were the only variables that modified the probability of a fatal outcome. Conclusion The association of elevated sRAGE with a fatal outcome suggests that it may have an independent causal effect in CAP. SOFA scores were the only clinical factor with the ability to identify surviving and ARDS patients. PMID:22264245

Validation of prognostic scores to predict short-term mortality in patients with acute-on-chronic liver failure.

PubMed

Song, Do Seon; Kim, Tae Yeob; Kim, Dong Joon; Kim, Hee Yeon; Sinn, Dong Hyun; Yoon, Eileen L; Kim, Chang Wook; Jung, Young Kul; Suk, Ki Tae; Lee, Sang Soo; Lee, Chang Hyeong; Kim, Tae Hun; Choe, Won Hyeok; Yim, Hyung Joon; Kim, Sung Eun; Baik, Soon Koo; Jang, Jae Young; Kim, Hyoung Su; Kim, Sang Gyune; Yang, Jin Mo; Sohn, Joo Hyun; Choi, Eun Hee; Cho, Hyun Chin; Jeong, Soung Won; Kim, Moon Young

2018-04-01

The aim of this study was to validate the chronic liver failure-sequential organ failure assessment score (CLIF-SOFAs), CLIF consortium organ failure score (CLIF-C OFs), CLIF-C acute-on-chronic liver failure score (CLIF-C ACLFs), and CLIF-C acute decompensation score in Korean chronic liver disease patients with acute deterioration. Acute-on-chronic liver failure was defined by either the Asian Pacific Association for the study of the Liver ACLF Research Consortium (AARC) or CLIF-C criteria. The diagnostic performances for short-term mortality were compared by the area under the receiver operating characteristic curve. Among a total of 1470 patients, 252 patients were diagnosed with ACLF according to the CLIF-C (197 patients) or AARC definition (95 patients). As the ACLF grades increased, the survival rates became significantly lower. The areas under the receiver operating characteristic of the CLIF-SOFAs, CLIF-C OFs, and CLIF-C ACLFs were significantly higher than those of the Child-Pugh, model for end-stage liver disease, and model for end-stage liver disease-Na scores in ACLF patients according to the CLIF-C definition (all P < 0.05), but there were no significant differences in patients without ACLF or in patients with ACLF according to the AARC definition. The CLIF-SOFAs, CLIF-C OFs, and CLIF-C ACLFs had higher specificities with a fixed sensitivity than liver specific scores in ACLF patients according to the CLIF-C definition, but not in ACLF patients according to the AARC definition. The CLIF-SOFAs, CLIF-C OFs, and CLIF-C ACLFs are useful scoring systems that provide accurate information on prognosis in patients with ACLF according to the CLIF-C definition, but not the AARC definition. © 2017 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

Are prognostic scores and biomarkers such as procalcitonin the appropriate prognostic precursors for elderly patients with sepsis in the emergency department?

PubMed

Lee, Woon Jeong; Woo, Seon Hee; Kim, Dae Hee; Seol, Seung Hwan; Park, Si Kyung; Choi, Seung Pill; Jekarl, Dong Wook; Lee, Seung Ok

2016-10-01

The mortality of patients with severe sepsis and septic shock is still high, and the prognosis of elderly patients tends to be particularly poor. Therefore, this study sought to conduct a comparative analysis of the abbreviated mortality in emergency department sepsis (abbMEDS) score, sequential organ failure assessment (SOFA) score, infection probability score (IPS), initial procalcitonin (PCT), and cytokine levels to investigate the effectiveness of each index in predicting the prognosis of elderly patients with sepsis in the emergency department (ED). This was a single-center prospective study, and classified 55 patients (≥65 years of age) with systemic inflammatory response syndrome (SIRS) from January 2013 to December 2013 in the ED. A total of 36 elderly patients were diagnosed with sepsis. The prediction of prognosis using the prognostic scores (abbMEDS, SOFA, IPS) was analyzed. An early blood examination (WBC count, C-reactive protein, PCT, and cytokines) was conducted within the first 2 h of the patient's arrival at the ED. The median (IQR) age of subjects was 76.5 (70.5-81.5). After 28 days, 27 subjects (75 %) had survived, and 9 (25 %) had died. Fifteen (41.7 %) were sent to intensive care units (ICUs). The SOFA score and abbMEDS showed higher median (IQR) values of 9.5 (7.0-11.0) and 13.5 (12.0-15.0), respectively, in the ICU group than in the general ward group (p < 0.001). Analysis of the levels of PCT, IL-10, IL-6, and IL-5 had a significantly better ability to predict ICU admission (p = 0.001, p = 0.023, p = 0.030, p = 0.001). The prediction of mortality in the first 28 days via SOFA and the abbMEDS resulted in scores of 11.0 (8.0-11.0) and 14.0 (12.5-15.5) (p = 0.004, p = 0.003), respectively. However, levels of IPS, PCT, and cytokines did not show significant differences. In predicting ICU admission and the death of elderly sepsis patients in ED, SOFA and abbMEDS scores were effective. Of the various biomarkers, PCT, IL-10, IL-6, and IL-5 were effective in predicting ICU admission, but were not effective in predicting the death of elderly sepsis patients.

NAS Report Reveals Dangers From SST

ERIC Educational Resources Information Center

Fowler, Jo Ann V.

1973-01-01

Reported are some harmful effects of supersonic travel on humans and other living organisms. Slight decreases in ozone concentration as a result of emissions from the SST aircrafts reduce absorption of ultraviolet radiation. Effects of this may include skin cancer, distort balance of activity in cells and have a deleterious effect on insects and…

Lysozyme revisited: crystallographic evidence for distortion of an N-acetylmuramic acid residue bound in site D.

PubMed

Strynadka, N C; James, M N

1991-07-20

A structure of the trisaccharide 2-acetamido-2-deoxy-D-muramic acid-beta (1----4)-2-acetamido-2-deoxy-D-glucose-beta (1----4)-2-acetamido-2-deoxy-D-muramic acid (NAM-NAG-NAM), bound to subsites B, C and D in the active-site cleft of hen egg-white lysozyme has been determined and refined at 1.5 A resolution. The resulting atomic co-ordinates indicate that the NAM residue in site D is distorted from the full 4C1 chair conformation to one in which the ring atoms C-1, C-2, O-5 and C-5 are approximately coplanar, and the hydroxymethyl group is positioned axially (a conformation best described as a sofa). This finding supports the original proposals that suggested the ground-state conformation of the sugar bound in site D is strained to one that more closely resembles the geometry required for the oxocarbonium-ion transition state, the next step along the reaction pathway. Additionally, detailed analysis at 1.5 A resolution of the environments of the catalytic residues Glu35 and Asp52 provides new information on the properties that may allow lysozyme to promote the stabilization of an unusually long-lived oxocarbonium-ion transition state. Intermolecular interactions between the N-acetylmuramic acid residue in site D and the lysozyme molecule that contribute to the saccharide ring distortion include: close packing of the O-3' lactyl group with a hydrogen-bonded "platform" of enzyme residues (Asp52, Asn46, Asn59, Ser50 and Asp48), a close contact between the hydroxymethyl group of ring D and the 2'-acetamido group of ring C and a strong hydrogen-bonded interaction between the NH group of Val109 and O-6 of ring D that stabilizes the observed quasi-axial orientation of the -CH2OH group. Additionally, the structure of this complex shows a strong hydrogen bond between the carboxyl group of Glu35 and the beta-anomeric hydroxyl group of the NAM residue in site D. The hydrogen-bonded environment of Asp52 in the native enzyme and in the complex coupled with the very unfavorable direction of approach of the potential carboxylate nucleophile makes it most unlikely that there is a covalent glycosylenzyme intermediate on the hydrolysis pathway of hen egg-white lysozyme.

High loading, 1800 ft/sec tip speed, transonic compressor fan stage. 2: Final report

NASA Technical Reports Server (NTRS)

Morris, A. L.; Sulam, D. H.

1972-01-01

Tests were conducted on a 0.5 hub/tip ratio, single-stage fan-compressor designed to produce a pressure ratio of 2.285 an efficiency of 84 percent with a rotor tip speed of 1800 feet per second. A peak efficiency of 82 percent was achieved by the stage at a stall margin of 6.5 percent. Tests showed that stall-limit line was slightly sensitive to tip-radial distortion, but stall-line improvements were noted when the stage was subjected to circumferential and hub-radial flow distortions. Rotor blade passage and trailing edge shock positions were inferred from static pressure contours over the rotor tips.

[Volatile organic compounds (VOCs) emitted from furniture and electrical appliances].

PubMed

Tanaka-Kagawa, Toshiko; Jinno, Hideto; Furukawa, Yoko; Nishimura, Tetsuji

2010-01-01

Organic chemicals are widely used as ingredients in household products. Therefore, furniture and other household products as well as building products may influence the indoor air quality. This study was performed to estimate quantitatively influence of household products on indoor air quality. Volatile organic compound (VOC) emissions were investigated for 10 products including furniture (chest, desk, dining table, sofa, cupboard) and electrical appliances (refrigerator, electric heater, desktop personal computer, liquid crystal display television and audio) by the large chamber test method (JIS A 1912) under the standard conditions of 28 degrees C, 50% relative humidity and 0.5 times/h ventilation. Emission rate of total VOC (TVOC) from the sofa showed the highest; over 7900 microg toluene-equivalent/unit/h. Relatively high TVOC emissions were observed also from desk and chest. Based on the emission rates, the impacts on the indoor TVOC were estimated by the simple model with a volume of 17.4 m3 and ventilation frequency of 0.5 times/h. The estimated TVOC increment for the sofa was 911 microg/m3, accounting for almost 230% of the provisional target value, 400 microg/m3. The values of estimated increment of toluene emitted from cupboard and styrene emitted from refrigerator were 10% and 16% of guideline values, respectively. These results revealed that VOC emissions from household products may influence significantly indoor air quality.

Rumen microbial response in production of CLA and methane to safflower oil in association with fish oil or/and fumarate.

PubMed

Li, Xiang Z; Long, Rui J; Yan, Chang G; Lee, Hong G; Kim, Young J; Song, Man K

2011-06-01

Supplementation effect of fish oil and/or fumarate on production of conjugated linoleic acid (CLA) and methane by rumen microbes was examined when incubated with safflower oil. One hundred and twenty milligrams of safflower oil (SO), safflower oil with 24 mg fish oil (SOFO), safflower oil with 24 mmol/L fumarate (SOFA), or safflower oil with 24 mg fish oil and 24 mmol/L fumarate (SOFOFA) were added to the 90 mL culture solution. The culture solution was also made without any supplements (control). The SOFA and SOFOFA increased pH and propionate (C3) compared to other treatments from 3 h incubation time. An accumulated amount of total methane (CH(4) ) for 12 h incubation was decreased by all the supplements compared to control. The concentrations of c9,t11CLA for all the incubation times were increased in the treatments of SOFO, SOFA and SOFOFA compared to SO. The highest concentration of c9,t11CLA was observed from SOFOFA among all the treatments at all incubation times. Overall data indicate that supplementation of combined fumarate and/or fish oil when incubated with safflower oil could depress CH(4) generation and increase production of C(3) and CLA under the condition of current in vitro study. © 2011 The Authors; Animal Science Journal © 2011 Japanese Society of Animal Science.

Adolescent girls' most common source of junk food away from home.

PubMed

Cohen, Deborah A; Ghosh-Dastidar, Bonnie; Beckman, Robin; Lytle, Leslie; Elder, John; Pereira, Mark A; Veblen Mortenson, Sara; Pickrel, Julie; Conway, Terry L

2012-09-01

Contextual factors associated with adolescent girls' dietary behaviors could inform future interventions to improve diet. High school girls completed a 7-day diary, recording all trips made. In places other than home or school they recorded the food eaten. Girls made an average of 11.4 trips per week other than to home or school. Snacks high in solid oils, fats and added sugars (SOFAS) were frequently consumed. Girls reported eating an average of 3.5 servings per week of snacks high in SOFAS at someone else's house compared to 3.0 servings per week at retail food outlets. Findings demonstrate that low nutrient foods are ubiquitous and efforts should be made to reduce their availability in multiple settings. Copyright © 2012 Elsevier Ltd. All rights reserved.

Iodine Incorporation in Calcite: Insights from Computational and Experimental Study

NASA Astrophysics Data System (ADS)

Feng, X.; Redfern, S. A. T.

2016-12-01

The incorporation of iodine into calcite is important both in the context of radioactive waste disposal (carbonates seem to be the principal host for iodine at the Hnaford site) as well as in paleoproxy methods applied in paleo-oceanography, where iodine content has been proposed as a proxy for fO2. Here, we report on studies of iodine incorporation into calcite carried out by a combination of earlier X-Ray absorption spectroscopy, Raman spectroscopy, X-Ray diffraction and new ab initio DFT calculations (using VASP). Our results show that iodine is principally incorporated into the calcite lattice as IO3, replacing carbon in the carbonate group. The much larger size of iodine, and different outer shell electronic configuration, leads to a distortion of the calcite structure locally. Our DFT results show that the adjacent layers of CO3 groups are significantly distorted, over a length scale of around 0.5 nm, and that this distortion leads to a slight increase in enthalpy associated with the iodine point defect. The relationship to the distorted structure of calcite II is considered, and the role of iodine as an agent of "internal pressure" will be discussed.

An adaptive optics approach for laser beam correction in turbulence utilizing a modified plenoptic camera

NASA Astrophysics Data System (ADS)

Ko, Jonathan; Wu, Chensheng; Davis, Christopher C.

2015-09-01

Adaptive optics has been widely used in the field of astronomy to correct for atmospheric turbulence while viewing images of celestial bodies. The slightly distorted incoming wavefronts are typically sensed with a Shack-Hartmann sensor and then corrected with a deformable mirror. Although this approach has proven to be effective for astronomical purposes, a new approach must be developed when correcting for the deep turbulence experienced in ground to ground based optical systems. We propose the use of a modified plenoptic camera as a wavefront sensor capable of accurately representing an incoming wavefront that has been significantly distorted by strong turbulence conditions (C2n <10-13 m- 2/3). An intelligent correction algorithm can then be developed to reconstruct the perturbed wavefront and use this information to drive a deformable mirror capable of correcting the major distortions. After the large distortions have been corrected, a secondary mode utilizing more traditional adaptive optics algorithms can take over to fine tune the wavefront correction. This two-stage algorithm can find use in free space optical communication systems, in directed energy applications, as well as for image correction purposes.

Dystonia: Physical Therapy

MedlinePlus

... straight. Soft, sunken chairs and sofas do not foster proper alignment and may affect the position of ... dystonia, one should consider modifying the task to foster posture and muscle control. A person with trouble ...

Decoupling the Lattice Distortion and Charge Doping Effects on the Phase Transition Behavior of VO2 by Titanium (Ti4+) Doping

PubMed Central

Wu, Yanfei; Fan, Lele; Liu, Qinghua; Chen, Shi; Huang, Weifeng; Chen, Feihu; Liao, Guangming; Zou, Chongwen; Wu, Ziyu

2015-01-01

The mechanism for regulating the critical temperature (TC) of metal-insulator transition (MIT) in ions-doped VO2 systems is still a matter of debate, in particular, the unclear roles of lattice distortion and charge doping effects. To rule out the charge doping effect on the regulation of TC, we investigated Ti4+-doped VO2 (TixV1-xO2) system. It was observed that the TC of TixV1-xO2 samples first slightly decreased and then increased with increasing Ti concentration. X-ray absorption fine structure (XAFS) spectroscopy was used to explore the electronic states and local lattice structures around both Ti and V atoms in TixV1-xO2 samples. Our results revealed the local structure evolution from the initial anatase to the rutile-like structure around the Ti dopants. Furthermore, the host monoclinic VO2 lattice, specifically, the VO6 octahedra would be subtly distorted by Ti doping. The distortion of VO6 octahedra and the variation of TC showed almost the similar trend, confirming the direct effect of local structural perturbations on the phase transition behavior. By comparing other ion-doping systems, we point out that the charge doping is more effective than the lattice distortion in modulating the MIT behavior of VO2 materials. PMID:25950809

Effect of aluminum on the local structure of silicon in zeolites as studied by Si K edge X-ray absorption near-edge fine structure: spectra simulation with a non-muffin tin atomic background.

PubMed

Bugaev, Lusegen A; Bokhoven, Jeroen A van; Khrapko, Valerii V

2009-04-09

Experimental Si K edge X-ray absorption near-edge fine structure (XANES) of zeolite faujasite, mordenite, and beta are interpreted by means of the FEFF8 code, replacing the theoretical atomic background mu(0) by a background that was extracted from an experimental spectrum. To some extent, this diminished the effect of the inaccuracy introduced by the MT potential and accounted for the intrinsic loss of photoelectrons. The agreement of the theoretical and experimental spectra at energies above the white lines enabled us to identify structural distortion around silicon, which occurs with increasing aluminum content. The Si K edge XANES spectra are very sensitive to slight distortions in the silicon coordination. Placing an aluminum atom on a nearest neighboring T site causes a distortion in the silicon tetrahedron, shortening one of the silicon-oxygen bonds relative to the other three.

Can Sepsis Be Detected in the Nursing Home Prior to the Need for Hospital Transfer?

PubMed

Sloane, Philip D; Ward, Kimberly; Weber, David J; Kistler, Christine E; Brown, Benjamin; Davis, Katherine; Zimmerman, Sheryl

2018-06-01

To determine whether and to what extent simple screening tools might identify nursing home (NH) residents who are at high risk of becoming septic. Retrospective chart audit of all residents who had been hospitalized and returned to participating NHs during the study period. A total of 236 NH residents, 59 of whom returned from hospitals with a diagnosis of sepsis and 177 who had nonsepsis discharge diagnoses, from 31 community NHs that are typical of US nursing homes overall. NH documentation of vital signs, mental status change, and medical provider visits 0-12 and 13-72 hours prior to the hospitalization. The specificity and sensitivity of 5 screening tools were evaluated for their ability to detect residents with incipient sepsis during 0-12 and 13-72 hours prior to hospitalization: The Systemic Inflammatory Response Syndrome criteria, the quick Sequential Organ Failure Assessment (SOFA), the 100-100-100 Early Detection Tool, and temperature thresholds of 99.0°F and 100.2°F. In addition, to validate the hospital diagnosis of sepsis, hospital discharge records in the NHs were audited to calculate SOFA scores. Documentation of 1 or more vital signs was absent in 26%-34% of cases. Among persons with complete vital sign documentation, during the 12 hours prior to hospitalization, the most sensitive screening tools were the 100-100-100 Criteria (79%) and an oral temperature >99.0°F (51%); and the most specific tools being a temperature >100.2°F (93%), the quick SOFA (88%), the Systemic Inflammatory Response Syndrome criteria (86%), and a temperature >99.0°F (85%). Many SOFA data points were missing from the record; in spite of this, 65% of cases met criteria for sepsis. NHs need better systems to monitor NH residents whose status is changing, and to present that information to medical providers in real time, either through rapid medical response programs or telemetry. Copyright © 2018 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Increased B-type natriuretic peptide and decreased proteinuria might reflect decreased capillary leakage and is associated with a better outcome in patients with severe burns

PubMed Central

2011-01-01

Introduction It is difficult to adjust fluid balance adequately in patients with severe burns due to various physical changes. B-type natriuretic peptide (BNP) is emerging as a potential marker of hydration state. Proteinuria is used as a predictor of outcome in severe illness and might correlate to systemic capillary leakage. This study investigates whether combining BNP and proteinuria can be used as a guide for individualized resuscitation and as a predictor of outcome in patients with severe burns. Methods From 2006 to 2009, 38 consecutive patients (age 47 ± 15 years, 74% male) with severe burns were included and followed for 20 days. All had normal kidney function at admission. BNP and proteinuria were routinely measured. Ordered and actually administered fluid resuscitation volumes were recorded. The Sequential Organ Failure Assessment (SOFA) score was used as the measure of outcome. Results BNP increased during follow-up, reaching a plateau level at Day 3. Based on median BNP levels at Day 3, patients were divided into those with low BNP and those with high BNP levels. Both groups had comparable initial SOFA scores. Patients with high BNP received less fluid from Days 3 to 10. Furthermore, patients with a high BNP at Day 3 had less morbidity, reflected by lower SOFA scores on the following days. To minimize effects of biological variability, proteinuria on Days 1 and 2 was averaged. By dividing the patients based on median BNP at Day 3 and median proteinuria, patients with high BNP and low proteinuria had significantly lower SOFA scores during the entire follow-up period compared to those patients with low BNP and high proteinuria. Conclusions Patients with higher BNP levels received less fluid. This might be explained by a lower capillary leakage in these patients, resulting in more intravascular fluid and consequently an increase in BNP. In combination with low proteinuria, possibly reflecting minimal systemic capillary leakage, a high BNP level was associated with a better outcome. BNP and proteinuria have prognostic potential in severely burned patients and may be used to adjust individual resuscitation. PMID:21722363

History, Pseudo-History, Anti-History: How Public School Textbooks Treat Religion. Policy Studies in Education.

ERIC Educational Resources Information Center

Bryan, Robert

American schools use history textbooks that distort history by slighting the influence of religion on customs and institutions. The textbooks used in Montgomery County, Maryland--a highly regarded district--may be considered a sample of those used in the nation's best schools. Yet among these texts there is a remarkable consensus that, after 1700,…

Simulation Study on Fit Indexes in CFA Based on Data with Slightly Distorted Simple Structure

ERIC Educational Resources Information Center

Beauducel, Andre; Wittmann, Werner W.

2005-01-01

Fit indexes were compared with respect to a specific type of model misspecification. Simple structure was violated with some secondary loadings that were present in the true models that were not specified in the estimated models. The c2 test, Comparative Fit Index, Goodness-of-Fit Index, Incremental Fit Index, Nonnormed Fit Index, root mean…

Chemical complexity induced local structural distortion in NiCoFeMnCr high-entropy alloy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zhang, Fuxiang; Tong, Yang; Jin, Ke

In order to study chemical complexity-induced lattice distortion in high-entropy alloys, the static Debye–Waller (D-W) factor of NiCoFeMnCr solid solution alloy is measured with low temperature neutron diffraction, ambient X-ray diffraction, and total scattering methods. Here, the static atomic displacement parameter of the multi-element component alloy at 0 K is 0.035–0.041 Å, which is obvious larger than that of element Ni (~0 Å). The atomic pair distance between individual atoms in the alloy investigated with extended X-ray absorption fine structure (EXAFS) measurements indicates that Mn has a slightly larger bond distance (~0.4%) with neighbor atoms than that of others.

Syntheses, Raman spectroscopy and crystal structures of alkali hexa­fluorido­rhenates(IV) revisited

PubMed Central

Louis-Jean, James; Salamat, Ashkan; Pham, Chien Thang; Poineau, Frederic

2018-01-01

The A 2[ReF6] (A = K, Rb and Cs) salts are isotypic and crystallize in the trigonal space group type P m1, adopting the K2[GeF6] structure type. Common to all A 2[ReF6] structures are slightly distorted octa­hedral [ReF6]2− anions with an average Re—F bond length of 1.951 (8) Å. In those salts, symmetry lowering on the local [ReF6]2− anions from Oh (free anion) to D 3d (solid-state structure) occur. The distortions of the [ReF6]2− anions, as observed in their Raman spectra, are correlated to the size of the counter-cations.

Chemical complexity induced local structural distortion in NiCoFeMnCr high-entropy alloy

DOE PAGES

Zhang, Fuxiang; Tong, Yang; Jin, Ke; ...

2018-06-16

In order to study chemical complexity-induced lattice distortion in high-entropy alloys, the static Debye–Waller (D-W) factor of NiCoFeMnCr solid solution alloy is measured with low temperature neutron diffraction, ambient X-ray diffraction, and total scattering methods. Here, the static atomic displacement parameter of the multi-element component alloy at 0 K is 0.035–0.041 Å, which is obvious larger than that of element Ni (~0 Å). The atomic pair distance between individual atoms in the alloy investigated with extended X-ray absorption fine structure (EXAFS) measurements indicates that Mn has a slightly larger bond distance (~0.4%) with neighbor atoms than that of others.

Syntheses, Raman spectroscopy and crystal structures of alkali hexafluoridorhenates(IV) revisited

DOE PAGES

Louis-Jean, James; Mariappan Balasekaran, Samundeeswari; Smith, Dean; ...

2018-04-06

The A 2[ReF 6] (A = K, Rb and Cs) salts are isotypic and crystallize in the trigonal space group type Pmore » $$\\bar{3}$$m1, adopting the K 2[GeF 6] structure type. Common to all A 2[ReF 6] structures are slightly distorted octa­hedral [ReF 6] 2- anions with an average Re—F bond length of 1.951 (8) Å. In these salts, symmetry lowering on the local [ReF 6] 2- anions from O h (free anion) to D 3d (solid-state structure) occur. The distortions of the [ReF 6] 2- anions, as observed in their Raman spectra, are correlated to the size of the counter-cations.« less

46 CFR 72.05-55 - Furniture and furnishings.

Code of Federal Regulations, 2013 CFR

2013-10-01

... be used on the top surface of such articles. (2) All free standing furniture such as chairs, sofas... incombustible materials with solid sides and bottoms. (c) Passageways and stairway enclosures shall contain only...

46 CFR 72.05-55 - Furniture and furnishings.

Code of Federal Regulations, 2011 CFR

2011-10-01

... be used on the top surface of such articles. (2) All free standing furniture such as chairs, sofas... incombustible materials with solid sides and bottoms. (c) Passageways and stairway enclosures shall contain only...

46 CFR 72.05-55 - Furniture and furnishings.

Code of Federal Regulations, 2014 CFR

2014-10-01

... be used on the top surface of such articles. (2) All free standing furniture such as chairs, sofas... incombustible materials with solid sides and bottoms. (c) Passageways and stairway enclosures shall contain only...

46 CFR 72.05-55 - Furniture and furnishings.

Code of Federal Regulations, 2012 CFR

2012-10-01

... be used on the top surface of such articles. (2) All free standing furniture such as chairs, sofas... incombustible materials with solid sides and bottoms. (c) Passageways and stairway enclosures shall contain only...

Correlation between the severity of critically ill patients and clinical predictors of bronchial aspiration

PubMed Central

de Medeiros, Gisele Chagas; Sassi, Fernanda Chiarion; Zambom, Lucas Santos; de Andrade, Claudia Regina Furquim

2016-01-01

Objective: To determine whether the severity of non-neurological critically ill patients correlates with clinical predictors of bronchial aspiration. Methods: We evaluated adults undergoing prolonged orotracheal intubation (> 48 h) and bedside swallowing assessment within the first 48 h after extubation. We collected data regarding the risk of bronchial aspiration performed by a speech-language pathologist, whereas data regarding the functional level of swallowing were collected with the American Speech-Language-Hearing Association National Outcome Measurement System (ASHA NOMS) scale and those regarding health status were collected with the Sequential Organ Failure Assessment (SOFA). Results: The study sample comprised 150 patients. For statistical analyses, the patients were grouped by ASHA NOMS score: ASHA1 (levels 1 and 2), ASHA2 (levels 3 to 5); and ASHA3 (levels 6 and 7). In comparison with the other patients, those in the ASHA3 group were significantly younger, remained intubated for fewer days, and less severe overall clinical health status (SOFA score). The clinical predictors of bronchial aspiration that best characterized the groups were abnormal cervical auscultation findings and cough after swallowing. None of the patients in the ASHA 3 group presented with either of those signs. Conclusions: Critically ill patients 55 years of age or older who undergo prolonged orotracheal intubation (≥ 6 days), have a SOFA score ≥ 5, have a Glasgow Coma Scale score ≤ 14, and present with abnormal cervical auscultation findings or cough after swallowing should be prioritized for a full speech pathology assessment. PMID:27167432

Is 'gut feeling' by medical staff better than validated scores in estimation of mortality in a medical intensive care unit? - The prospective FEELING-ON-ICU study.

PubMed

Radtke, Anne; Pfister, Roman; Kuhr, Kathrin; Kochanek, Matthias; Michels, Guido

2017-10-01

The aim of the FEELING-ON-ICU study was to compare mortality estimations of critically ill patients based on 'gut feeling' of medical staff and by Acute Physiology And Chronic Health Evaluation (APACHE) II, Simplified Acute Physiology Score (SAPS) II and Sequential Organ Failure Assessment (SOFA). Medical staff estimated patients' mortality risks via questionnaires. APACHE II, SAPS II and SOFA were calculated retrospectively from records. Estimations were compared with actual in-hospital mortality using receiver operating characteristic (ROC) curves and the area under the ROC curve (AUC). 66 critically ill patients (60.6% male, mean age 63±15years (range 30-86)) were evaluated each by a nurse (n=66, male 32.4%) and a physician (n=66, male 67.6%). 15 (22.7%) patients died on the intensive care unit. AUC was largest for estimations by physicians (AUC 0.814 (95% CI 0.705-0.923)), followed by SOFA (AUC 0.749 (95% CI 0.629-0.868)), SAPS II (AUC 0.723 (95% CI 0.597-0.849)), APACHE II (AUC 0.721 (95% CI 0.595-0.847)) and nursing staff (AUC 0.669 (95% CI 0.529-0.810)) (p<0.05 for all results). The concept of physicians' 'gut feeling' was comparable to classical objective scores in mortality estimations of critically ill patients. Concerning practicability physicians' evaluations were advantageous to complex score calculation. Copyright © 2017 Elsevier Inc. All rights reserved.

The predictive value of resting heart rate following osmotherapy in brain injury: back to basics.

PubMed

Hasanpour Mir, Mahsa; Yousefshahi, Fardin; Abdollahi, Mohammad; Ahmadi, Arezoo; Nadjafi, Atabak; Mojtahedzadeh, Mojtaba

2012-12-30

The importance of resting heart rate as a prognostic factor was described in several studies. An elevated heart rate is an independent risk factor for adverse cardiovascular events and total mortality in patients with coronary artery disease, chronic heart failure, and the general population. Also heart rate is elevated in the Multi Organ Dysfunction Syndrome (MODS) and the mortality due to MODS is highly correlated with inadequate sinus tachycardia.To evaluate the value of resting heart rate in predicting mortality in patients with traumatic brain injury along scoring systems like Acute Physiology and Chronic Health Evaluation(APACHE II), Sequential Organ Failure Assessment (SOFA) and Glasgow Coma Score (GCS). By analyzing data which was collected from an open labeled randomized clinical trial that compared the different means of osmotherapy (mannitol vs bolus or infusion hypertonic saline), heart rate, GCS, APACHE II and SOFA score were measured at baseline and daily for 7 days up to 60 days and the relationship between elevated heart rate and mortality during the first 7 days and 60th day were assessed. After adjustments for confounding factors, although there was no difference in mean heart rate between either groups of alive and expired patients, however, we have found a relative correlation between 60th day mortality rate and resting heart rate (P=0.07). Heart rate can be a prognostic factor for estimating mortality rate in brain injury patients along with APACHE II and SOFA scores in patients with brain injury.

Risk Factors for Mortality in Patients with Serratia marcescens Bacteremia

PubMed Central

Kim, Sun Bean; Jeon, Yong Duk; Kim, Jung Ho; Kim, Jae Kyoung; Ann, Hea Won; Choi, Heun; Kim, Min Hyung; Song, Je Eun; Ahn, Jin Young; Jeong, Su Jin; Han, Sang Hoon; Choi, Jun Yong; Song, Young Goo; Kim, June Myung

2015-01-01

Purpose Over the last 30 years, Serratia marcescens (S. marcescens) has emerged as an important pathogen, and a common cause of nosocomial infections. The aim of this study was to identify risk factors associated with mortality in patients with S. marcescens bacteremia. Materials and Methods We performed a retrospective cohort study of 98 patients who had one or more blood cultures positive for S. marcescens between January 2006 and December 2012 in a tertiary care hospital in Seoul, South Korea. Multiple risk factors were compared with association with 28-day all-cause mortality. Results The 28-day mortality was 22.4% (22/98 episodes). In a univariate analysis, the onset of bacteremia during the intensive care unit stay (p=0.020), serum albumin level (p=0.011), serum C-reactive protein level (p=0.041), presence of indwelling urinary catheter (p=0.023), and Sequential Oran Failure Assessment (SOFA) score at the onset of bacteremia (p<0.001) were significantly different between patients in the fatal and non-fatal groups. In a multivariate analysis, lower serum albumin level and an elevated SOFA score were independently associated with 28-day mortality [adjusted odds ratio (OR) 0.206, 95% confidential interval (CI) 0.044-0.960, p=0.040, and adjusted OR 1.474, 95% CI 1.200-1.810, p<0.001, respectively]. Conclusion Lower serum albumin level and an elevated SOFA score were significantly associated with adverse outcomes in patients with S. marcescens bacteremia. PMID:25683980

Risk factors for mortality in patients with Serratia marcescens bacteremia.

PubMed

Kim, Sun Bean; Jeon, Yong Duk; Kim, Jung Ho; Kim, Jae Kyoung; Ann, Hea Won; Choi, Heun; Kim, Min Hyung; Song, Je Eun; Ahn, Jin Young; Jeong, Su Jin; Ku, Nam Su; Han, Sang Hoon; Choi, Jun Yong; Song, Young Goo; Kim, June Myung

2015-03-01

Over the last 30 years, Serratia marcescens (S. marcescens) has emerged as an important pathogen, and a common cause of nosocomial infections. The aim of this study was to identify risk factors associated with mortality in patients with S. marcescens bacteremia. We performed a retrospective cohort study of 98 patients who had one or more blood cultures positive for S. marcescens between January 2006 and December 2012 in a tertiary care hospital in Seoul, South Korea. Multiple risk factors were compared with association with 28-day all-cause mortality. The 28-day mortality was 22.4% (22/98 episodes). In a univariate analysis, the onset of bacteremia during the intensive care unit stay (p=0.020), serum albumin level (p=0.011), serum C-reactive protein level (p=0.041), presence of indwelling urinary catheter (p=0.023), and Sequential Oran Failure Assessment (SOFA) score at the onset of bacteremia (p<0.001) were significantly different between patients in the fatal and non-fatal groups. In a multivariate analysis, lower serum albumin level and an elevated SOFA score were independently associated with 28-day mortality [adjusted odds ratio (OR) 0.206, 95% confidential interval (CI) 0.044-0.960, p=0.040, and adjusted OR 1.474, 95% CI 1.200-1.810, p<0.001, respectively]. Lower serum albumin level and an elevated SOFA score were significantly associated with adverse outcomes in patients with S. marcescens bacteremia.

Intelligent correction of laser beam propagation through turbulent media using adaptive optics

NASA Astrophysics Data System (ADS)

Ko, Jonathan; Wu, Chensheng; Davis, Christopher C.

2014-10-01

Adaptive optics methods have long been used by researchers in the astronomy field to retrieve correct images of celestial bodies. The approach is to use a deformable mirror combined with Shack-Hartmann sensors to correct the slightly distorted image when it propagates through the earth's atmospheric boundary layer, which can be viewed as adding relatively weak distortion in the last stage of propagation. However, the same strategy can't be easily applied to correct images propagating along a horizontal deep turbulence path. In fact, when turbulence levels becomes very strong (Cn 2>10-13 m-2/3), limited improvements have been made in correcting the heavily distorted images. We propose a method that reconstructs the light field that reaches the camera, which then provides information for controlling a deformable mirror. An intelligent algorithm is applied that provides significant improvement in correcting images. In our work, the light field reconstruction has been achieved with a newly designed modified plenoptic camera. As a result, by actively intervening with the coherent illumination beam, or by giving it various specific pre-distortions, a better (less turbulence affected) image can be obtained. This strategy can also be expanded to much more general applications such as correcting laser propagation through random media and can also help to improve designs in free space optical communication systems.

Acute encephalopathy due to angel's trumpet intoxication: A case report and literature review.

PubMed

Takeshima, Shinichi; Neshige, Shuichiro; Hara, Naoyuki; Kubo, Tomoshi; Himeno, Takahiro; Kuriyama, Masaru

2017-05-27

We report two cases (a married couple) of intoxication due to angel's trumpet ingestion. Case 1: A 71-year-old woman was found lying unconscious on the sofa at home and was brought to our hospital by ambulance. She showed mydriatic anisocoria, and an intracerebral lesion was suspected. However, the brain magnetic resonance imaging showed no abnormal lesion and acute encephalopathy of unknown cause was diagnosed. Case 2: A 68-year-old man (husband of the patient of Case 1) showed alteration of consciousness with agitation and was admitted to our hospital on the next day. He also had slight mydriasis. As his manifestations were similar to those of his wife, we studied their medical history again. We found that they mistook the roots of angel's trumpet for burdock and cooked and ate them. This intoxication causes characteristic encephalopathy with altered consciousness and mydriasis. In the case of anisocoria or mild mydriasis, the diagnosis is difficult sometimes. The intoxication occurred within a family; this was a clue to the correct diagnosis. Severe cases exhibit pyramidal signs and symptoms or convulsion, and deaths have been reported. Angel's trumpet intoxication is an important neurological emergency.

Comparison of the plenoptic sensor and the Shack-Hartmann sensor.

PubMed

Ko, Jonathan; Davis, Christopher C

2017-05-01

Adaptive optics has been successfully used for decades in the field of astronomy to correct for atmospheric turbulence. A well-developed example involves sensing the slightly distorted wavefronts with a Shack-Hartmann sensor and then correcting them with a phase conjugate device. While the Shack-Hartmann sensor has proven effective for astronomical purposes, it has been less successful for use in deep turbulence conditions often found in ground-to-ground-based optical systems. We have studied an alternative way to sense and correct distorted wavefronts using a plenoptic sensor. We review the design of the plenoptic sensor and directly compare it with the well-known Shack-Hartmann sensor. An experimental comparison of the plenoptic sensor and the Shack-Hartmann sensor is performed to highlight their differences in real-world atmospheric turbulence conditions.

Apply 3D model on the customized product color combination for the interior decoration

NASA Astrophysics Data System (ADS)

Chen, Cheih-Ying

2013-03-01

The customized product color interface for the interior decoration is designed to simulate the display of various color combination sofas in the interior of the room. There are 144 color combinations of the spatial image resulted from four the interior rooms and 36 popular color sofas. The image compositing technique is adopted to appear the 144 color combinations of the spatial image on computer screen. This study tests the experience of using the interface by the questionnaire for User Interface Satisfaction (QUIS). The results show that the high grade of evaluation items including wonderful, easy, satisfying, stimulating and flexible for the experience of users. Therefore, the entrepreneur who wants to display the color primarily commodity could using the customized color combination interface with 3D models for consumers to take opportunity to find the appropriate products to meet with the interior room, so as to shorten communication time between entrepreneurs and consumers.

High Reynolds Number Investigation of a Flush-Mounted, S-Duct Inlet With Large Amounts of Boundary Layer Ingestion

NASA Technical Reports Server (NTRS)

Berrier, Bobby L.; Carter, Melissa B.; Allan, Brian G.

2005-01-01

An experimental investigation of a flush-mounted, S-duct inlet with large amounts of boundary layer ingestion has been conducted at Reynolds numbers up to full scale. The study was conducted in the NASA Langley Research Center 0.3-Meter Transonic Cryogenic Tunnel. In addition, a supplemental computational study on one of the inlet configurations was conducted using the Navier-Stokes flow solver, OVERFLOW. Tests were conducted at Mach numbers from 0.25 to 0.83, Reynolds numbers (based on aerodynamic interface plane diameter) from 5.1 million to 13.9 million (full-scale value), and inlet mass-flow ratios from 0.29 to 1.22, depending on Mach number. Results of the study indicated that increasing Mach number, increasing boundary layer thickness (relative to inlet height) or ingesting a boundary layer with a distorted profile decreased inlet performance. At Mach numbers above 0.4, increasing inlet airflow increased inlet pressure recovery but also increased distortion. Finally, inlet distortion was found to be relatively insensitive to Reynolds number, but pressure recovery increased slightly with increasing Reynolds number.

Contemporary Patterns of Multiple Organ Dysfunction in Trauma.

PubMed

Shepherd, Joanna M; Cole, Elaine; Brohi, Karim

2017-04-01

Multiple organ dysfunction syndrome (MODS) is associated with poor outcomes for trauma patients. Different forms of MODS may exist and have different consequences. The ability to distinguish them clinically may have implications for prognosis and treatment. We wished to study whether prolonged MODS (PRMODS) could be observed as a distinct clinical entity to early resolving MODS (ERMODS) in critically injured patients. Adult major trauma patients recruited to a prospective observational study at a single major trauma center were eligible for inclusion. MODS was defined as Sequential Organ Failure Assessment (SOFA) score >5; and PRMODS as lasting >7 days. Time to recovery (TTR) was calculated as the number of days before the SOFA fell below the MODS threshold (≤5). Five hundred ninety-five patients were enrolled of whom 285 developed ERMODS (48%) and 184 (31%) PRMODS. Organ dysfunction was more severe and protracted in PRMODS, especially in patients without brain injury (mean SOFA 11 vs. 6, Day 2, P < 0.001; TTR 17 vs. 3 days, P < 0.001). PRMODS exhibited higher rates of hepatic and renal dysfunction (84% vs. 56%; and 78% vs. 47%, P≤0.001). Patterns of recovery were distinct in hepatic, renal, and neurological systems (TTR 15 vs. 4; 20 vs. 3; and 28 vs. 7 days, P < 0.01). PRMODS was associated with higher infection and mortality rates (91% vs. 41%; and 22% vs. 7%, P < 0.001). PRMODS appears common, a distinct clinical entity, and associated with worse patient outcomes. PRMODS may represent an important endpoint for studies evaluating outcomes following trauma.

Robust expertise effects in right FFA

PubMed Central

McGugin, Rankin Williams; Newton, Allen T; Gore, John C; Gauthier, Isabel

2015-01-01

The fusiform face area (FFA) is one of several areas in occipito-temporal cortex whose activity is correlated with perceptual expertise for objects. Here, we investigate the robustness of expertise effects in FFA and other areas to a strong task manipulation that increases both perceptual and attentional demands. With high-resolution fMRI at 7Telsa, we measured responses to images of cars, faces and a category globally visually similar to cars (sofas) in 26 subjects who varied in expertise with cars, in (a) a low load 1-back task with a single object category and (b) a high load task in which objects from two categories rapidly alternated and attention was required to both categories. The low load condition revealed several areas more active as a function of expertise, including both posterior and anterior portions of FFA bilaterally (FFA1/FFA2 respectively). Under high load, fewer areas were positively correlated with expertise and several areas were even negatively correlated, but the expertise effect in face-selective voxels in the anterior portion of FFA (FFA2) remained robust. Finally, we found that behavioral car expertise also predicted increased responses to sofa images but no behavioral advantages in sofa discrimination, suggesting that global shape similarity to a category of expertise is enough to elicit a response in FFA and other areas sensitive to experience, even when the category itself is not of special interest. The robustness of expertise effects in right FFA2 and the expertise effects driven by visual similarity both argue against attention being the sole determinant of expertise effects in extrastriate areas. PMID:25192631

Prognosis Biomarkers of Severe Sepsis and Septic Shock by 1H NMR Urine Metabolomics in the Intensive Care Unit

PubMed Central

Modesto-Alapont, Vicente; Gonzalez-Marrachelli, Vannina; Vento-Rehues, Rosa; Jorda-Miñana, Angela; Blanquer-Olivas, Jose; Monleon, Daniel

2015-01-01

Early diagnosis and patient stratification may improve sepsis outcome by a timely start of the proper specific treatment. We aimed to identify metabolomic biomarkers of sepsis in urine by 1H-NMR spectroscopy to assess the severity and to predict outcomes. Urine samples were collected from 64 patients with severe sepsis or septic shock in the ICU for a 1H NMR spectra acquisition. A supervised analysis was performed on the processed spectra, and a predictive model for prognosis (30-days mortality/survival) of sepsis was constructed using partial least-squares discriminant analysis (PLS-DA). In addition, we compared the prediction power of metabolomics data respect the Sequential Organ Failure Assessment (SOFA) score. Supervised multivariate analysis afforded a good predictive model to distinguish the patient groups and detect specific metabolic patterns. Negative prognosis patients presented higher values of ethanol, glucose and hippurate, and on the contrary, lower levels of methionine, glutamine, arginine and phenylalanine. These metabolites could be part of a composite biopattern of the human metabolic response to sepsis shock and its mortality in ICU patients. The internal cross-validation showed robustness of the metabolic predictive model obtained and a better predictive ability in comparison with SOFA values. Our results indicate that NMR metabolic profiling might be helpful for determining the metabolomic phenotype of worst-prognosis septic patients in an early stage. A predictive model for the evolution of septic patients using these metabolites was able to classify cases with more sensitivity and specificity than the well-established organ dysfunction score SOFA. PMID:26565633

The predictive value of resting heart rate following osmotherapy in brain injury: back to basics

PubMed Central

2012-01-01

Background The importance of resting heart rate as a prognostic factor was described in several studies. An elevated heart rate is an independent risk factor for adverse cardiovascular events and total mortality in patients with coronary artery disease, chronic heart failure, and the general population. Also heart rate is elevated in the Multi Organ Dysfunction Syndrome (MODS) and the mortality due to MODS is highly correlated with inadequate sinus tachycardia. To evaluate the value of resting heart rate in predicting mortality in patients with traumatic brain injury along scoring systems like Acute Physiology and Chronic Health Evaluation(APACHE II), Sequential Organ Failure Assessment (SOFA) and Glasgow Coma Score (GCS). Method By analyzing data which was collected from an open labeled randomized clinical trial that compared the different means of osmotherapy (mannitol vs bolus or infusion hypertonic saline), heart rate, GCS, APACHE II and SOFA score were measured at baseline and daily for 7 days up to 60 days and the relationship between elevated heart rate and mortality during the first 7 days and 60th day were assessed. Results After adjustments for confounding factors, although there was no difference in mean heart rate between either groups of alive and expired patients, however, we have found a relative correlation between 60th day mortality rate and resting heart rate (P=0.07). Conclusion Heart rate can be a prognostic factor for estimating mortality rate in brain injury patients along with APACHE II and SOFA scores in patients with brain injury. PMID:23351393

Variceal bleeding in cirrhotic patients: What is the best prognostic score?

PubMed

Mohammad, Asmaa N; Morsy, Khairy H; Ali, Moustafa A

2016-09-01

To find the most accurate, suitable, and applicable scoring system for the prediction of outcome in cirrhotic patients with bleeding varices. A prospective study was conducted comprising 120 cirrhotic patients with acute variceal bleeding who were admitted to Tropical Medicine and Gastroenterology Department in Sohag University Hospital, over a 1-year period (1/2015 to 1/2016). The clinical, laboratory, and endoscopic parameters were studied. Child-Turcotte-Pugh (CTP) classification score, Model for end-stage liver disease (MELD) score, acute physiology and chronic health evaluation II (APACHE II) score, sequential organ failure assessment (SOFA) score, and AIMS65 score were calculated for all patients. Univariate and multivariate analyses were performed for all the measured parameters and scores. Of the 120 patients (92 male) admitted during the study period, eight patients (6.67%) died in the hospital. Advanced age, the presence of encephalopathy, rebleeding, and higher serum bilirubin were independent factors associated with higher hospital mortality. The largest area under the receiver operator curve (AUROC) was obtained for the AIMS65 score and SOFA score, followed by the MELD score and APACHEII score, then CTP score, all of which achieved very good performance (AUROC>0.8). AIMS65 score showed the best sensitivity, specificity, and negative and positive predictive values. Although the AIMS65 score was not significantly different from the MELD, SOFA, and APACHEII scores, it was the optimum among them in terms of the prediction of mortality. AIMS65 score is the best simple and applicable scoring system for independently predicting mortality in cirrhotic patients with acute variceal bleeding.

Fluid overload and survival in critically ill patients with acute kidney injury receiving continuous renal replacement therapy

PubMed Central

Kim, Il Young; Kim, Joo Hui; Lee, Dong Won; Lee, Soo Bong; Rhee, Harin; Seong, Eun Young; Kwak, Ihm Soo

2017-01-01

Background Fluid overload is known to be associated with increased mortality in patients with acute kidney injury (AKI) who are critically ill. In this study, we intended to uncover whether the adverse effect of fluid overload on survival could be applied to all of the patients with AKI who received continuous renal replacement therapy (CRRT). Methods We analyzed 341 patients with AKI who received CRRT in our intensive care units. The presence of fluid overload was defined as a minimum 10% increase in body weight from the baseline. Demographics, comorbid diseases, clinical data, severity of illness [the sequential organ failure assessment (SOFA) score, number of vasopressors, diagnosis of sepsis, use of ventilator] upon ICU admission, fluid overload status, and time elapsed from AKI diagnosis until CRRT initiation were reviewed from the medical charts. Results Patients with total fluid overload from 3 days before CRRT initiation to ICU discharge had a significantly lower survival rate after ICU admission, as compared to patients with no fluid overload (P < 0.001). Among patients with sepsis (P < 0.001) or with high SOFA scores (P < 0.001), there was a significant difference in survival of the patients with and without fluid overload. In patients without sepsis or with low SOFA score, there was no significant difference in survival of patients irrespective of fluid overload. Conclusion Our study demonstrates that the adverse effect of fluid overload on survival is more evident in patients with sepsis or with more severe illness, and that it might not apply to patients without sepsis or with less severe illness. PMID:28196107

Using a plenoptic camera to measure distortions in wavefronts affected by atmospheric turbulence

NASA Astrophysics Data System (ADS)

Eslami, Mohammed; Wu, Chensheng; Rzasa, John; Davis, Christopher C.

2012-10-01

Ideally, as planar wave fronts travel through an imaging system, all rays, or vectors pointing in the direction of the propagation of energy are parallel, and thus the wave front is focused to a particular point. If the wave front arrives at an imaging system with energy vectors that point in different directions, each part of the wave front will be focused at a slightly different point on the sensor plane and result in a distorted image. The Hartmann test, which involves the insertion of a series of pinholes between the imaging system and the sensor plane, was developed to sample the wavefront at different locations and measure the distortion angles at different points in the wave front. An adaptive optic system, such as a deformable mirror, is then used to correct for these distortions and allow the planar wave front to focus at the point desired on the sensor plane, thereby correcting the distorted image. The apertures of a pinhole array limit the amount of light that reaches the sensor plane. By replacing the pinholes with a microlens array each bundle of rays is focused to brighten the image. Microlens arrays are making their way into newer imaging technologies, such as "light field" or "plenoptic" cameras. In these cameras, the microlens array is used to recover the ray information of the incoming light by using post processing techniques to focus on objects at different depths. The goal of this paper is to demonstrate the use of these plenoptic cameras to recover the distortions in wavefronts. Taking advantage of the microlens array within the plenoptic camera, CODE-V simulations show that its performance can provide more information than a Shack-Hartmann sensor. Using the microlens array to retrieve the ray information and then backstepping through the imaging system provides information about distortions in the arriving wavefront.

Crystal structure of (2-{[(8-aminona-phthalen-1-yl)imino]-meth-yl}-4,6-di-tert-butyl-phenolato-κ3N,N',O)bromido-nickel(II).

PubMed

O'Brien, Patrick; Zeller, Matthias; Lee, Wei-Tsung

2018-04-01

The title compound, [NiBr(C 25 H 29 N 2 O)], contains an Ni II atom with a slightly distorted square-planar coordination environment defined by one O and two N atoms from the 2-{[(8-aminona-phthalen-1-yl)imino]-meth-yl}-4,6-di- tert -butyl-phenolate ligand and a bromide anion. The Ni-O and Ni-N bond lengths are slightly longer than those observed in the phenyl backbone counterpart, which can be attributed to the larger steric hindrance of the naphthyl group in the structure of the title compound. The mol-ecule as a whole is substanti-ally distorted, with both the planar naphthalene-1,8-di-amine and imino-meth-yl-phenolate substitutents rotated against the NiN 2 OBr plane by 38.92 (7) and 37.22 (8)°, respectively, giving the mol-ecule a twisted appearance. N-H⋯Br hydrogen bonds and N-H⋯C(π) contacts connect the mol-ecules into dimers, and additional C-H⋯Br contacts, C-H⋯π inter-actions, and an offset stacking inter-action between naphthyl units inter-connect these dimers into a three-dimensional network.

32 CFR 651.54 - Introduction.

Code of Federal Regulations, 2012 CFR

2012-07-01

... for Significant Impacts Outside the United States) provide guidance for analyzing the environmental impacts of Army actions abroad and in the global commons. Army components will, consistent with diplomatic factors (including applicable Status of Forces Agreements (SOFAs) and stationing agreements), national...

32 CFR 651.54 - Introduction.

Code of Federal Regulations, 2014 CFR

2014-07-01

... for Significant Impacts Outside the United States) provide guidance for analyzing the environmental impacts of Army actions abroad and in the global commons. Army components will, consistent with diplomatic factors (including applicable Status of Forces Agreements (SOFAs) and stationing agreements), national...

32 CFR 651.54 - Introduction.

Code of Federal Regulations, 2013 CFR

2013-07-01

... for Significant Impacts Outside the United States) provide guidance for analyzing the environmental impacts of Army actions abroad and in the global commons. Army components will, consistent with diplomatic factors (including applicable Status of Forces Agreements (SOFAs) and stationing agreements), national...

32 CFR 651.54 - Introduction.

Code of Federal Regulations, 2011 CFR

2011-07-01

... for Significant Impacts Outside the United States) provide guidance for analyzing the environmental impacts of Army actions abroad and in the global commons. Army components will, consistent with diplomatic factors (including applicable Status of Forces Agreements (SOFAs) and stationing agreements), national...

Albumin supplementation for hypoalbuminemia following burns: unnecessary and costly!

PubMed

Melinyshyn, Alex; Callum, Jeannie; Jeschke, Marc C; Cartotto, Robert

2013-01-01

Following fluid resuscitation, patients with major burns frequently develop prolonged hypoalbuminemia. It is not known whether this should be corrected by albumin supplementation. The purpose of this study was to determine whether there are any benefits associated with albumin supplementation to correct hypoalbuminemia in burned adults. We conducted a retrospective comparison of patients with burns ≥ 20% TBSA admitted to an adult regional American Burn Association-verified burn center, from May 1, 2009, to September 30, 2010, where we did not routinely supplement albumin (control group), with patients admitted from October 1, 2010, to May 30, 2011, where we had instituted a protocol in which 5% human albumin was provided to maintain serum albumin levels >20 g/L (albumin group). Comparisons were made from postburn (PB) day 2 to day 30 inclusive. There were no significant differences between control (n = 26) and albumin (n = 17) in age (48 ± 15 vs 45 ± 21 years; P = .56), burn size (33 ± 13 vs 34 ± 13 %TBSA; P = .831), or full thickness burn size (19 ± 19 vs 23 ± 19 %TBSA; P = .581). Inhalation injury was significantly more frequent in the albumin group than in controls (71% vs 31%; P = .01). The groups did not differ significantly in need for admission escharotomy, admission Sequential Organ Failure Assessment (SOFA) score, number of surgical procedures/first 30 days, or 24 and 48 hours fluid resuscitation volume requirements. The overall mean daily serum albumin level from PB day 2 to 30 in the albumin group (26.9 ± 3.0 g/L) was significantly greater than in controls (21.9 ± 4.4 g/L; P < .001). There were no significant differences between the groups in daily SOFA score/first 30 days, peak SOFA score, ΔSOFA, hospital length of stay, time to wound healing, duration of mechanical ventilation, or 30-day and in-hospital mortality. The cost of routinely supplementing 5% albumin between PB day 2 to 30 in the albumin group was more than four times that for the controls where we did not routinely provide albumin (Can $65.50 vs Can $16.57 per patient per day). We conclude that routine supplementation of 5% human albumin to maintain a serum albumin level ≥ 20 g/L in burn patients is expensive and provides no benefit.

Effects of Mn Substitution on the Thermoelectric Properties and Thermal Excitations of the Electron-doped Perovskite Sr1-xLaxTiO3

NASA Astrophysics Data System (ADS)

Okuda, Tetsuji; Hata, Hiroto; Eto, Takahiro; Sobaru, Shogo; Oda, Ryosuke; Kaji, Hiroki; Nishina, Kousuke; Kuwahara, Hideki; Nakamura, Mitsutaka; Kajimoto, Ryoichi

2016-09-01

We studied how Mn substitution affects the thermoelectric properties and thermal excitations of the electron-doped perovskite Sr1-xLaxTiO3 by measuring its electrical and thermal transport properties, magnetization, specific heat, and inelastic neutron scattering. Slight Mn substitution with the lattice defects enhanced the Seebeck coefficient, perhaps because of coupling between itinerant electrons and localized spins or between itinerant electrons and local lattice distortion around Mn3+ ions, while it enhanced anharmonic lattice vibrations, which effectively suppressed thermal conductivity in a state of high electrical conductivity. Consequently, slight Mn substitution increased the dimensionless thermoelectric figure of merit for Sr1-xLaxTiO3 near room temperature.

Modified plenoptic camera for phase and amplitude wavefront sensing

NASA Astrophysics Data System (ADS)

Wu, Chensheng; Davis, Christopher C.

2013-09-01

Shack-Hartmann sensors have been widely applied in wavefront sensing. However, they are limited to measuring slightly distorted wavefronts whose local tilt doesn't surpass the numerical aperture of its micro-lens array and cross talk of incident waves on the mrcro-lens array should be strictly avoided. In medium to strong turbulence cases of optic communication, where large jitter in angle of arrival and local interference caused by break-up of beam are common phenomena, Shack-Hartmann sensors no longer serve as effective tools in revealing distortions in a signal wave. Our design of a modified Plenoptic Camera shows great potential in observing and extracting useful information from severely disturbed wavefronts. Furthermore, by separating complex interference patterns into several minor interference cases, it may also be capable of telling regional phase difference of coherently illuminated objects.

[N,N-Bis(2,6-diisopropyl­phen­yl)pent-2-ene-2,4-diiminato(1−)]bis­(1,2,4-diaza­phosphol-1-yl)aluminium(III)

PubMed Central

Yang, Dongming; Pi, Chengfu; Ding, Yuqiang; Zheng, Wenjun

2010-01-01

In the title compound, [Al(C29H41N2)(C2H2N2P)2], the AlIII atom is coordinated by four N atoms from β-diketiminate and 1,2,4-diaza­phospho­lide ligands in a slightly distorted tetra­hedral fashion. PMID:21589338

An Independent Evaluation of the Switching Operations Facility Analysis 2010 Working Group's Processes

DOT National Transportation Integrated Search

2009-12-01

The Switching Operations Fatality Analysis (SOFA) Working Group was formed to analyze the factors contributing to fatalities in switching operations. The 2010 Working Group invited an independent team of evaluators to assess the thoroughness of the S...

Structural and conformational analysis of pentostatin (2'-deoxycoformycin), a potent inhibitor of adenosine deaminase.

PubMed

Cox, M B; Arjunan, P; Arora, S K

1990-08-01

X-ray, NMR and molecular mechanics studies on pentostatin (C11H16N4O4), a potent inhibitor of the enzyme adenosine deaminase, have been carried out to study the structure and conformation. The crystals belong to the monoclinic space group P21 with the cell dimensions of a = 4.960(1), b = 10.746(3), c = 11.279(4)A, beta = 101.18(2) degrees and Z = 2. The structure was solved by direct methods and difference Fourier methods and refined to an R value of 0.047 for 997 reflections. The trihydrodiazepine ring is nonplanar and adopts a distorted sofa conformation with C(7) deviated from the mean plane by 0.66A. The deoxyribose ring adopts a C3'-endo conformation, different from coformycin where the sugar has a C2'-endo conformation. The observed glycosidic torsion angle (chi = -119.5 degrees) is in the anti range. The conformation about the C(4')-C(5') bond is gauche+. The conformation of the molecule is compared with that of coformycin and 2-azacoformycin. 1 and 2D NMR studies have been carried out and the dihedral angles obtained from coupling constants have been compared with those obtained from the crystal structure. The conformation of deoxyribose in solution is approximately 70% S and 30% N. Molecular mechanics studies were performed to obtain the energy minimized conformation, which is compared with X-ray and NMR results.

Early prediction of norepinephrine dependency and refractory septic shock with a multimodal approach of vascular failure.

PubMed

Conrad, Marie; Perez, Pierre; Thivilier, Carine; Levy, Bruno

2015-08-01

The purpose of the study is to improve our ability to detect catecholamine dependency and refractory septic shock. Fifty-one patients with septic shock were studied within the first 4 hours of norepinephrine administration. Patients were divided into 2 groups according to their evolution in the intensive care unit, namely, group A, shock reversal, and group B, no shock reversal. Reversal of shock was defined as the maintenance of a systolic blood pressure greater than or equal to 90 mm Hg without vasopressor support for 24 hours or more. Vascular reactivity was tested using incremental doses of phenylephrine. Muscle tissue oxygen saturation and its changes during a vascular occlusion test were measured. Group B patients had a higher Sequential Organ Failure Assessment (SOFA) score and lactate level and more frequently received norepinephrine and renal replacement. Overall mortality was 100% in group B (16/16) and 20% (7/35) in group A. Phenylephrine increased mean arterial pressure in a dose-dependent manner more significantly in group A patients than in group B (P = .0004). Basal tissue oxygen saturation and the recovery slope after vascular occlusion test were lower in group B. In multivariate analysis, 4 parameters remained independently associated with mortality: the increase in mean arterial pressure at phenylephrine 6 μg/kg per minute, the recovery slope, SOFA score, and norepinephrine doses at H0. The intensity of septic shock-induced vascular hyporesponsiveness to vasopressor is tightly linked to septic shock severity and evolution and may potentially be identified early with simple to obtain parameters such as near-infrared spectroscopy value, SOFA score, or norepinephrine dose. Copyright © 2015 Elsevier Inc. All rights reserved.

Clinical features, complications and mortality in critically ill patients with 2009 influenza A(H1N1) in Sfax,Tunisia.

PubMed

Damak, Hassen; Chtara, Kamilia; Bahloul, Mabrouk; Kallel, Hatem; Chaari, Anis; Ksibi, Hichem; Chaari, Adel; Chelly, Hedi; Rekik, Noureddine; Ben Hamida, Chokri; Bouaziz, Mounir

2011-07-01

Africa, as the rest of the world, was touched by the 2009 pandemic influenza A(H1N1). In the literature, a few publications covering this subject emerged from this continent. We prospectively describe baseline characteristics, treatment and outcomes of consecutive critically ill patients with confirmed 2009 influenza A(H1N1) in the intensive care unit (ICU) of Sfax hospital. From 29 November 2009 through 21 January 2010, 32 patients with confirmed 2009 influenza A(H1N1) were admitted to our ICU. We prospectively analysed data and outcomes of these patients and compared survivors and dead patients to identify any predictors of death. Patients were young (mean, 36·1 [SD], 20·7 years) and 21 (65·6%) of whom had co-morbidities. During ICU care, 29 (90·6%) patients had respiratory failure; among these, 15 (46·9%) patients required invasive ventilation with a median duration of 9 (IQR 3-12) days. In our experience, respiratory dysfunction can remain isolated but may also be associated with other dysfunctions or complications, such as, septic shock, seizures, myasthenia gravis exacerbation, Guillan-Barre syndrome, acute renal failure, nosocomial infections and biological disturbances. The nine patients (28·1%) who died had greater initial severity of illness (SAPS II and sequential organ failure assessment (SOFA) scores) but also a higher SOFA score and increasing severity of organ dysfunction during their ICU evolution. Critical illness from the 2009 influenza A(H1N1) in Sfax occurred in young individuals and was associated with severe acute respiratory and additional organ system failure. SAPS II and SOFA scores at ICU admission, and also during evolution, constitute a good predictor of death. © 2011 Blackwell Publishing Ltd.

Hypophosphatemia after nontraumatic intracranial hemorrhage.

PubMed

Junttila, E; Koskenkari, J; Ala-Kokko, T

2017-07-01

The aim of this study was to assess the incidence and contributing factors of hypophosphatemia and the association with poor long-term outcome after nontraumatic intracranial hemorrhage. This was a prospective, observational study of patients with nontraumatic intracranial hemorrhage (i.e., aneurysmal or perimesencephalic subarachnoid hemorrhage, or spontaneous intracerebral or intraventricular hemorrhage) treated in the intensive care unit (ICU) at our university hospital. Plasma phosphate concentrations were measured serially in 2-day sections during the 6 day study period. The ICU mortality was recorded, 3-month and 1-year outcomes were assessed using the Glasgow Outcome Scale. One hundred patients were enrolled. The frequency of hypophosphatemia (Pi ≤ 0.65 mmol/l) was 70%. Chronic hypertension, acute hydrocephalus, and diffuse brain edema were more common in patients with hypophosphatemia compared with normophosphatemics (44% vs. 21%, P = 0.021; 59% vs. 33%, P = 0.021; and 43% vs. 13%, P = 0.004, respectively). Hypophosphatemic patients had higher maximum SOFA scores [10 (7-11) vs. 7.5 (5.75-10), P = 0.024]. Initial phosphate concentration correlated inversely with APACHE II score on admission (ρ = -0.304, P = 0.002) and SOFA score on the first ICU day (ρ = -0.269, P = 0.008). There was no difference in outcome between hypophosphatemic and normophosphatemic patients. In all five patients with severe hypophosphatemia (Pi < 0.32 mmol/l) the functional outcome was good. Hypophosphatemia was common in this patient population. The outcome was similar between hypophosphatemic and normophosphatemic patients. Chronic hypertension, acute hydrocephalus, diffuse brain edema and higher SOFA scores were more common in patients with hypophosphatemia. © 2017 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Daily laxative therapy reduces organ dysfunction in mechanically ventilated patients: a phase II randomized controlled trial.

PubMed

de Azevedo, Rodrigo Palacio; Freitas, Flávio Geraldo Resende; Ferreira, Elaine Maria; Pontes de Azevedo, Luciano Cesar; Machado, Flávia Ribeiro

2015-09-16

Constipation is a common problem in intensive care units. We assessed the efficacy and safety of laxative therapy aiming to promote daily defecation in reducing organ dysfunction in mechanically ventilated patients. We conducted a prospective, randomized, controlled, nonblinded phase II clinical trial at two general intensive care units. Patients expected to remain ventilated for over 3 days were randomly assigned to daily defecation or control groups. The intervention group received lactulose and enemas to produce 1-2 defecations per day. In the control group, absence of defecation was tolerated up to 5 days. Primary outcome was the change in Sequential Organ Failure Assessment (SOFA) score between the date of enrollment and intensive care unit discharge, death or day 14. We included 88 patients. Patients in the treatment group had a higher number of defecations per day (1.3 ± 0.42 versus 0.7 ± 0.56, p < 0.0001) and lower percentage of days without defecation (33.1 ± 15.7% versus 62.3 ± 24.5%, p < 0.0001). Patients in the intervention group had a greater reduction in SOFA score (-4.0 (-6.0 to 0) versus -1.0 (-4.0 to 1.0), p = 0.036) with no difference in mortality rates or in survival time. Adverse events were more frequent in the treatment group (4.5 (3.0-8.0) versus 3.0 (1.0-5.7), p = 0.016), including more days with diarrhea (2.0 (1.0-4.0) versus 1.0 (0-2.0) days, p < 0.0001). Serious adverse events were rare and did not significantly differ between groups. Laxative therapy improved daily defecation in ventilated patients and was associated with a greater reduction in SOFA score. Clinical Trials.gov NCT01607060, registered 24 May 2012.

Evolution and prognosis of long intensive care unit stay patients suffering a deterioration: A multicenter study.

PubMed

Hernández-Tejedor, Alberto; Cabré-Pericas, Lluís; Martín-Delgado, María Cruz; Leal-Micharet, Ana María; Algora-Weber, Alejandro

2015-06-01

The prognosis of a patient who deteriorates during a prolonged intensive care unit (ICU) stay is difficult to predict. We analyze the prognostic value of the serialized Sequential Organ Failure Assessment (SOFA) score and other variables in the early days after a complication and to build a new predictive score. EPIPUSE (Evolución y pronóstico de los pacientes con ingreso prolongado en UCI que sufren un empeoramiento, Evolution and prognosis of long intensive care unit stay patients suffering a deterioration) study is a prospective, observational study during a 3-month recruitment period in 75 Spanish ICUs. We focused on patients admitted in the ICU for 7 days or more with complications of adverse events that involve organ dysfunction impairment. Demographics, clinical variables, and serialized SOFA after a supervening clinical deterioration were recorded. Univariate and multivariate analyses were performed, and a predictive model was created with the most discriminating variables. We included 589 patients who experienced 777 cases of severe complication or adverse event. The entire sample was randomly divided into 2 subsamples, one for development purposes (528 cases) and the other for validation (249 cases). The predictive model maximizing specificity is calculated by minimum SOFA + 2 * cardiovascular risk factors + 2 * history of any oncologic disease or immunosuppressive treatment + 3 * dependence for basic activities of daily living. The area under the receiver operating characteristic curve is 0.82. A 14-point cutoff has a positive predictive value of 100% (92.7%-100%) and negative predictive value of 51% (46.4%-55.5%) for death. EPIPUSE model can predict mortality with a specificity and positive predictive value of 99% in some groups of patients. Copyright © 2015 Elsevier Inc. All rights reserved.

Mortality of adult intensive care units in Turkey using the APACHE II and SOFA systems (outcome assessment in Turkish intensive care units).

PubMed

Kaymak, Cetin; Sencan, Irfan; Izdes, Seval; Sari, Aydin; Yagmurdur, Hatice; Karadas, Derya; Oztuna, Derya

2018-04-01

The aim of this study was to evaluate intensive care unit (ICU) performance using risk-adjusted ICU mortality rates nationally, assessing patients who died or had been discharged from the ICU. For this purpose, this study analyzed the Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) databases, containing detailed clinical and physiological information and mortality of mixed critically ill patients in a medical ICU at secondary and tertiary referral ICUs in Turkey. A total of 690 adult intensive care units in Turkey were included in the study. Among 690 ICUs evaluated, 39.7% were secondary and 60.3% were tertiary ICUs. A total of 4188 patients were enrolled in this study. Intensive care units of ministry, university, and private hospitals were evaluated all over Turkey. During the study period, clinical data that were collected concurrently for each patient contained demographic details and the diagnostic category leading to ICU admission. APACHE II and SOFA scores following ICU admission were calculated and recorded. Patients were followed up for outcome data until death or ICU discharge. The mean age of patients was 68.8 ±19 and 54% of them were male. The mean APACHE II score was 20 ±8.7. The ICUs' mortality rate was 46.3%, and mean predicted mortality was 37.2% for APACHE II. The standardized mortality ratio was 1.28 (95% confidence interval: 1.21-1.31). There was a wide difference in outcome for patients admitted to different ICUs and severity of illness using risk adjustment methods. The high mortality rate in patients could be related to comorbid diseases, high mechanical ventilation rates and older ages.

Early thrombomodulin-α administration outcome for acute disseminated intravascular coagulopathy in gastrointestinal surgery.

PubMed

Konishi, Hirotaka; Okamoto, Kazuma; Shoda, Katsutoshi; Arita, Tomohiro; Kosuga, Toshiyuki; Morimura, Ryo; Komatsu, Shuhei; Murayama, Yasutoshi; Shiozaki, Atsushi; Kuriu, Yoshiaki; Ikoma, Hisashi; Nakanishi, Masayoshi; Ichikawa, Daisuke; Fujiwara, Hitoshi; Otsuji, Eigo

2017-02-07

To investigate the efficacy of thrombomodulin (TM)-α for treatment of disseminated intravascular coagulopathy (DIC) in the field of gastrointestinal surgery. Thirty-six peri-operative DIC patients in the field of gastrointestinal surgery who were treated with TM-α were retrospectively investigated. The relationships between patient demographics and the efficacy of TM-α were examined. Analysis of survival at 28 d was also performed on some parameters by means of the Kaplan-Meier method. Relationships between the initiation of TM-α and patient demographics were also evaluated. Abscess formation or bacteremia was the most frequent cause of DIC (33%), followed by digestive tract perforation (31%). Twenty-six patients developed DIC after surgery, frequently within 1 wk (81%). TM-α was most often administered within 1 d of the DIC diagnosis (72%) and was continued for more than 3 d (64%). Although bleeding tendency was observed in 7 patients (19%), a hemostatic procedure was not needed. DIC scores, systemic inflammatory response syndrome (SIRS) scores, quick-sequential organ failure assessment (qSOFA) scores, platelet counts, and prothrombin time ratios significantly improved after 1 wk ( P < 0.05, for all). The overall survival rate at 28 d was 71%. The duration of TM-α administration (≥ 4 , ≤ 6) and improvements in DIC-associated scores (DIC, SIRS and qSOFA) at 1 wk were significantly better prognostic factors for 28-d survival ( P < 0.05, for all). TM-α was administered significantly earlier to patients with severe clinical symptoms, such as high qSOFA scores, sepsis, shock or high lactate values ( P < 0.05, for all). Early administration of TM-α and improvements in each parameter were essential for treatment of DIC. The diagnosis of patients with mild symptoms requires further study.

Two-thirds of foods consumed on myplate contain SoFAS

USDA-ARS?s Scientific Manuscript database

Background: Public health efforts focus upon improving diet quality to prevent chronic disease. MyPlate, which represents the 2010 Dietary Guidelines for Americans, encourages limiting the consumption of solid fats (SoF) and added sugars (AS). We examined nationally representative consumption data t...

Software Products - Naval Oceanography Portal

Science.gov Websites

section Advanced Search... Sections Home Time Earth Orientation Astronomy Meteorology Oceanography Ice You astronomy. Available as Fortran, C, or Python source code. Current version: 3.1 Software Products by Our computer or programmable calculator. Standards Of Fundamental Astronomy (SOFA) Libraries The International

PAL: Positional Astronomy Library

NASA Astrophysics Data System (ADS)

Jenness, T.; Berry, D. S.

2016-06-01

The PAL library is a partial re-implementation of Pat Wallace's popular SLALIB library written in C using a Gnu GPL license and layered on top of the IAU's SOFA library (or the BSD-licensed ERFA) where appropriate. PAL attempts to stick to the SLA C API where possible.

16 CFR 1633.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-01-01

... confirmation test on the mattress set it manufactures. (r) Confirmation test means a pre-market test conducted... included; examples are convertible sofa bed mattresses, corner group mattresses, day bed mattresses, roll...) This term includes any one, or any combination of the following: replacing the ticking or batting...

16 CFR 1633.2 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-01-01

... confirmation test on the mattress set it manufactures. (r) Confirmation test means a pre-market test conducted... included; examples are convertible sofa bed mattresses, corner group mattresses, day bed mattresses, roll...) This term includes any one, or any combination of the following: replacing the ticking or batting...

16 CFR 1633.2 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-01-01

... confirmation test on the mattress set it manufactures. (r) Confirmation test means a pre-market test conducted... included; examples are convertible sofa bed mattresses, corner group mattresses, day bed mattresses, roll...) This term includes any one, or any combination of the following: replacing the ticking or batting...

16 CFR 1633.2 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-01-01

... confirmation test on the mattress set it manufactures. (r) Confirmation test means a pre-market test conducted... included; examples are convertible sofa bed mattresses, corner group mattresses, day bed mattresses, roll...) This term includes any one, or any combination of the following: replacing the ticking or batting...

16 CFR § 1633.2 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-01-01

... confirmation test on the mattress set it manufactures. (r) Confirmation test means a pre-market test conducted... included; examples are convertible sofa bed mattresses, corner group mattresses, day bed mattresses, roll...) This term includes any one, or any combination of the following: replacing the ticking or batting...

Diaqua­bis­(4-meth­oxy­benzoato-κO 1)bis­(nicotinamide-κN 1)cobalt(II) dihydrate

PubMed Central

Hökelek, Tuncer; Dal, Hakan; Tercan, Barış; Tenlik, Erdinç; Necefoğlu, Hacali

2010-01-01

In the mononuclear title compound, [Co(C8H7O3)2(C6H6N2O)2(H2O)2]·2H2O, the CoII ion is located on a crystallographic inversion center. The asymmetric unit is completed by one 4-meth­oxy­benzoate anion, one nicotinamide (NA) ligand and one coordinated and one uncoordinated water mol­ecule. All ligands act in a monodentate mode. The four O atoms in the equatorial plane around the CoII ion form a slightly distorted square-planar arrangement, while the slightly distorted octa­hedral coordination is completed by the two pyridine N atoms of the NA ligands in the axial positions. The dihedral angle between the carboxyl­ate group and the attached benzene ring is 6.47 (7)°, while the pyridine and benzene rings are oriented at a dihedral angle of 72.80 (4)°. An O—H⋯O hydrogen bond links the uncoordinated water mol­ecule to one of the carboxyl­ate groups. In the crystal structure, inter­molecular O—H⋯O, N—H⋯O and C—H⋯O hydrogen bonds link the mol­ecules into a three-dimensional network. PMID:21588149

Comparison of the Manganese Cluster in Oxygen-Evolving Photosystem II with Distorted Cubane Manganese Compounds through X-ray Absorption Spectroscopy

PubMed Central

Cinco, Roehl M.; Rompel, Annette; Visser, Hendrik; Aromí, Guillem; Christou, George; Sauer, Kenneth; Klein, Melvin P.; Yachandra, Vittal K.

2014-01-01

X-ray absorption spectroscopy has been employed to assess the degree of similarity between the oxygen-evolving complex (OEC) in photosystem II (PS II) and a family of synthetic manganese complexes containing the distorted cubane [Mn4O3X] core (X = benzoate, acetate, methoxide, hydroxide, azide, fluoride, chloride, or bromide). These [Mn4(μ3-O)3(μ3-X)] cubanes possess C3v symmetry except for the X = benzoate species, which is slightly more distorted with only Cs symmetry. In addition, Mn4O3Cl complexes containing three or six terminal Cl ligands at three of the Mn were included in this study. The Mn K-edge X-ray absorption near edge structure (XANES) from the oxygen-ligated complexes begin to resemble general features of the PS II (S1 state) spectrum, although the second derivatives are distinct from those in PS II. The extended X-ray absorption fine structure (EXAFS) of these Mn compounds also displays superficial resemblance to that of PS II, but major differences emerge on closer examination of the phases and amplitudes. The most obvious distinction is the smaller magnitude of the Fourier transform (FT) of the PS II EXAFS compared to the FTs from the distorted cubanes. Curve fitting of the Mn EXAFS spectra verifies the known core structures of the Mn cubanes, and shows that the number of the crucial 2.7 and 3.3 Å Mn–Mn distances differs from that observed in the OEC. The EXAFS method detects small changes in the core structures as X is varied in this series, and serves to exclude the distorted cubane of C3v symmetry as a topological model for the Mn catalytic cluster of the OEC. Instead, the method shows that even more distortion of the cubane framework, altering the ratio of the Mn–Mn distances, is required to resemble the Mn cluster in PS II. PMID:11671305

Prospects for measuring cosmic microwave background spectral distortions in the presence of foregrounds

NASA Astrophysics Data System (ADS)

Abitbol, Maximilian H.; Chluba, Jens; Hill, J. Colin; Johnson, Bradley R.

2017-10-01

Measurements of cosmic microwave background (CMB) spectral distortions have profound implications for our understanding of physical processes taking place over a vast window in cosmological history. Foreground contamination is unavoidable in such measurements and detailed signal-foreground separation will be necessary to extract cosmological science. In this paper, we present Markov chain Monte Carlo based spectral distortion detection forecasts in the presence of Galactic and extragalactic foregrounds for a range of possible experimental configurations, focusing on the Primordial Inflation Explorer (PIXIE) as a fiducial concept. We consider modifications to the baseline PIXIE mission (operating ≃ 12 months in distortion mode), searching for optimal configurations using a Fisher approach. Using only spectral information, we forecast an extended PIXIE mission to detect the expected average non-relativistic and relativistic thermal Sunyaev-Zeldovich distortions at high significance (194σ and 11σ, respectively), even in the presence of foregrounds. The ΛCDM Silk damping μ-type distortion is not detected without additional modifications of the instrument or external data. Galactic synchrotron radiation is the most problematic source of contamination in this respect, an issue that could be mitigated by combining PIXIE data with future ground-based observations at low frequencies (ν ≲ 15-30 GHz). Assuming moderate external information on the synchrotron spectrum, we project an upper limit of |μ| < 3.6 × 10-7 (95 per cent c.l.), slightly more than one order of magnitude above the fiducial ΛCDM signal from the damping of small-scale primordial fluctuations, but a factor of ≃250 improvement over the current upper limit from COBE/Far Infrared Absolute Spectrophotometer. This limit could be further reduced to |μ| < 9.4 × 10-8 (95 per cent c.l.) with more optimistic assumptions about extra low-frequency information and would rule out many alternative inflation models and provide new constraints on decaying particle scenarios.

Di­chlorido­[N-(N,N-di­methyl­carbamimido­yl)-N′,N′,4-tri­methyl­benzohydrazonamide]­platinum(II) nitro­methane hemisolvate

PubMed Central

Bolotin, Dmitrii S.; Bokach, Nadezha A.; Haukka, Matti

2014-01-01

In the title compound, [PtCl2(C13H21N5)]·0.5CH3NO2, the PtII atom is coordinated in a slightly distorted square-planar geometry by two Cl atoms and two N atoms of the bidentate ligand. The (1,3,5-tri­aza­penta­diene)PtII metalla ring is slightly bent and does not conjugate with the aromatic ring. In the crystal, N—H⋯Cl hydrogen bonds link the complex mol­ecules, forming chains along [001]. The nitromethane solvent molecule shows half-occupancy and is disordered over two sets of sites about an inversion centre. PMID:24826095

Watching the brain recalibrate: Neural correlates of renormalization during face adaptation.

PubMed

Kloth, Nadine; Rhodes, Gillian; Schweinberger, Stefan R

2017-07-15

The face perception system flexibly adjusts its neural responses to current face exposure, inducing aftereffects in the perception of subsequent faces. For instance, adaptation to expanded faces makes undistorted faces appear compressed, and adaptation to compressed faces makes undistorted faces appear expanded. Such distortion aftereffects have been proposed to result from renormalization, in which the visual system constantly updates a prototype according to the adaptors' characteristics and evaluates subsequent faces relative to that. However, although consequences of adaptation are easily observed in behavioral aftereffects, it has proven difficult to observe renormalization during adaptation itself. Here we directly measured brain responses during adaptation to establish a neural correlate of renormalization. Given that the face-evoked occipito-temporal P2 event-related brain potential has been found to increase with face prototypicality, we reasoned that the adaptor-elicited P2 could serve as an electrophysiological indicator for renormalization. Participants adapted to sequences of four distorted (compressed or expanded) or undistorted faces, followed by a slightly distorted test face, which they had to classify as undistorted or distorted. We analysed ERPs evoked by each of the adaptors and found that P2 (but not N170) amplitudes evoked by consecutive adaptor faces exhibited an electrophysiological pattern of renormalization during adaptation to distorted faces: P2 amplitudes evoked by both compressed and expanded adaptors significantly increased towards asymptotic levels as adaptation proceeded. P2 amplitudes were smallest for the first adaptor, significantly larger for the second, and yet larger for the third adaptor. We conclude that the sensitivity of the occipito-temporal P2 to the perceived deviation of a face from the norm makes this component an excellent tool to study adaptation-induced renormalization. Copyright © 2017 Elsevier Inc. All rights reserved.

Eddy current-nulled convex optimized diffusion encoding (EN-CODE) for distortion-free diffusion tensor imaging with short echo times.

PubMed

Aliotta, Eric; Moulin, Kévin; Ennis, Daniel B

2018-02-01

To design and evaluate eddy current-nulled convex optimized diffusion encoding (EN-CODE) gradient waveforms for efficient diffusion tensor imaging (DTI) that is free of eddy current-induced image distortions. The EN-CODE framework was used to generate diffusion-encoding waveforms that are eddy current-compensated. The EN-CODE DTI waveform was compared with the existing eddy current-nulled twice refocused spin echo (TRSE) sequence as well as monopolar (MONO) and non-eddy current-compensated CODE in terms of echo time (TE) and image distortions. Comparisons were made in simulations, phantom experiments, and neuro imaging in 10 healthy volunteers. The EN-CODE sequence achieved eddy current compensation with a significantly shorter TE than TRSE (78 versus 96 ms) and a slightly shorter TE than MONO (78 versus 80 ms). Intravoxel signal variance was lower in phantoms with EN-CODE than with MONO (13.6 ± 11.6 versus 37.4 ± 25.8) and not different from TRSE (15.1 ± 11.6), indicating good robustness to eddy current-induced image distortions. Mean fractional anisotropy values in brain edges were also significantly lower with EN-CODE than with MONO (0.16 ± 0.01 versus 0.24 ± 0.02, P < 1 x 10 -5 ) and not different from TRSE (0.16 ± 0.01 versus 0.16 ± 0.01, P = nonsignificant). The EN-CODE sequence eliminated eddy current-induced image distortions in DTI with a TE comparable to MONO and substantially shorter than TRSE. Magn Reson Med 79:663-672, 2018. © 2017 International Society for Magnetic Resonance in Medicine. © 2017 International Society for Magnetic Resonance in Medicine.

Morphologies of mid-IR variability-selected AGN host galaxies

NASA Astrophysics Data System (ADS)

Polimera, Mugdha; Sarajedini, Vicki; Ashby, Matthew L. N.; Willner, S. P.; Fazio, Giovanni G.

2018-05-01

We use multi-epoch 3.6 and 4.5 μm data from the Spitzer Extended Deep Survey (SEDS) to probe the AGN population among galaxies to redshifts ˜3 via their mid-IR variability. About 1 per cent of all galaxies in our survey contain varying nuclei, 80 per cent of which are likely to be AGN. Twenty-three per cent of mid-IR variables are also X-ray sources. The mid-IR variables have a slightly greater fraction of weakly disturbed morphologies compared to a control sample of normal galaxies. The increased fraction of weakly distorted hosts becomes more significant when we remove the X-ray emitting AGN, while the frequency of strongly disturbed hosts remains similar to the control galaxy sample. These results suggest that mid-IR variability identifies a unique population of obscured, Compton-thick AGN revealing elevated levels of weak distortion among their host galaxies.

41 CFR 301-11.15 - What expenses may be considered part of the daily lodging cost when I rent on a long-term basis?

Code of Federal Regulations, 2010 CFR

2010-07-01

...., stove, refrigerator, chairs, tables, bed, sofa, television, or vacuum cleaner); (b) Cost of connecting/disconnecting and using utilities; (c) Cost of reasonable maid fees and cleaning charges; (d) Monthly telephone...

46 CFR 116.423 - Furniture and furnishings.

Code of Federal Regulations, 2011 CFR

2011-10-01

... ARRANGEMENT Fire Protection § 116.423 Furniture and furnishings. (a) For the purpose of this subpart, rooms containing “fire resistant furnishings” are considered to be those in which: (1) Furniture such as chairs, sofas, and similar items are tested and meet the requirements in UL 1056 “Fire Test of Upholstered...

46 CFR 116.423 - Furniture and furnishings.

Code of Federal Regulations, 2010 CFR

2010-10-01

... ARRANGEMENT Fire Protection § 116.423 Furniture and furnishings. (a) For the purpose of this subpart, rooms containing “fire resistant furnishings” are considered to be those in which: (1) Furniture such as chairs, sofas, and similar items are tested and meet the requirements in UL 1056 “Fire Test of Upholstered...

Replacing the Sofa with the Spotlight: Interrogating the Therapeutic Value of Personal Testimony within Community-Based Theatre

ERIC Educational Resources Information Center

Leffler, Elliot

2012-01-01

Julie Salverson, a Canadian scholar-practitioner, has long challenged the assumption that personal storytelling within Community-Based Theatre is necessarily therapeutic. Salverson critiques an "aesthetic of injury," arguing that theatre practitioners have foregrounded personal narratives in a way that reinscribes a "victim…

46 CFR 72.05-55 - Furniture and furnishings.

Code of Federal Regulations, 2010 CFR

2010-10-01

... shall be of approved fire resistant fabrics. (4) All rugs and carpets shall be of wool or other material... subpart, rooms containing “fire resistant furnishings” will be considered to be those in which: (1) All... fire resistant furnishings. In addition, all upholstery and padding of chairs, sofas, etc., in these...

A Modal Analysis of Submerged Composite Plates Using Digital Speckle Pattern Interferometry

DTIC Science & Technology

1991-05-01

the drive point. The underwater mode shapes were slightly deformed compared to the in- air modes which is probably due to modal coupling by the dense...modes according to Leissa. The mode shapes in water are very similar to those in air with a small amount of distortion due to modal coupling by the fluid...and cantilever boundarv conditions is described in this thesis. The vibrations of the plates are studies in air and when Submerged in a water tank to

Convection-induced distortion of a solid-liquid interface

NASA Technical Reports Server (NTRS)

Schaefer, R. J.; Coriell, S. R.

1984-01-01

Measurements of convective flow fields and solid-liquid interface shapes during the solidification of a pure and a slightly alloyed transparent material reveal that the convective transport of solute can cause a macroscopic depression to develop in the solid-liquid interface. This effect occurs under conditions close to those which are predicted to produce morphological instability of a planar interface. A cellular or dendritic microstructure later develops within the interface depression. The convection is attributed to the effect of radial temperature gradients in the crystal growth apparatus.

Fac-Re(bpy)(CO){sub 3}(COOMe): A model metallocarboxylate complex of rhenium with a bipyridyl ligand

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gibson, D.H.; Sleadd, B.A.; Vij, A.

1999-05-01

The title compound fac-(2,2{prime}-bipyridyl)(carbomethoxy)rhenium tricarbonyl, crystallizes in the monoclinic system, space group P2{sub 1}/c with the following crystal data: a = 8.37551(1), b = 6.6934(1), c = 26.2098(1) {angstrom}, V({angstrom}{sup 3}) = 1,535.93(3), Z = 4, and {beta} = 90.0971(2). The metal environment is slightly distorted octahedral with a chelating bipyridyl ligand and a facial arrangement of the carbon monoxide ligands.

16 CFR 1632.8 - Glossary of terms.

Code of Federal Regulations, 2010 CFR

2010-01-01

.... The seat slopes, in the sitting position, for added comfort (see fig. 5). (w) Push-back sofa. When... lounge. An upholstered couch chair or a couch with a chair back. It has a permanent back rest, no arms... positions for a chaise lounge effect or a single sleeper. The vertical back support always remains upright...

32 CFR 536.17 - Single-service claims responsibility (DODD 5515.8 and DODD 5515.9).

Code of Federal Regulations, 2011 CFR

2011-07-01

... U.S.C. 2734); (2) MCA (10 U.S.C. 2733); (3) Status of Forces Agreements (10 U.S.C. 2734a and 2734b); (4) NATO SOFA (4 U.S.T. 1792, Treaties and International Acts Series (T.I.A.S.) 2846) and other...

32 CFR 536.17 - Single-service claims responsibility (DODD 5515.8 and DODD 5515.9).

Code of Federal Regulations, 2010 CFR

2010-07-01

... U.S.C. 2734); (2) MCA (10 U.S.C. 2733); (3) Status of Forces Agreements (10 U.S.C. 2734a and 2734b); (4) NATO SOFA (4 U.S.T. 1792, Treaties and International Acts Series (T.I.A.S.) 2846) and other...

Release of volatile and semi-volatile toxicants during house fires.

PubMed

Hewitt, Fiona; Christou, Antonis; Dickens, Kathryn; Walker, Richard; Stec, Anna A

2017-04-01

Qualitative results are presented from analysis of volatile and semi-volatile organic compounds (VOCs/SVOCs) obtained through sampling of gaseous effluent and condensed particulates during a series of experimental house fires conducted in a real house. Particular emphasis is given to the 16 polycyclic aromatic hydrocarbons (PAHs) listed by the Environmental Protection Agency due to their potentially carcinogenic effects. The initial fuel packages were either cooking oil or a single sofa; these were burned both alone, and in furnished surroundings. Experiments were performed at different ventilation conditions. Qualitative Gas Chromatography-Mass Spectrometry (GC-MS) analysis found VOC/SVOC releases in the developing stages of the fires, and benzo(a)pyrene - the most carcinogenic PAH - was found in at least one sampling interval in the majority of fires. A number of phosphorus fire retardants were detected, in both the gaseous effluent and particulates, from fires where the initial fuel source was a sofa. Their release during the fire is significant as they pose toxicological concerns separate from those presented by the PAHs. Copyright © 2016. Published by Elsevier Ltd.

High Reynolds Number Investigation of a Flush Mounted, S-Duct Inlet With Large Amounts of Boundary Layer Ingestion

NASA Technical Reports Server (NTRS)

Berrier, Bobby L.; Carter, Melissa B.; Allan, Brian G.

2005-01-01

An experimental investigation of a flush-mounted, S-duct inlet with large amounts of boundary layer ingestion has been conducted at Reynolds numbers up to full scale. The study was conducted in the NASA Langley Research Center 0.3-Meter Transonic Cryogenic Tunnel. In addition, a supplemental computational study on one of the inlet configurations was conducted using the Navier-Stokes flow solver, OVERFLOW. Tests were conducted at Mach numbers from 0.25 to 0.83, Reynolds numbers (based on aerodynamic interface plane diameter) from 5.1 million to 13.9 million (full-scale value), and inlet mass-flow ratios from 0.29 to 1.22, depending on Mach number. Results of the study indicated that increasing Mach number, increasing boundary layer thickness (relative to inlet height) or ingesting a boundary layer with a distorted profile decreased inlet performance. At Mach numbers above 0.4, increasing inlet airflow increased inlet pressure recovery but also increased distortion. Finally, inlet distortion was found to be relatively insensitive to Reynolds number, but pressure recovery increased slightly with increasing Reynolds number.This CD-ROM supplement contains inlet data including: Boundary layer data, Duct static pressure data, performance-AIP (fan face) data, Photos, Tunnel wall P-PTO data and definitions.

Magnetochemistry of the tetrahaloferrate (III) ions. 7. Crystal structure and magnetic ordering in (pyridinium){sub 3}Fe{sub 2}Br{sub 9}

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lowe, C.B.; Shaviv, R.; Carlin, R.L.

1994-07-06

A monoclinic crystal structure was found by X-ray diffraction for bis [pyridinium tetrabromferrate(III)]-pyridinium bromide. The double salt contains two slightly distorted [FeBr{sub 4}]{sup -} tetrahedra, three pyridinium rings, and an uncoordinated halide in each asymmetric unit, as is characteristic of the A{sub 3}Fe{sub 2}X{sub 9} series of compounds. Unit cell parameters, monoclinic space group P2{sub 1}, are a = 7.656(3) {angstrom}, b = 14.237(5) {angstrom}, c = 13.725(5) {angstrom}, {beta} = 93.42(3){degrees}, and V = 1493(1) {angstrom}{sup 3}, using Mo K{alpha} radiation {lambda} = 0.710 69 {angstrom}, {rho}{sub calc} = 2.38 g cm{sup -3}, and Z = 2. The tetrahedramore » are aligned with their 3-fold axes parallel to the crystallographic c axis. Bond lengths (Fe-Br) range from 2.271(9) {angstrom} to 2.379(9) {angstrom} for the two different slightly distorted tetrahedral units. Magnetic susceptibility studies show that the material orders three-dimensionally at 7.4 {+-} 0.2 K. The data are compared to a HTS expansion of 1/{sub {chi}} for the S = 5/2 three-dimensional Heisenberg model antiferromagnet for a sc lattice with g = 1.98 and J/k{sub B} = -0.43 K. The specific heat measurements indicate two odd-shaped {lambda} features, at 7.3 and 8 K.« less

Fever, thrombocytopenia, and AKI-A profile of malaria, dengue, and leptospirosis with renal failure in a South Indian tertiary-care hospital.

PubMed

Prabhu, Mayoor V; S, Arun; Ramesh, Venkat

In the tropics, the triad of fever, thrombocytopenia, and AKI portends a grim prognosis with high mortality and a severe strain on already-stretched resources. Malaria, dengue, and leptospirosis account for most cases. We undertook a review of cases to determine factors accounting for adverse prognosis. All patients presenting to the emergency room (ER) with a history of fever, thrombocytopenia, and renal failure were included in the study. Patients were followed until discharge or death, and end points looked at were 1-week and 30-day mortality, and renal function upon discharge. Parameters like liver function test (LFT), renal function, and platelet count upon discharge were also documented. A total of 43 patients was included in the study. Mean age was 42.5 years with 86% males. Mean APACHE and SOFA scores on admission were 23.89 and 15.42, respectively. Mean admission platelet counts were 41,000. Mean serum creatinine was 4.1, and bilirubin was 9.94. A platelet count of < 34,000, serum creatinine of > 4, albumin of > 2.3, SOFA score of > 20, and APACHE score of > 32.2 were significantly predictive of 1 week mortality. Need for mechanical ventilation, oliguria on admission, and need for dialysis all were highly predictive of 30-day mortality. In addition, a serum bicarbonate of < 12, INR of > 1.5, hemoglobin of < 9.5 were highly predictive of higher 30 day mortality. Overall, 1-week mortality was 16.3%, of which 48% was accounted for by patients with leptospirosis. Factors like low platelet count, oliguria, need for dialysis, high APACHE and SOFA scores on admission, need for mechanical ventilation, and low serum albumin portend a grave prognosis. There is need for randomized control trials (RCT) to further determine adverse prognostic factors in this subsect of patients.

[Prolonged mechanical ventilation probability model].

PubMed

Añón, J M; Gómez-Tello, V; González-Higueras, E; Oñoro, J J; Córcoles, V; Quintana, M; López-Martínez, J; Marina, L; Choperena, G; García-Fernández, A M; Martín-Delgado, C; Gordo, F; Díaz-Alersi, R; Montejo, J C; Lorenzo, A García de; Pérez-Arriaga, M; Madero, R

2012-10-01

To design a probability model for prolonged mechanical ventilation (PMV) using variables obtained during the first 24 hours of the start of MV. An observational, prospective, multicenter cohort study. Thirteen Spanish medical-surgical intensive care units. Adult patients requiring mechanical ventilation for more than 24 hours. None. APACHE II, SOFA, demographic data, clinical data, reason for mechanical ventilation, comorbidity, and functional condition. A multivariate risk model was constructed. The model contemplated a dependent variable with three possible conditions: 1. Early mortality; 2. Early extubation; and 3. PMV. Of the 1661 included patients, 67.9% (n=1127) were men. Age: 62.1±16.2 years. APACHE II: 20.3±7.5. Total SOFA: 8.4±3.5. The APACHE II and SOFA scores were higher in patients ventilated for 7 or more days (p=0.04 and p=0.0001, respectively). Noninvasive ventilation failure was related to PMV (p=0.005). A multivariate model for the three above exposed outcomes was generated. The overall accuracy of the model in the training and validation sample was 0.763 (95%IC: 0.729-0.804) and 0.751 (95%IC: 0.672-0.816), respectively. The likelihood ratios (LRs) for early extubation, involving a cutoff point of 0.65, in the training sample were LR (+): 2.37 (95%CI: 1.77-3.19) and LR (-): 0.47 (95%CI: 0.41-0.55). The LRs for the early mortality model, for a cutoff point of 0.73, in the training sample, were LR (+): 2.64 (95%CI: 2.01-3.4) and LR (-): 0.39 (95%CI: 0.30-0.51). The proposed model could be a helpful tool in decision making. However, because of its moderate accuracy, it should be considered as a first approach, and the results should be corroborated by further studies involving larger samples and the use of standardized criteria. Copyright © 2011 Elsevier España, S.L. y SEMICYUC. All rights reserved.

Defining sepsis on the wards: results of a multi-centre point-prevalence study comparing two sepsis definitions.

PubMed

Szakmany, T; Pugh, R; Kopczynska, M; Lundin, R M; Sharif, B; Morgan, P; Ellis, G; Abreu, J; Kulikouskaya, S; Bashir, K; Galloway, L; Al-Hassan, H; Grother, T; McNulty, P; Seal, S T; Cains, A; Vreugdenhil, M; Abdimalik, M; Dennehey, N; Evans, G; Whitaker, J; Beasant, E; Hall, C; Lazarou, M; Vanderpump, C V; Harding, K; Duffy, L; Guerrier Sadler, A; Keeling, R; Banks, C; Ng, S W Y; Heng, S Y; Thomas, D; Puw, E W; Otahal, I; Battle, C; Minik, O; Lyons, R A; Hall, J E

2018-02-01

Our aim was to prospectively determine the predictive capabilities of SEPSIS-1 and SEPSIS-3 definitions in the emergency departments and general wards. Patients with National Early Warning Score (NEWS) of 3 or above and suspected or proven infection were enrolled over a 24-h period in 13 Welsh hospitals. The primary outcome measure was mortality within 30 days. Out of the 5422 patients screened, 431 fulfilled inclusion criteria and 380 (88%) were recruited. Using the SEPSIS-1 definition, 212 patients had sepsis. When using the SEPSIS-3 definitions with Sequential Organ Failure Assessment (SOFA) score ≥ 2, there were 272 septic patients, whereas with quickSOFA score ≥ 2, 50 patients were identified. For the prediction of primary outcome, SEPSIS-1 criteria had a sensitivity (95%CI) of 65% (54-75%) and specificity of 47% (41-53%); SEPSIS-3 criteria had a sensitivity of 86% (76-92%) and specificity of 32% (27-38%). SEPSIS-3 and SEPSIS-1 definitions were associated with a hazard ratio (95%CI) 2.7 (1.5-5.6) and 1.6 (1.3-2.5), respectively. Scoring system discrimination evaluated by receiver operating characteristic curves was highest for Sequential Organ Failure Assessment score (0.69 (95%CI 0.63-0.76)), followed by NEWS (0.58 (0.51-0.66)) (p < 0.001). Systemic inflammatory response syndrome criteria (0.55 (0.49-0.61)) and quickSOFA score (0.56 (0.49-0.64)) could not predict outcome. The SEPSIS-3 definition identified patients with the highest risk. Sequential Organ Failure Assessment score and NEWS were better predictors of poor outcome. The Sequential Organ Failure Assessment score appeared to be the best tool for identifying patients with high risk of death and sepsis-induced organ dysfunction. © 2017 The Association of Anaesthetists of Great Britain and Ireland.

[Epidemiology of acute kidney failure in Spanish ICU. Multicenter prospective study FRAMI].

PubMed

Herrera-Gutiérrez, M E; Seller-Pérez, G; Maynar-Moliner, J; Sánchez-Izquierdo-Riera, J A

2006-01-01

Multicenter study oriented at establishing the incidence and prognosis of acute kidney failure (AKF) in the ICU of our country. Prospective study of adult patients admitted over 8 months in 43 Spanish ICUs to detect AKF defined as creatinine>or=2 mg/dl or diuresis<400 ml/24 hours (in chronic patients 100% increase of creatinine, excluding those with baseline creatinine>or=4 mg/dl). 901 episodes of AKF (AKF episodes (incidence 5.7%), 55% of which occurred on admission. A total of 38.4% of the episodes were due to acute tubular necrosis (ATN), 36.6% to prerenal, and 21.2% to mixed. Renal depuration (RC) was required in 38%. Mortality was 42.3% during the AKF episode (34.1% in those who were admitted with AKF versus 50.9% in those who developed it after admission), 80% in patients with Hepatorenal Syndrome, 51.6% in ATN and 29.9% in prerenal. We detect an independent relationship with mortality for age (OR 1.03), background of diabetes (OR 2.06), development of AKF in the ICU (OR 2.51), oliguria (OR 5.76) and RC (OR 2.32). Recovery of the kidney function occurred in 85.6% of the survivors and RC was maintained in only 1.1% on discharge from the ICU. We calculated the area under the curve of APACHE II on admission (0.62), SOFA on onset of AKF (0.68), Liaño index (0.7) and maximum SOFA (0.79). AKF in ICU patients does not show an elevated incidence but does have high mortality, presenting greater seriousness when it appears after admission. However, recovery is elevated in patients who survive. The usual prognostic indexes are not exact in this patient group, the ISA and maximum SOFA being those which shows a closer relationship with mortality.

Early non-invasive ventilation treatment for severe influenza pneumonia.

PubMed

Masclans, J R; Pérez, M; Almirall, J; Lorente, L; Marqués, A; Socias, L; Vidaur, L; Rello, J

2013-03-01

The role of non-invasive ventilation (NIV) in acute respiratory failure caused by viral pneumonia remains controversial. Our objective was to evaluate the use of NIV in a cohort of (H1N1)v pneumonia. Usefulness and success of NIV were assessed in a prospective, observational registry of patients with influenza A (H1N1) virus pneumonia in 148 Spanish intensive care units (ICUs) in 2009-10. Significant variables for NIV success were included in a multivariate analysis. In all, 685 patients with confirmed influenza A (H1N1)v viral pneumonia were admitted to participating ICUs; 489 were ventilated, 177 with NIV. The NIV was successful in 72 patients (40.7%), the rest required intubation. Low Acute Physiology and Chronic Health Evaluation (APACHE) II, low Sequential Organ Failure Assessment (SOFA) and absence of renal failure were associated with NIV success. Success of NIV was independently associated with fewer than two chest X-ray quadrant opacities (OR 3.5) and no vasopressor requirement (OR 8.1). However, among patients with two or more quadrant opacities, a SOFA score ≤7 presented a higher success rate than those with SOFA score >7 (OR 10.7). Patients in whom NIV was successful required shorter ventilation time, shorter ICU stay and hospital stay than NIV failure. In patients in whom NIV failed, the delay in intubation did not increase mortality (26.5% versus 24.2%). Clinicians used NIV in 25.8% of influenza A (H1N1)v viral pneumonia admitted to ICU, and treatment was effective in 40.6% of them. NIV success was associated with shorter hospital stay and mortality similar to non-ventilated patients. NIV failure was associated with a mortality similar to those who were intubated from the start. © 2012 The Authors. Clinical Microbiology and Infection © 2012 European Society of Clinical Microbiology and Infectious Diseases.

Coronary flow reserve is associated with tissue ischemia and is an additive predictor of intensive care unit mortality to traditional risk scores in septic shock.

PubMed

Ikonomidis, Ignatios; Makavos, George; Nikitas, Nikitas; Paraskevaidis, Ioannis; Diamantakis, Argyris; Kopterides, Petros; Theodorakopoulou, Maria; Parissis, John; Lekakis, John; Armaganidis, Apostolos; Dimopoulou, Ioanna

2014-03-01

Reduced coronary velocity flow reserve (CFR) is associated with poor outcome in patients with cardiovascular disease. We investigated whether CFR is associated with tissue ischemia and acidosis, impaired myocardial deformation and adverse outcome in patients with septic shock. In 70 mechanically-ventilated patients with septic shock, we examined: a) S' and E' mitral annular velocities using tissue Doppler imaging (TDI), b) CFR of the left anterior descending artery after adenosine infusion using transesophageal Doppler echocardiography and c) lactate, pyruvate and glycerol in tissue by means of a microdialysis (MD) catheter inserted into the subcutaneous adipose tissue as markers of tissue ischemia and acidosis. SOFA and APACHE II prognostic scores and mortality in the intensive care unit (ICU) were recorded. Reduced CFR, S' and E' as well as increased E/E' correlated with increased SOFA, APACHE II and MD lactate to pyruvate ratio (p<0.05 for all correlations). Impaired TDI markers also correlated with increased MD glycerol (p<0.05). Reduced CFR correlated with decreased E' (p<0.05). CFR was 1.8 ± 0.42 in non-survivors (n=34) versus 2.08 ± 0.44 in survivors (p=0.007). A CFR<1.90 predicted mortality with sensitivity of 70% and specificity of 69% (area under the curve 77%; p=0.003). CFR had an additive value to APACHE (chi-square change: 4.358, p=0.03) and SOFA (chi-square change: 3.692, p=0.04) for the prediction of mortality. Tissue ischemia and acidosis is a common pathophysiological link between decreased CFR and impaired LV myocardial deformation in septic shock. CFR is an additive predictor of ICU mortality to traditional risk scores in septic shock. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

[Prevalence of upper limb work-related musculoskeletal disorders (UL-WMSDs) in workers of the upholstered furniture industry].

PubMed

Nicoletti, S; Carino, M; Di Leone, G; Trani, G; Carella, F; Rubino, G; Leone, E; Popolizio, R; Colafiglio, S; Ambrosi, L

2008-01-01

The upholstered furniture industry, the so-called "triangle of the sofa industry", is a geographic area of national and strategic economic importance in southern Italy. The single tasks are carried out mostly manually, with the characteristics of a handicraft approach. The aim of the survey was to assess the prevalence of upper limb work-related musculoskeletal disorders (UL-WMSDs) in 30 factories of the sofa industry located in a large geographic area of the Puglia and Basilicata Regions. In the period 1 January-31 December 2003 a network of occupational physicians investigated a population of 5.477 subjects (exposed n=3481, controls n=1996, M=3865, F=1612) in 30 different factories of the area. More than 60 percent of the total workforce studied was employed in large-sized companies (>500 employees). The following work tasks were considered: filling preparation workers, leather-cutting operators, sewing and upholstery-assembly workers. Case-definition was assessed through standardized procedures: symptoms by questionnaire plus physical and laboratory/imaging findings. Cumulative prevalence rates of UL-WMSDs as at 31 December 2003 reached values of up to 30% in high risk groups. Prevalence rates showed good correlation with the concise OCRA index used for assessment of exposure to repetitive strain and movements of the upper limb. The most frequently occurring disorders were tendon-related cysts and wrist tendonitis. Shoulder disorders were more frequent in male and female leather-cutting operators. This survey showed a significantly high prevalence of UL-WMSDs in sofa industry workers. It did not seem to be confirmed in this study that there was a greater female susceptibility to UL-WMSDs with the exception of carpal tunnel syndrome: gender difference seems to be less relevant at increasing levels of occupational exposure to repetitive movements and exertion of the upper limbs.

Comparison of the Performance Between Sepsis-1 and Sepsis-3 in ICUs in China: A Retrospective Multicenter Study.

PubMed

Cheng, Baoli; Li, Zhongwang; Wang, Jingya; Xie, Guohao; Liu, Xu; Xu, Zhipeng; Chu, Lihua; Zhao, Jialian; Yao, Yongming; Fang, Xiangming

2017-09-01

The definition of sepsis was updated to sepsis-3 in February 2016. However, the performance of the previous and new definition of sepsis remains unclear in China. This was a retrospective multicenter study in six intensive care unit (ICUs) from five university-affiliated hospitals to compare the performance between sepsis-1 and sepsis-3 in China. From May 1, 2016 to June 1, 2016, 496 patients were enrolled consecutively. Data were extracted from the electronic clinical records. We evaluated the performance of sepsis-1 and sepsis-3 by measuring the area under the receiver operating characteristic curves (AUROC) to predict 28-day mortality rates. Of 496 enrolled patients, 186 (37.5%) were diagnosed with sepsis according to sepsis-1, while 175 (35.3%) fulfilled the criteria of sepsis-3. The AUROC of systemic inflammatory response syndrome (SIRS) is significantly smaller than that of sequential organ failure assessment (SOFA) (0.55 [95% confidence interval, 0.46-0.64] vs. 0.69 (95% confidence interval, 0.61-0.77], P = 0.008) to predict 28-day mortality rates of infected patients. Moreover, 5.9% infected patients (11 patients) were diagnosed as sepsis according to sepsis-1 but not to sepsis-3. The APACHE II, SOFA scores, and mortality rate of the 11 patients were significantly lower than of patients whose sepsis was defined by both the previous and new criteria (8.6±3.5 vs. 16.3±6.2, P =  < 0.001; 1 (0-1) vs. 6 (4-8), P = <0.001; 0.0 vs. 33.1%, P = 0.019). In addition, the APACHE II, length of stay in ICU, and 28-day mortality rate of septic patients rose gradually corresponding with the raise in SOFA score (but not the SIRS score). Sepsis-3 performed better than sepsis-1 in the study samples in ICUs in China.

Diagnostic and prognostic value of presepsin vs. established biomarkers in critically ill patients with sepsis or systemic inflammatory response syndrome.

PubMed

Brodska, Helena; Valenta, Jiri; Pelinkova, Kveta; Stach, Zdenek; Sachl, Robert; Balik, Martin; Zima, Tomas; Drabek, Tomas

2018-03-28

Inflammatory biomarkers may aid to distinguish between systemic inflammatory response syndrome (SIRS) vs. sepsis. We tested the hypotheses that (1) presepsin, a novel biomarker, can distinguish between SIRS and sepsis, and (2) higher presepsin levels will be associated with increased severity of illness and (3) with 28-day mortality, outperforming traditional biomarkers. Procalcitonin (PCT), C-reactive protein (CRP), presepsin, and lactate were analyzed in 60 consecutive patients (sepsis and SIRS, n=30 per group) on day 1 (D1) to D3 (onset sepsis, or after cardiac surgery). The systemic organ failure assessment (SOFA) score was determined daily. There was no difference in mortality in sepsis vs. SIRS (12/30 vs. 8/30). Patients with sepsis had higher SOFA score vs. patients with SIRS (11±4 vs. 8±5; p=0.023), higher presepsin (AUC=0.674; p<0.021), PCT (AUC=0.791; p<0.001), CRP (AUC=0.903; p<0.0001), but not lactate (AUC=0.506; p=0.941). Unlike other biomarkers, presepsin did not correlate with SOFA on D1. All biomarkers were associated with mortality on D1: presepsin (AUC=0.734; p=0.0006; best cutoff=1843 pg/mL), PCT (AUC=0.844; p<0.0001), CRP (AUC=0.701; p=0.0048), and lactate (AUC=0.778; p<0.0001). Multiple regression analyses showed independent associations of CRP with diagnosis of sepsis, and CRP and lactate with mortality. Increased neutrophils (p=0.002) and decreased lymphocytes (p=0.007) and monocytes (p=0.046) were also associated with mortality. Presepsin did not outperform traditional sepsis biomarkers in diagnosing sepsis from SIRS and in prognostication of mortality in critically ill patients. Presepsin may have a limited adjunct value for both diagnosis and an early risk stratification, performing independently of clinical illness severity.

Outcome scoring systems for short-term prognosis in critically ill cirrhotic patients.

PubMed

Tu, Kun-Hua; Jenq, Chang-Chyi; Tsai, Ming-Hung; Hsu, Hsiang-Hao; Chang, Ming-Yang; Tian, Ya-Chung; Hung, Cheng-Chieh; Fang, Ji-Tseng; Yang, Chih-Wei; Chen, Yung-Chang

2011-11-01

Cirrhotic patients admitted to intensive care units (ICUs) have high mortality rates. This study evaluated specific predictors and scoring systems for hospital and 6-month mortality in critically ill cirrhotic patients. This investigation is a prospective clinical study performed in a 10-bed specialized hepatogastroenterology ICU in a tertiary care university hospital in Taiwan. Two hundred two consecutive cirrhotic patients admitted to the ICU during a 2-year period were enrolled in this study. Demographic, clinical, and laboratory variables recorded on the first day of ICU admission and scoring systems applied were prospectively recorded for post hoc analysis for predicting survival. The overall hospital mortality was 59.9%, and the 6-month mortality rate was 70.8%. The main causes of cirrhosis were hepatitis B (29%), hepatitis C (22%), and alcoholism (20%). The major cause of ICU admission was upper gastrointestinal bleeding (36%). Multiple logistic regression analysis revealed that the Acute Kidney Injury Network (AKIN) score at the 48th hour of ICU admission and the Sequential Organ Failure Assessment (SOFA) as well as the Model for End-Stage Liver Disease scores on the first day of ICU admission were independent risk factors for hospital mortality. The SOFA score had the best discriminatory power (0.872 ± 0.036), whereas the AKIN had the best Youden index (0.57) and the highest correctness of prediction (79%). Cumulative survival rates at the 6-month follow-up after hospital discharge differed significantly (P < 0.05) for AKIN stage 0 vs. stages 1, 2, and 3, and for AKIN stage 1 vs. stage 3. The AKIN, SOFA, and Model for End-stage Liver Disease (MELD) scores showed well discriminative power in predicting hospital mortality in this group of patients. The AKIN scoring system proved to be a reproducible evaluation tool with excellent prognostic abilities for these patients.

Comparison of scoring systems and outcome of patients admitted to a liver intensive care unit of a tertiary referral centre with severe variceal bleeding.

PubMed

Al-Freah, M A B; Gera, A; Martini, S; McPhail, M J W; Devlin, J; Harrison, P M; Shawcross, D; Abeles, R D; Taylor, N J; Auzinger, G; Bernal, W; Heneghan, M A; Wendon, J A

2014-06-01

Acute variceal haemorrhage (AVH) is associated with significant mortality. To determine outcome and factors associated with hospital mortality (HM) in patients with AVH admitted to intensive care unit (ICU) and to compare outcomes of patients requiring transfer to a tertiary ICU (transfer group, TG) to a local in-patient group (LG). A retrospective study of all adult patients (N = 177) admitted to ICU with AVH from 2000-2008 was performed. Median age was 48 years (16-80). Male represented 58%. Median MELD score was 16 (6-39), SOFA score was 8 (6-11). HM was higher in patients who had severe liver disease or critical illness measured by MELD, SOFA, APACHE II scores and number of failed organs (NFO), P < 0.05. Patients with day-1 lactate ≥ 2 mmol/L had increased HM (P < 0.001). MELD score performed as well as APACHE II, SOFA and NFO (P < 0.001) in predicting HM (AUROC = 0.84, 0.81, 0.79 and 0.82, respectively P > 0.05 for pair wise comparisons). Re-bleeding was associated with increased HM (56.9% vs. 31.6%, P = 0.002). The TG (n = 124) had less severe liver disease and critical illness and consequently had lower HM than local patients (32% vs. 57%, P = 0.002). TG patients with ≥2 endoscopies prior to transfer had increased 6-week mortality (P = 0.03). Time from bleeding to transfer ≥3 days was associated with re-bleeding (OR = 2.290, P = 0.043). MELD score was comparable to ICU prognostic models in predicting mortality. Blood lactate was also predictive of hospital mortality. Delays in referrals and repeated endoscopy were associated with increased re-bleeding and mortality in this group. © 2014 John Wiley & Sons Ltd.

Clinical Significance of Soluble Hemoglobin Scavenger Receptor CD163 (sCD163) in Sepsis, a Prospective Study

PubMed Central

Feng, Lin; Zhou, Xin; Su, Long-Xiang; Feng, Dan; Jia, Yan-Hong; Xie, Li-Xin

2012-01-01

Objective We investigated serum soluble CD163 (sCD163) levels for use in the diagnosis, severity assessment, and prognosis of sepsis in the critical ill patients and compared sCD163 with other infection-related variables. Methods During july 2010 and April 2011, serum was obtained from 102 sepsis patients (days 1, 3, 5, 7, and 10 after admission to an ICU) and 30 systemic inflammatory response syndrome (SIRS) patients with no sepsis diagnosed. Serum levels of sCD163, procalcitonon (PCT), and C reactive protein (CRP) were determined respectively. Sequential organ failure assessment (SOFA) scores for sepsis patients were also recorded. Then evaluated their roles in sepsis. Results The sCD163 levels were 0.88(0.78–1.00)ug/mL for SIRS patients, 1.50(0.92–2.00)ug/mL for moderate sepsis patients, and 2.95(2.18–5.57)ug/mL for severe sepsis patients on day1. The areas under the ROC curves for sCD163, CRP, and PCT for the diagnosis of sepsis were, respectively, 0.856(95%CI: 0.791–0.921), 0.696(95%CI: 0.595–0.797), and 0.629(95%CI: 0.495–0.763), At the recommended cut-off 1.49 ug/mL for sCD163, the sensitivity is 74.0% with 93.3% specificity. Based on 28-day survivals, sCD163 levels in the surviving group stay constant, while they tended to gradually increase in the non-surviving group.The area under the ROC curve for sCD163 for sepsis prognosis was 0.706(95%CI 0.558–0.804). Levels of sCD163 with cut-off point >2.84 ug/mL have sensitivity of 55.8.0%, specificity 80.4%.Common risk factors for death and sCD163 were included in multivariate logistic regression analysis; the odds ratios (OR) for sCD163 and SOFA scores for sepsis prognosis were 1.173 and 1.396, respectively (P<0.05). Spearman rank correlation analysis showed that sCD163 was weakly, but positively correlated with CRP, PCT, and SOFA scores (0.2< r <0.4, P<0.0001), but not with leukocyte counts (r <0.2, P = 0.450). Conclusion Serum sCD163 is superior to PCT and CRP for the diagnosis of sepsis and differentiate the severity of sepsis. sCD163 levels were more sensitive for dynamic evaluations of sepsis prognosis. Serum sCD163 and SOFA scores are prognostic factors for sepsis. Trial Registration www.chictr.org ChiCTR-ONC-10000812 PMID:22911680

Essays on price cap regulation and yardstick competition

NASA Astrophysics Data System (ADS)

Noronha, Vernon Andrew

This dissertation presents three papers on the regulation of monopoly firms in the same industry using yardstick competition to determine prices. In the first paper, "Yardstick Competition for Diversified Firms," we extend Shleifer's (1985) model to the case of diversified firms, and find that the social optimum, in which firms would need to produce at lower marginal cost than in Shleifer's model, is unlikely to be attained through profit maximization. In the second paper, "Cost Reduction under a Regression-Based Revenue Cap Regime," we identify certain hitherto unexplored and potentially undesirable properties for the form of yardstick competition that is widely applied. Allowed revenue totals for monopoly utility firms are determined by a regression of all firms' current costs on their cost drivers. It is shown that this mechanism induces firms to invest less in cost-reducing technology than if prices are determined purely exogenously, and that such cost-distorting behavior is not uniform across the industry. In particular, firms whose sizes are most different from the industry-mean elevate their costs proportionately much more than firms of similar size to the mean. However, this distortion vanishes as the number of firms grows large. In the third paper, "Predicted Cost-Distorting Conduct by UK Electricity Distribution Firms," by undertaking numerical examples using data on the UK electricity distribution industry, we discover that although the currently employed system of yardstick competition may have theoretical shortcomings, in practice, these are of slight consequence. There is found to be relatively little predicted distortion of costs for the majority of firms. In fact, this system is shown to generate greater social welfare than a similar system in which firms would not have any incentive to distort costs, unless consumer surplus enjoys a very high weight relative to industry profits. It is also shown that mergers within the industry could have an unexpected beneficial effect by reducing the extent of cost-distorting behavior by larger firms, although the industry-wide net effect has to be judged on a case-by-case basis.

Quantitative model validation of manipulative robot systems

NASA Astrophysics Data System (ADS)

Kartowisastro, Iman Herwidiana

This thesis is concerned with applying the distortion quantitative validation technique to a robot manipulative system with revolute joints. Using the distortion technique to validate a model quantitatively, the model parameter uncertainties are taken into account in assessing the faithfulness of the model and this approach is relatively more objective than the commonly visual comparison method. The industrial robot is represented by the TQ MA2000 robot arm. Details of the mathematical derivation of the distortion technique are given which explains the required distortion of the constant parameters within the model and the assessment of model adequacy. Due to the complexity of a robot model, only the first three degrees of freedom are considered where all links are assumed rigid. The modelling involves the Newton-Euler approach to obtain the dynamics model, and the Denavit-Hartenberg convention is used throughout the work. The conventional feedback control system is used in developing the model. The system behavior to parameter changes is investigated as some parameters are redundant. This work is important so that the most important parameters to be distorted can be selected and this leads to a new term called the fundamental parameters. The transfer function approach has been chosen to validate an industrial robot quantitatively against the measured data due to its practicality. Initially, the assessment of the model fidelity criterion indicated that the model was not capable of explaining the transient record in term of the model parameter uncertainties. Further investigations led to significant improvements of the model and better understanding of the model properties. After several improvements in the model, the fidelity criterion obtained was almost satisfied. Although the fidelity criterion is slightly less than unity, it has been shown that the distortion technique can be applied in a robot manipulative system. Using the validated model, the importance of friction terms in the model was highlighted with the aid of the partition control technique. It was also shown that the conventional feedback control scheme was insufficient for a robot manipulative system due to high nonlinearity which was inherent in the robot manipulator.

Probing the anisotropic vortex lattice in the Fe-based superconductor KFe2As2 using small angle neutron scattering

DOE Office of Scientific and Technical Information (OSTI.GOV)

Debeer-Schmitt, Lisa M; Dewhurst, Charles; Kikuchi, Hiroko

Using small angle neutron scattering, the anisotropy of the magnetic vortex lattice (VL), in the heavily hole-doped pnictide superconductor, KFe2As2, was studied. Well-ordered VL scattering patterns were measured with elds applied in directions between B k c and the basal plane, rotating either towards [100] or [110]. Slightly distorted hexagonal patterns were observed when B k c. However, the scattering pattern distorted strongly as the eld was rotated away from the c- axis. At low eld, the arrangement of vortices is strongly aected by the anisotropy of penetration depth in the plane perpendicular to the eld. By tting the distortionmore » with the anisotropic London model, we obtained an estimate of 3:4 for the anisotropy factor, , between the in-plane and c-axis penetration depths at the lowest temperature studied. The results further reveal VL phase transitions as a function of eld direction. We discuss these transitions using the "Hairy Ball" theorem.« less

Co3(PO4)2·4H2O

PubMed Central

Lee, Young Hoon; Clegg, Jack K.; Lindoy, Leonard F.; Lu, G. Q. Max; Park, Yu-Chul; Kim, Yang

2008-01-01

Single crystals of Co3(PO4)2·4H2O, tricobalt(II) bis­[ortho­phosphate(V)] tetra­hydrate, were obtained under hydro­thermal conditions. The title compound is isotypic with its zinc analogue Zn3(PO4)2·4H2O (mineral name hopeite) and contains two independent Co2+ cations. One Co2+ cation exhibits a slightly distorted tetra­hedral coordination, while the second, located on a mirror plane, has a distorted octa­hedral coordination environment. The tetra­hedrally coordinated Co2+ is bonded to four O atoms of four PO4 3− anions, whereas the six-coordinate Co2+ is cis-bonded to two phosphate groups and to four O atoms of four water mol­ecules (two of which are located on mirror planes), forming a framework structure. In addition, hydrogen bonds of the type O—H⋯O are present throughout the crystal structure. PMID:21200978

Structural and electrical properties of large area epitaxial VO2 films grown by electron beam evaporation

NASA Astrophysics Data System (ADS)

Théry, V.; Boulle, A.; Crunteanu, A.; Orlianges, J. C.; Beaumont, A.; Mayet, R.; Mennai, A.; Cosset, F.; Bessaudou, A.; Fabert, M.

2017-02-01

Large area (up to 4 squared inches) epitaxial VO2 films, with a uniform thickness and exhibiting an abrupt metal-insulator transition with a resistivity ratio as high as 2.85 × 10 4 , have been grown on (001)-oriented sapphire substrates by electron beam evaporation. The lattice distortions (mosaicity) and the level of strain in the films have been assessed by X-ray diffraction. It is demonstrated that the films grow in a domain-matching mode where the distortions are confined close to the interface which allows growth of high-quality materials despite the high film-substrate lattice mismatch. It is further shown that a post-deposition high-temperature oxygen annealing step is crucial to ensure the correct film stoichiometry and provide the best structural and electrical properties. Alternatively, it is possible to obtain high quality films with a RF discharge during deposition, which hence do not require the additional annealing step. Such films exhibit similar electrical properties and only slightly degraded structural properties.

Applicability of regular particle shapes in light scattering calculations for atmospheric ice particles.

PubMed

Macke, A; Mishchenko, M I

1996-07-20

We ascertain the usefulness of simple ice particle geometries for modeling the intensity distribution of light scattering by atmospheric ice particles. To this end, similarities and differences in light scattering by axis-equivalent, regular and distorted hexagonal cylindric, ellipsoidal, and circular cylindric ice particles are reported. All the results pertain to particles with sizes much larger than a wavelength and are based on a geometrical optics approximation. At a nonabsorbing wavelength of 0.55 µm, ellipsoids (circular cylinders) have a much (slightly) larger asymmetry parameter g than regular hexagonal cylinders. However, our computations show that only random distortion of the crystal shape leads to a closer agreement with g values as small as 0.7 as derived from some remote-sensing data analysis. This may suggest that scattering by regular particle shapes is not necessarily representative of real atmospheric ice crystals at nonabsorbing wavelengths. On the other hand, if real ice particles happen to be hexagonal, they may be approximated by circular cylinders at absorbing wavelengths.

Antiprismatic Coordination about Xenon: The Structure of Nitrosonium Octafluoroxenate(VI).

PubMed

Peterson, S W; Holloway, J H; Coyle, B A; Williams, J M

1971-09-24

The structure of nitrosonium octafluoroxenate(VI), 2NOF . XeF(6), has been determined by means of single-crystal x-ray counter methods (R-index = 0.046, weighted R-index = 0.042). The space group is Pnma, with a = 8.914(10) angstroms, b = 5.945(10) angstroms, and c = 12.83(2) angstroms (the numbers in parentheses are the standard deviations to the least significant digit or digits); the calculated density (rho) is 3.354 grams per cubic centimeter, and there are four formula units per unit cell. The material consists of well-separated NO(+) and (XeF(8))(2-) ions; the structural formula is thus (NO)(2) (XeF(8)). The anion configuration is that of a slightly distorted Archimedean antiprism. The observed distortion appears incompatible with a lone-pair repulsion model. Xenon-fluorine bond lengths of 1.971(7), 1.946(5), 1.958(7), 2.052(5), and 2.099(5) angstroms were found.

A2TiF 5· nH 2O ( A=K, Rb, or Cs; n=0 or 1): Synthesis, structure, characterization, and calculations of three new uni-dimensional titanium fluorides

NASA Astrophysics Data System (ADS)

Jo, Vinna; Woo Lee, Dong; Koo, Hyun-Joo; Ok, Kang Min

2011-04-01

Three new uni-dimensional alkali metal titanium fluoride materials, A2TiF 5· nH 2O ( A=K, Rb, or Cs; n=0 or 1) have been synthesized by hydrothermal reactions. The structures of A2TiF 5· nH 2O have been determined by single-crystal X-ray diffraction. The Ti 4+ cations have been reduced to Ti 3+ during the synthesis reactions. All three A2TiF 5· nH 2O materials contain novel 1-D chain structures that are composed of the slightly distorted Ti 3+F 6 corner-sharing octahedra attributable to the Jahn-Teller distortion. The coordination environment of the alkali metal cations plays an important role to determine the degree of turning in the chain structures. Complete structural analyses, Infrared and UV-vis diffuse reflectance spectra, and thermal analyses are presented, as are electronic structure calculations.

The XRD Study of the Effect of Slight Change in Structure on the Superconductivity of Y-Ba-Cu-O System Material

NASA Astrophysics Data System (ADS)

Huaqin, Wang; Shiyuan, Zhang; Tongzheng, Jin; Shiying, Han; Dirong, Qiu; Hao, Wang; Ningsheng, Zhou

In this paper the differences in diffraction intensities from some crystal planes in the X-ray diffraction patterns of high Tc Y-Ba-Cu-O system superconductors prepared by different processing conditions and the difference among various structure cells in references are interpreted using computer fitting. The results suggest that there exists two structure cells in the single phase YBa2Cu3O7-x samples. Both structure cells have the same crystal symmetry and almost the same lattice parameters, a=3.821Å, b=3.892Å and c=11.676Å, but the different distortion degree of Cu2-O plane. According to EPR spectra measured on the same samples, it is considered that the improvement of superconductivity for the samples prepared by two-step annealing in flowing oxygen may be related to concentration of the structure cell with more serious distortion on the Cu2-O plane.

Solvothermal synthesis and structural characterization of a three-dimensional metal organic polymer [NaZn(1,2,4-BTC)] (1,2,4-BTC=1,2,4-benzenetricarboxylate)

NASA Astrophysics Data System (ADS)

Wang, Lei; Shi, Zhan; Li, Guanghua; Fan, Yong; Fu, Wensheng; Feng, Shouhua

2004-01-01

A new three-dimensional metal-organic polymer, [NaZn(1,2,4-BTC)] (where 1,2,4-BTC=1,2,4-benzenetricarboxylate), has been prepared under solvothermal conditions and characterized by single crystal X-ray diffraction. The compound crystallizes in the monoclinic space group P2 1/ c, with cell parameters: a=9.7706(4) Å, b=12.3549(5) Å, c=6.8897(3) Å, β=91.640(2)°, V=831.35(6) Å 3 and Z=4. In the three-dimensional structure of the compound, each Zn atom is five-coordinated in distorted trigonal bipyramidal geometry, while the sixfold coordination of Na corresponds to a slightly distorted triangular prism. The organic ligand, 1,2,4-BTC, shows a novel and unprecedented coordination mode: 11 bonds to 10 metals with each carboxylate function exhibiting different linkages. It remains stable when desolvated and when heated up to 410 °C.

Good Buy! Buying Home Furnishings.

ERIC Educational Resources Information Center

Thypin, Marilyn; Glasner, Lynne

A short fictional work for limited English speakers relates a young couple's experience in learning about buying home furnishings. The newly married couple need a comfortable place to sit in their living room but cannot afford to buy a sofa in one payment, and they do not qualify for credit cards. They consider the prices and credit arrangement at…

Manufacturing Distortions of Curved Composite Panels

NASA Technical Reports Server (NTRS)

Starnes, James H., Jr. (Technical Monitor); Ochinero, T. T.; Hyer, M. W.

2002-01-01

This papa briefly discusses the influences of through-thickness thermal expansion, a misaligned ply, and a resin-rich slightly thicker ply on the deformations of a curved composite laminate during cool down from tbc cure temperature. Both two-dimensional and three-dimensional level finite-element analyses are used. The deformations are categorized as to radial and tangential deformations and twist, and for each of the three influences, these deformations are quantified. An additional outcome of the study is an indication of the level of analysis needed to study each of these three influences.

Chloridotetra­kis(pyridine-4-carb­alde­hyde-κN)copper(II) chloride

PubMed Central

Meng, Xiu-Jin; Zhang, Shu-Hua; Yang, Ge-Ge; Huang, Xue-Ren; Jiang, Yi-Min

2009-01-01

In the mol­ecular structure of the title compound, [CuCl(C6H5NO)4]Cl, the CuII atom is coordinated by four N atoms of four pyridine-4-carboxaldehyde ligands and one chloride anion in a slightly distorted square-pyramidal coordination geometry. There is also a non-coordinating Cl− anion in the crystal structure. The CuII atom and both Cl atoms are situated on fourfold rotation axes. A weak C—H⋯Cl inter­action is also present. PMID:21578129

Optical wave distortion at perturbations of air density near aircrafts with subsonic velocities

NASA Astrophysics Data System (ADS)

Banakh, V. A.; Sukharev, A. A.

2017-11-01

The mean intensity, intensity fluctuations, and regular and random displacements of optical beams propagating through a zone of increased density formed at subsonic airflow about a turret in the turbulent atmosphere have been analyzed. It has been shown that the presence of perturbations around a turret due to the subsonic velocity of aircraft affects slightly the studied characteristics of the beam. Data illustrating changes in the studied beam characteristics for paths of different geometry and different turbulent conditions of radiation propagation are presented.

Emergence of periodic order in electric-field-driven planar nematic liquid crystals: An exclusive ac effect absent in static fields

NASA Astrophysics Data System (ADS)

Krishnamurthy, K. S.; Kumar, Pramoda

2007-11-01

We report, for a nematic liquid crystal with a low conductivity anisotropy, an ac field generated transition from a uniformly planar to a periodically modulated director configuration with the wave vector parallel to the initial director. Significantly, with unblocked electrodes, this instability is not excited by dc fields. Additionally, in very low frequency square wave fields, it occurs transiently after each polarity reversal, vanishing completely during field constancy. The time of occurrence of maximum distortion after polarity reversal decreases exponentially with voltage. The time dependence of optical phase change during transient distortion is nearly Gaussian. The pattern threshold Vc is linear in f , f denoting the frequency; the critical wave number qc of the modulation scales nearly linearly as f to a peak at ˜50Hz before falling slightly thereafter. The observed Vc(f) and qc(f) characteristics differ from the predictions of the standard model (SM). The instability may be interpreted as a special case of the Carr-Helfrich distortion suppressed in static fields due to weak charge focusing and strong charge injection. Its transient nature in the low frequency regime is suggestive of the possible role of gradient flexoelectric effect in its occurrence. The study includes measurement of certain elastic and viscosity parameters relevant to the application of the SM.

Jahn-Teller distortion of Mn3+-occupied octahedra in red beryl from Utah indicated by optical spectroscopy

NASA Astrophysics Data System (ADS)

Fridrichová, Jana; Bačík, Peter; Ertl, Andreas; Wildner, Manfred; Dekan, Július; Miglierini, Marcel

2018-01-01

Red beryl from Utah is chemically homogeneous and contains only Fe < 0.163, Mn < 0.018, and Mg < 0.016 apfu. Channel sites contain only up to Cs 0.011, K 0.009, Rb 0.004, and Na 0.004 apfu. This suggests only very slight tetrahedral (Cs,K,Rb)Li□-1Be-1 substitution, octahedral Na(Fe2+,Mg)□-1Al-1 substitution can be excluded. Fe and Mn are trivalent as documented by Mössbauer spectroscopy and optical absorption spectroscopy. Red beryl optimized formula is ∼[(Cs,Rb,K)0.02□0.98]Σ1.00□1.00(Al1.79Fe3+0.16Mn3+0.02Ti4+0.02Mg0.01)Σ2.00Be3(Si6O18). Location of Mn3+ was estimated to the octahedral Al3+ site, other choices are improbable due to the bond-length requirements. No Mn3+-induced Jahn-Teller structural distortion was detected due to site symmetry restrictions and small Mn3+ content. However, optical spectroscopy shows broad band at ∼7190 cm-1 assigned to the excited level of the spin-allowed pseudo-tetragonal split E ground state of elongated six-fold Mn3+ coordination. Crystal field calculations indicate that the local Mn3+ environment complies well with crystal chemical expectations for Jahn-Teller distorted Mn3+O6 octahedra.

Synthesis and Fluorescence Properties of Structurally Characterized Heterobimetalic Cu(II)⁻Na(I) Bis(salamo)-Based Complex Bearing Square Planar, Square Pyramid and Triangular Prism Geometries of Metal Centers.

PubMed

Dong, Xiu-Yan; Zhao, Qing; Wei, Zhi-Li; Mu, Hao-Ran; Zhang, Han; Dong, Wen-Kui

2018-04-25

A novel heterotrinuclear complex [Cu₂(L)Na( µ -NO₃)]∙CH₃OH∙CHCl₃ derived from a symmetric bis(salamo)-type tetraoxime H₄L having a naphthalenediol unit, was prepared and structurally characterized via means of elemental analyses, UV-Vis, FT-IR, fluorescent spectra and single-crystal X-ray diffraction. The heterobimetallic Cu(II)⁻Na(I) complex was acquired via the reaction of H₄L with 2 equivalents of Cu(NO₃)₂·2H₂O and 1 equivalent of NaOAc. Clearly, the heterotrinuclear Cu(II)⁻Na(I) complex has a 1:2:1 ligand-to-metal (Cu(II) and Na(I)) ratio. X-ray diffraction results exhibited the different geometric behaviors of the Na(I) and Cu(II) atoms in the heterotrinuclear complex; the both Cu(II) atoms are sited in the N₂O₂ coordination environments of fully deprotonated (L) 4− unit. One Cu(II) atom (Cu1) is five-coordinated and possesses a geometry of slightly distorted square pyramid, while another Cu(II) atom (Cu2) is four-coordination possessing a square planar coordination geometry. Moreover, the Na(I) atom is in the O₆ cavity and adopts seven-coordination with a geometry of slightly distorted single triangular prism. In addition, there are abundant supramolecular interactions in the Cu(II)⁻Na(I) complex. The fluorescence spectra showed the Cu(II)⁻Na(I) complex possesses a significant fluorescent quenching and exhibited a hypsochromic-shift compared with the ligand H₄L.

Nominal group technique-elicited barriers and facilitators to following the Dietary Guidelines for solid fats and added sugars in children: The HEALTH Study

USDA-ARS?s Scientific Manuscript database

The US population has a high intake of discretionary solid fats and added sugars (SoFAS) which currently exceeds federal dietary recommendations. The goal of this study was to identify barriers and facilitators to following the DGA. Thirty-eight 5th grade children across six Human Nutrition Resear...

Developmental Changes in Mother-Infant Face-to-Face Communication: Birth to 3 Months.

ERIC Educational Resources Information Center

Lavelli, Manuela; Fogel, Alan

2002-01-01

Investigated development of face-to-face communication in infants between 1 and 14 weeks old and their mothers. Found a curvilinear development of early face-to-face communication, with increases occurring between weeks 4 and 9. When placed on a sofa, infants' face-to-face communication was longer than when they were held. Girls spent a longer…

Commonly used severity scores are not good predictors of mortality in sepsis from severe leptospirosis: a series of ten patients.

PubMed

Velissaris, Dimitrios; Karanikolas, Menelaos; Flaris, Nikolaos; Fligou, Fotini; Marangos, Markos; Filos, Kriton S

2012-01-01

Introduction. Severe leptospirosis, also known as Weil's disease, can cause multiorgan failure with high mortality. Scoring systems for disease severity have not been validated for leptospirosis, and there is no documented method to predict mortality. Methods. This is a case series on 10 patients admitted to ICU for multiorgan failure from severe leptospirosis. Data were collected retrospectively, with approval from the Institution Ethics Committee. Results. Ten patients with severe leptospirosis were admitted in the Patras University Hospital ICU in a four-year period. Although, based on SOFA scores, predicted mortality was over 80%, seven of 10 patients survived and were discharged from the hospital in good condition. There was no association between SAPS II or SOFA scores and mortality, but survivors had significantly lower APACHE II scores compared to nonsurvivors. Conclusion. Commonly used severity scores do not seem to be useful in predicting mortality in severe leptospirosis. Early ICU admission and resuscitation based on a goal-directed therapy protocol are recommended and may reduce mortality. However, this study is limited by retrospective data collection and small sample size. Data from large prospective studies are needed to validate our findings.

On the mechanism of peptidoglycan binding and cleavage by the endo-specific lytic transglycosylase MltE from Escherichia coli.

PubMed

Fibriansah, Guntur; Gliubich, Francesca I; Thunnissen, Andy-Mark W H

2012-11-13

The lytic transglycosylase MltE from Escherichia coli is a periplasmic, outer membrane-attached enzyme that cleaves the β-1,4-glycosidic bonds between N-acetylmuramic acid and N-acetylglucosamine residues in the cell wall peptidoglycan, producing 1,6-anhydromuropeptides. Here we report three crystal structures of MltE: in a substrate-free state, in a binary complex with chitopentaose, and in a ternary complex with the glycopeptide inhibitor bulgecin A and the murodipeptide N-acetylglucosaminyl-N-acetylmuramyl-l-Ala-d-Glu. The substrate-bound structures allowed a detailed analysis of the saccharide-binding interactions in six subsites of the peptidoglycan-binding groove (subsites -4 to +2) and, combined with site-directed mutagenesis analysis, confirmed the role of Glu64 as catalytic acid/base. The structures permitted the precise modeling of a short glycan strand of eight saccharide residues, providing evidence for two additional subsites (+3 and +4) and revealing the productive conformational state of the substrate at subsites -1 and +1, where the glycosidic bond is cleaved. Full accessibility of the peptidoglycan-binding groove and preferential binding of an N-acetylmuramic acid residue in a (4)C(1) chair conformation at subsite +2 explain why MltE shows only endo- and no exo-specific activity toward glycan strands. The results further indicate that catalysis of glycosidic bond cleavage by MltE proceeds via distortion toward a sofa-like conformation of the N-acetylmuramic acid sugar ring at subsite -1 and by anchimeric assistance of the sugar's N-acetyl group, as shown previously for the lytic transglycosylases Slt70 and MltB.

Hexakis(N,N-dimethyl­formamide-κO)cobalt(II) bis­(perchlorate)

PubMed Central

Eissmann, Frank; Böhle, Tony; Mertens, Florian O. R. L.; Weber, Edwin

2010-01-01

The asymmetric unit of the title complex, [Co(DMF)6](ClO4)2 (DMF = N,N-dimethyl­formamide, C3H7NO), consists of two half complex cations with the Co2+ metal ions located on centers of inversion and two perchlorate anions. In the crystal packing, each Co2+ ion is coordinated by six mol­ecules of DMF in a slightly distorted octa­hedral geometry. The crystal structure is mainly stabilized by coordinative, ionic and C—H⋯O hydrogen-bonding inter­actions. PMID:21580225

Bis(2,4-dibromo-6-formyl­phenolato-κ2 O,O′)copper(II)

PubMed Central

Li, Guang Zhao; Zhang, Shu Hua; Liu, Zheng

2008-01-01

In the title compound, [Cu(C7H3Br2O2)2], the CuII atom, which lies on an inversion centre, is coordinated by four O atoms from two chelating bidentate 2,4-dibromo-6-formyl­phenolate ligands in a slightly distorted square-planar coordination geometry. In the crystal structure, short inter­molecular Br⋯Br [3.516 (4) and 3.653 (4) Å] and Cu⋯Br [3.255 (1) Å] contacts together with C—H⋯O hydrogen bonds generate a three-dimensional network. PMID:21200624

cis-Bis(O-methyl-dithio-carbonato-κ(2) S,S')bis-(tri-phenyl-phosphane-κP)ruthenium(II).

PubMed

Valerio-Cárdenas, Cintya; Hernández-Ortega, Simón; Reyes-Martínez, Reyna; Morales-Morales, David

2013-01-01

In the title compound, [Ru(CH3OCS2)2(C18H15P)2], the Ru(II) atom is in a distorted octa-hedral coordination by two xanthate anions (CH3OCS2) and two tri-phenyl-phosphane (PPh3) ligands. Both bidentate xanthate ligands coordinate the Ru(II) atom with two slightly different Ru-S bond lengths but with virtually equal bite angles [71.57 (4) and 71.58 (3)°]. The packing of the complexes is assured by C-H⋯O and C-H⋯π inter-actions.

Where Should Infants Sleep? A Comparison of Risk for Suffocation of Infants Sleeping in Cribs, Adult Beds, and Other Sleeping Locations

ERIC Educational Resources Information Center

Maloney, Michael J.

2004-01-01

Objectives: To ascertain whether the number of sudden infant deaths as a result of suffocation in cribs, in adult beds, on sofas or chairs, and on other sleep surfaces was increasing whether attributable to increased reporting, diagnostic shift, or an actual increase in suffocation deaths and to compare the risk of reported accidental suffocation…

Arterial to end-tidal carbon dioxide tension difference (CO2 gap) as a prognostic marker for adverse outcomes in emergency department patients presenting with suspected sepsis.

PubMed

Shetty, Amith; Sparenberg, Sebastian; Adams, Kristian; Selvedran, Selwyn; Tang, Benjamin; Hanna, Kim; Iredell, Jonathan

2018-05-13

The arterial to end-tidal carbon dioxide tension difference (CO 2 gap) correlates with physiologic dead space. The prognostic value of increased CO 2 gap in trauma and respiratory distress patients is documented. Transpulmonary arteriovenous shunting is identified as a predictor of mortality in non-pulmonary sepsis. We set out to investigate the prognostic value of the CO 2 gap in a pilot study of patients with suspected sepsis from non-respiratory causes. Patients presenting to tertiary Australian ED with suspected sepsis (n = 215) underwent near-simultaneous end-tidal carbon dioxide and partial pressure of carbon dioxide measurements. We investigated the correlation of CO 2 gap levels with the primary outcome of in-hospital mortality (IHM) and secondary outcomes of sepsis (ΔSOFA ≥2) and IHM and/or intensive care unit stay ≥72 h (IHM/ICU72h) in patients with sepsis because of non-respiratory causes. Among patients included in the analysis (n = 165), the CO 2 gap showed modest positive correlation with qSOFA (ρ = 0.39) and weak positive correlation with SOFA scores (ρ = 0.29) (both P < 0.01). The CO 2 gap had modest predictive value for primary outcome (IHM), area under receiver operating curve (AUROC 0.85, 95% confidence interval [CI] 0.78-0.90) and IHM/ICU72h outcome (AUROC 0.80, 95% CI 0.73-0.86), but lower predictive value for sepsis outcome (AUROC 0.64, 95% CI 0.55-0.71) (all P < 0.001). We report modest test performance for primary outcome at CO 2 gap ≥5 and ≥10 mmHg cut-offs. In this pilot study of patients with suspected sepsis from non-respiratory causes, an increased CO 2 gap demonstrates value in risk stratification and needs to be further evaluated and compared to other existent biomarkers. © 2018 Australasian College for Emergency Medicine & Australasian Society for Emergency Medicine.

Rhabdomyolysis and acute kidney injury in patients with traumatic spinal cord injury

PubMed Central

Galeiras, Rita; Mourelo, Mónica; Pértega, Sonia; Lista, Amanda; Ferreiro, Mª Elena; Salvador, Sebastián; Montoto, Antonio; Rodríguez, Antonio

2016-01-01

Background: Patients with acute traumatic spinal cord injuries (SCIs) exhibit factors that, in other populations, have been associated with rhabdomyolysis. Purpose: The aim of the study is to determine the incidence of rhabdomyolysis in patients with acute traumatic SCI admitted to the Intensive Care Unit (ICU), as well as the development of secondary acute kidney injury and associated factors. Study Design and Setting: This was an observational, retrospective study. Patient Sample: All adult patients admitted to the ICU with acute traumatic SCI who presented rhabdomyolysis, diagnosed through creatine phosphokinase (CPK) levels >500 IU/L. Outcome Measures: Incidence of rhabdomyolysis and subsequent renal dysfunction was calculated. Materials and Methods: Data about demographic variables, comorbidity, rhabdomyolysis risk factors, and variables involving SCI, severity scores, and laboratory parameters were obtained from clinical records. Multivariate logistic regression was used to identify renal injury risk factors. Results: In 2006–2014, 200 patients with acute SCI were admitted to ICU. Of these, 103 had rhabdomyolysis (incidence = 51.5%; 95% confidence interval [CI]: 44.3%–58.7%). The most typical American Spinal Injury Association classification was A (70.3%). The injury severity score was 30.3 ± 12.1 and sequential organ failure assessment (SOFA) score was 5.6 ± 3.3 points. During their stay, 57 patients (55.3%; 95% CI: 45.2%–65.4%) presented renal dysfunction (creatinine ≥1.2 mg/dL). In the multivariate analysis, variables associated with renal dysfunction were creatinine at admission (odds ratio [OR] = 9.20; P = 0.006) and hemodynamic SOFA score the day following admission (OR = 1.33; P = 0.024). Creatinine was a better predictor of renal dysfunction than the peak CPK value during the rhabdomyolysis (area under the receiver operating characteristic curve: 0.91 vs. 0.63, respectively). Conclusions: Rhabdomyolysis is a frequent condition in patients with acute traumatic SCI admitted to the ICU, and renal dysfunction occurs in half of the cases. Creatinine values should be requested starting at the admission while neither the peak CPK values nor the hemodynamic SOFA scores could be used to properly discriminate between patients with and without renal dysfunction. PMID:27688625

An Evaluation of the Usefulness of Extracorporeal Liver Support Techniques in Patients Hospitalized in the ICU for Severe Liver Dysfunction Secondary to Alcoholic Liver Disease

PubMed Central

Piechota, Mariusz; Piechota, Anna

2016-01-01

Background The mortality rate in patients with severe liver dysfunction secondary to alcoholic liver disease (ALD) who do not respond to the standard treatment is exceptionally high. Objectives The main aim of this study was to evaluate the usefulness of applying extracorporeal liver support techniques to treat this group of patients. Patients and Methods The data from 23 hospital admissions of 21 patients with ALD who were admitted to the department of anesthesiology and intensive therapy (A&IT) at the Dr Wł. Biegański Regional Specialist Hospital in Łódź between March 2013 and July 2015 were retrospectively analyzed. Results A total of 111 liver dialysis procedures were performed during the 23 hospitalizations, including 13 dialyses using fractionated plasma separation and adsorption (FPSA) with the Prometheus® system, and 98 procedures using the single pass albumin dialysis (SPAD) system. Upon admission to the intensive care unit (ICU), the median (interquartile range [IQR]) Glasgow coma scale (GCS), sequential organ failure assessment (SOFA), acute physiology and chronic health evaluation (APACHE) II, and simplified acute physiology score (SAPS) II scores were 15 (14 - 15), 9 (7 - 13), 17 (14 - 24), and 32 (22 - 50), respectively. The ICU, 30-day, and three-month mortality rates were 43.48%, 39.13%, and 73.91%, respectively. As determined by the receiver operative characteristic (ROC) analysis for single-factor models, the significant predictors of death in the ICU included the patients’ SOFA, APACHE II, SAPS II, and model of end-stage liver disease modified by the united network for organ sharing (MELD UNOS Modification) scores; the duration of stay (in days) in the A&IT Department; and bile acid, creatinine and albumin levels upon ICU admission. The ROC analysis indicated the significant discriminating power of the SOFA, APACHE II, SAPS II, and MELD UNOS modification scores on the three-month mortality rate. Conclusions The application of extracorporeal liver support techniques in patients with severe liver dysfunction secondary to ALD appears justified in the subset of patients with MELD UNOS Modification scores of 18 - 30. PMID:27642344

Clinical course of sepsis, severe sepsis, and septic shock in a cohort of infected patients from ten Colombian hospitals

PubMed Central

2013-01-01

Background Sepsis has several clinical stages, and mortality rates are different for each stage. Our goal was to establish the evolution and the determinants of the progression of clinical stages, from infection to septic shock, over the first week, as well as their relationship to 7-day and 28-day mortality. Methods This is a secondary analysis of a multicenter cohort of inpatients hospitalized in general wards or intensive care units (ICUs). The general estimating equations (GEE) model was used to estimate the risk of progression and the determinants of stages of infection over the first week. Cox regression with time-dependent covariates and fixed covariates was used to determine the factors related with 7-day and 28-day mortality, respectively. Results In 2681 patients we show that progression to severe sepsis and septic shock increases with intraabdominal and respiratory sources of infection [OR = 1,32; 95%IC = 1,20-1,46 and OR = 1.21, 95%CI = 1,11-1,33 respectively], as well as according to Acute Physiology and Chronic Health Evaluation II (APACHE II) [OR = 1,03; 95%CI = 1,02-1,03] and Sequential Organ Failure Assessment (SOFA) [OR = 1,16; 95%CI = 1,14-1,17] scores. The variables related with first-week mortality were progression to severe sepsis [HR = 2,13; 95%CI = 1,13-4,03] and septic shock [HR = 3,00; 95%CI = 1,50-5.98], respiratory source of infection [HR = 1,76; 95%IC = 1,12-2,77], APACHE II [HR = 1,07; 95% CI = 1,04-1,10] and SOFA [HR = 1,09; 95%IC = 1,04-1,15] scores. Conclusions Intraabdominal and respiratory sources of infection, independently of SOFA and APACHE II scores, increase the risk of clinical progression to more severe stages of sepsis; and these factors, together with progression of the infection itself, are the main determinants of 7-day and 28-day mortality. PMID:23883312

Biomarkers of Endothelial Activation Are Associated with Poor Outcome in Critical Illness.

PubMed

Mikacenic, Carmen; Hahn, William O; Price, Brenda L; Harju-Baker, Susanna; Katz, Ronit; Kain, Kevin C; Himmelfarb, Jonathan; Liles, W Conrad; Wurfel, Mark M

2015-01-01

Endothelial activation plays a role in organ dysfunction in the systemic inflammatory response syndrome (SIRS). Angiopoietin-1 (Ang-1) promotes vascular quiescence while angiopoietin-2 (Ang-2) mediates microvascular leak. Circulating levels of Ang-1 and Ang-2 in patients with SIRS could provide insight on risks for organ dysfunction and death distinct from inflammatory proteins. In this study, we determined if biomarkers of endothelial activation and inflammation exhibit independent associations with poor outcomes in SIRS. We studied 943 critically ill patients with SIRS admitted to an Intensive Care Unit (ICU) of an academic medical center. We measured plasma levels of endothelial markers (Ang-1, Ang-2, soluble vascular cell adhesion molecule-1 (sVCAM-1)) and inflammatory markers (interleukin-6 (IL-6), interleukin-8 (IL-8), granulocyte-colony stimulating factor (G-CSF), soluble tumor necrosis factor receptor-1 (sTNFR-1)) within 24 hours of enrollment. We tested for associations between each marker and 28 day mortality, shock, and day 3 sequential organ failure assessment (SOFA) score. For 28 day mortality, we performed sensitivity analysis for those subjects with sepsis and those with sterile inflammation. We used multivariate models to adjust for clinical covariates and determine if associations identified with endothelial activation markers were independent of those observed with inflammatory markers. Higher levels of all biomarkers were associated with increased 28 day mortality except levels of Ang-1 which were associated with lower mortality. After adjustment for comorbidities and sTNFR-1 concentration, a doubling of Ang-1 concentration was associated with lower 28 day mortality (Odds ratio (OR) = 0.81; p<0.01), shock (OR = 0.82; p<0.001), and SOFA score (β = -0.50; p<0.001), while Ang-2 concentration was associated with increased mortality (OR = 1.55; p<0.001), shock (OR = 1.51; p<0.001), and SOFA score (β = +0.63; p<0.001). sVCAM-1 was not independently associated with SIRS outcomes. In critically ill patients with SIRS, early measurements of Ang-1 and Ang-2 are associated with death and organ dysfunction independently of simultaneously-measured markers of inflammation.

Risk Factors for Noninvasive Ventilation Failure in Critically Ill Subjects With Confirmed Influenza Infection.

PubMed

Rodríguez, Alejandro; Ferri, Cristina; Martin-Loeches, Ignacio; Díaz, Emili; Masclans, Joan R; Gordo, Federico; Sole-Violán, Jordi; Bodí, María; Avilés-Jurado, Francesc X; Trefler, Sandra; Magret, Monica; Moreno, Gerard; Reyes, Luis F; Marin-Corral, Judith; Yebenes, Juan C; Esteban, Andres; Anzueto, Antonio; Aliberti, Stefano; Restrepo, Marcos I

2017-10-01

Despite wide use of noninvasive ventilation (NIV) in several clinical settings, the beneficial effects of NIV in patients with hypoxemic acute respiratory failure (ARF) due to influenza infection remain controversial. The aim of this study was to identify the profile of patients with risk factors for NIV failure using chi-square automatic interaction detection (CHAID) analysis and to determine whether NIV failure is associated with ICU mortality. This work was a secondary analysis from prospective and observational multi-center analysis in critically ill subjects admitted to the ICU with ARF due to influenza infection requiring mechanical ventilation. Three groups of subjects were compared: (1) subjects who received NIV immediately after ICU admission for ARF and then failed (NIV failure group); (2) subjects who received NIV immediately after ICU admission for ARF and then succeeded (NIV success group); and (3) subjects who received invasive mechanical ventilation immediately after ICU admission for ARF (invasive mechanical ventilation group). Profiles of subjects with risk factors for NIV failure were obtained using CHAID analysis. Of 1,898 subjects, 806 underwent NIV, and 56.8% of them failed. Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Sequential Organ Failure Assessment (SOFA) score, infiltrates in chest radiograph, and ICU mortality (38.4% vs 6.3%) were higher ( P < .001) in the NIV failure than in the NIV success group. SOFA score was the variable most associated with NIV failure, and 2 cutoffs were determined. Subjects with SOFA ≥ 5 had a higher risk of NIV failure (odds ratio = 3.3, 95% CI 2.4-4.5). ICU mortality was higher in subjects with NIV failure (38.4%) compared with invasive mechanical ventilation subjects (31.3%, P = .018), and NIV failure was associated with increased ICU mortality (odds ratio = 11.4, 95% CI 6.5-20.1). An automatic and non-subjective algorithm based on CHAID decision-tree analysis can help to define the profile of patients with different risks of NIV failure, which might be a promising tool to assist in clinical decision making to avoid the possible complications associated with NIV failure. Copyright © 2017 by Daedalus Enterprises.

A variety of characteristic behaviour of resonant KL23L23 Auger decays following Si K-shell photoexcitation of SiCl4

NASA Astrophysics Data System (ADS)

Suzuki, I. H.; Kono, Y.; Sakai, K.; Kimura, M.; Ueda, K.; Tamenori, Y.; Takahashi, O.; Nagaoka, S.

2013-04-01

Spectator resonant Auger electron spectra with the Si 1s photoexcitation of SiCl4 have been measured using an electron spectroscopic technique combined with undulator radiation. The transition with the highest intensity in the total ion yield (TIY) spectrum, coming from excitation of a 1s electron into the 9t2 valence orbital, generates the resonant Auger decay in which the excited electron remains in the 9t2 orbital. A TIY peak positioned slightly above the 1s ionization threshold induces Auger decay in which the slow photoelectron is re-captured into a higher lying Rydberg orbital or the normal Auger peak shape is distorted due to a post-collision interaction effect. Another structure above the threshold, originating from a doubly excited state, yields the normal Auger peak with the distortion of peak shape and a resonant Auger peak with a higher kinetic energy. These findings provide a clear understanding of the properties of the excited orbitals which were ambiguous previously.

Crystal structure of cis-aqua­bis­(2,2′-bi­pyridine-κ2 N,N′)chlorido­chromium(III) tetra­chlorido­zincate determined from synchrotron data

PubMed Central

Moon, Dohyun; Ryoo, Keon Sang; Choi, Jong-Ha

2016-01-01

The structure of the title salt, [CrCl(C10H8N2)2(H2O)][ZnCl4], has been determined from synchrotron data. The CrIII ion is coordinated by four N atoms from two 2,2′-bi­pyridine (bipy) ligands, one O atom from a water mol­ecule and a chloride anion in a cis arrangement, displaying a distorted octa­hedral geometry. The tetra­hedral [ZnCl4]2− anion is slightly distorted owing to its involvement in O—H⋯Cl hydrogen bonding with the coordinating water mol­ecule. The Cr—N(bipy) bond lengths are in the range 2.0485 (13)–2.0632 (12) Å, while the Cr—Cl and Cr—(OH2) bond lengths are 2.2732 (6) and 1.9876 (12) Å, respectively. In the crystal, mol­ecules are stacked along the a axis. PMID:27006786

Zn2+ selectively stabilizes FdU-substituted DNA through a unique major groove binding motif

PubMed Central

Ghosh, Supratim; Salsbury, Freddie R.; Horita, David A.; Gmeiner, William H.

2011-01-01

We report, based on semi-empirical calculations, that Zn2+ binds duplex DNA containing consecutive FdU–dA base pairs in the major groove with distorted trigonal bipyramidal geometry. In this previously uncharacterized binding motif, O4 and F5 on consecutive FdU are axial ligands while three water molecules complete the coordination sphere. NMR spectroscopy confirmed Zn2+ complexation occurred with maintenance of base pairing while a slight hypsochromic shift in circular dichroism (CD) spectra indicated moderate structural distortion relative to B-form DNA. Zn2+ complexation inhibited ethidium bromide (EtBr) intercalation and stabilized FdU-substituted duplex DNA (ΔTm > 15°C). Mg2+ neither inhibited EtBr complexation nor had as strong of a stabilizing effect. DNA sequences that did not contain consecutive FdU were not stabilized by Zn2+. A lipofectamine preparation of the Zn2+–DNA complex displayed enhanced cytotoxicity toward prostate cancer cells relative to the individual components prepared as lipofectamine complexes indicating the potential utility of Zn2+–DNA complexes for cancer treatment. PMID:21296761

Super-luminescent jet light generated by femtosecond laser pulses

PubMed Central

Xu, Zhijun; Zhu, Xiaonong; Yu, Yang; Zhang, Nan; Zhao, Jiefeng

2014-01-01

Phenomena of nonlinear light-matter interaction that occur during the propagation of intense ultrashort laser pulses in continuous media have been extensively studied in ultrafast optical science. In this vibrant research field, conversion of the input laser beam into optical filament(s) is commonly encountered. Here, we demonstrate generation of distinctive single or double super-luminescent optical jet beams as a result of strong spatial-temporal nonlinear interaction between focused 50 fs millijoule laser pulses and their induced micro air plasma. Such jet-like optical beams, being slightly divergent and coexisting with severely distorted conical emission of colored speckles, are largely different from optical filaments, and obtainable when the focal lens of proper f-number is slightly tilted or shifted. Once being collimated, the jet beams can propagate over a long distance in air. These beams not only reveal a potentially useful approach to coherent optical wave generation, but also may find applications in remote sensing. PMID:24463611

Stability Improvement of High-Pressure-Ratio Turbocharger Centrifugal Compressor by Asymmetric Flow Control-Part I: Non-Axisymmetrical Flow in Centrifugal Compressor.

PubMed

Yang, Mingyang; Zheng, Xinqian; Zhang, Yangjun; Bamba, Takahiro; Tamaki, Hideaki; Huenteler, Joern; Li, Zhigang

2013-03-01

This is Part I of a two-part paper documenting the development of a novel asymmetric flow control method to improve the stability of a high-pressure-ratio turbocharger centrifugal compressor. Part I focuses on the nonaxisymmetrical flow in a centrifugal compressor induced by the nonaxisymmetrical geometry of the volute while Part II describes the development of an asymmetric flow control method to avoid the stall on the basis of the characteristic of nonaxisymmetrical flow. To understand the asymmetries, experimental measurements and corresponding numerical simulation were carried out. The static pressure was measured by probes at different circumferential and stream-wise positions to gain insights about the asymmetries. The experimental results show that there is an evident nonaxisymmetrical flow pattern throughout the compressor due to the asymmetric geometry of the overhung volute. The static pressure field in the diffuser is distorted at approximately 90 deg in the rotational direction of the volute tongue throughout the diffuser. The magnitude of this distortion slightly varies with the rotational speed. The magnitude of the static pressure distortion in the impeller is a function of the rotational speed. There is a significant phase shift between the static pressure distributions at the leading edge of the splitter blades and the impeller outlet. The numerical steady state simulation neglects the aforementioned unsteady effects found in the experiments and cannot predict the phase shift, however, a detailed asymmetric flow field structure is obviously obtained.

Whiplash-type neck distortion in restrained car drivers: frequency, causes and long-term results.

PubMed

Richter, M; Otte, D; Pohlemann, T; Krettek, C; Blauth, M

2000-04-01

An analysis was made of 1176 whiplash-type neck distortions taken from a total of 3838 restrained car driver incident reports. The percentage of whiplash-type neck distortion among injured drivers increased from less than 10% in 1985 to over 30% in 1997. Most occurred in head-on crashes or crashes with multiple collisions; only 15% occurred in rear-end collisions. More than 1,000 questionnaires were sent to the injured to find out about the duration and type of complaints caused by their cervical spine injury. Although only 138 (12%) returned the questionnaire, which may not be a representative sample, a further analysis was carried out. Of the 138, 121 (88%) indicated that they had suffered or were still suffering from their symptoms. The percentages of the various complaints were as follows: pain (74%), tension (6%) and stiffness (5%) in the head (27%), neck (55%) and shoulder (8%). The duration of the complaints was longest after multiple collisions and when the onset of complaints was longer than 24 h after trauma. Women and elderly persons predominated slightly in the group with longer duration of complaints. A correlation between the severity of the accompanying injuries and duration of complaints was found. Lack of adequate follow-up for patients with less severe injuries posed considerable difficulties for this retrospective study. In order to better evaluate this problem, prospective studies are necessary, with documentation including diagnosis, treatments, complaint duration and type.

Can partial coherence interferometry be used to determine retinal shape?

PubMed

Atchison, David A; Charman, W Neil

2011-05-01

To determine likely errors in estimating retinal shape using partial coherence interferometric instruments when no allowance is made for optical distortion. Errors were estimated using Gullstrand no. 1 schematic eye and variants which included a 10 diopter (D) axial myopic eye, an emmetropic eye with a gradient-index lens, and a 10.9 D accommodating eye with a gradient-index lens. Performance was simulated for two commercial instruments, the IOLMaster (Carl Zeiss Meditec) and the Lenstar LS 900 (Haag-Streit AG). The incident beam was directed toward either the center of curvature of the anterior cornea (corneal-direction method) or the center of the entrance pupil (pupil-direction method). Simple trigonometry was used with the corneal intercept and the incident beam angle to estimate retinal contour. Conics were fitted to the estimated contours. The pupil-direction method gave estimates of retinal contour that were much too flat. The cornea-direction method gave similar results for IOLMaster and Lenstar approaches. The steepness of the retinal contour was slightly overestimated, the exact effects varying with the refractive error, gradient index, and accommodation. These theoretical results suggest that, for field angles ≤30°, partial coherence interferometric instruments are of use in estimating retinal shape by the corneal-direction method with the assumptions of a regular retinal shape and no optical distortion. It may be possible to improve on these estimates out to larger field angles by using optical modeling to correct for distortion.

Relative Bradycardia in Patients with Septic Shock Requiring Vasopressor Therapy

PubMed Central

Beesley, Sarah J.; Wilson, Emily L.; Lanspa, Michael J.; Grissom, Colin K.; Shahul, Sajid; Talmor, Daniel; Brown, Samuel M.

2017-01-01

Importance Tachycardia is common in septic shock, but many patients with septic shock are relatively bradycardic. The incidence, determinants, and implications of relative bradycardia (heart rate <80 beats/min) in septic shock are unknown. Objective To determine mortality associated with patients who are relatively bradycardic while in septic shock. Design Retrospective study of patients admitted for septic shock to study ICUs during 2005-2013. Setting One large academic referral hospital and two community hospitals. Participants Adult patients with septic shock requiring vasopressors. Intervention None. Measurements Primary outcome was 28-day mortality. We used multivariate logistic regression to evaluate the association between relative bradycardia and mortality, controlling for confounding with inverse probability treatment weighting using a propensity score. Results We identified 1,554 patients with septic shock, of whom 686 (44%) met criteria for relative bradycardia at some time. Twenty-eight day mortality in this group was 21% compared to 34% in the never-bradycardic group (p<0.001). Relatively bradycardic patients were older (65 vs. 60 years, p<0.001) and had slightly lower illness severity (SOFA 10 vs 11, p = 0.004, and APACHE II 27 vs. 28, p=0.008). After inverse probability treatment weighting, covariates were balanced, and the association between relative bradycardia and survival persisted (p<0.001). Conclusions Relative bradycardia in patients with septic shock is associated with lower mortality, even after adjustment for confounding. Our data support expanded investigation into whether inducing relative bradycardia will benefit patients with septic shock. PMID:27618277

[How does the Regional Psychiatry Budget (RPB) work in an area with initially low capacity of psychiatric hospital beds?].

PubMed

König, Hans-Helmut; Heider, Dirk; Rechlin, Thomas; Hoffmann, Peter; Birker, Thomas; Heinrich, Sven; Brettschneider, Christian; Hierholzer, Cornelia; Riedel-Heller, Steffi G; Roick, Christiane

2013-11-01

To analyze the impact of a capitated multi-sector-financing model for psychiatric care (RPB) in the model region Rendsburg-Eckernförde on costs and effectiveness of care. In a prospective controlled cohort study 244 patients with a diagnosis according to ICD-10: F10, F2 or F3 were interviewed in the model region (MR) and compared to 244 patients from a control region (CR) financed according to the fee-for-service principle. At baseline, 1.5 years and 3.5 years follow-up patients were interviewed using measures of psychopathology (CGI-S, HONOS, SCL-90 R/GSI, PANSS, BRMAS/BRMES), functioning (GAF, SOFAS), quality of life (EQ-5 D) and service use/costs (CSSRI). Subjective symptom severity (GSI) and functioning (GAF) developed more favourably in the MR than in the CR, the HONOS score developed slightly worse in the MR. The latter effect occurred mainly in ICD-10: F10 patients, while patients with F2/3 rather did benefit under RPB conditions. The development of total costs of care was not different between MR and CR. The potential to reduce costs of in-patient care was low due to the initially low capacity of inpatient beds. The RPB did not reduce the total costs of mental health care, but certain diagnosis groups may benefit from improved trans-sectoral treatment flexibility. © Georg Thieme Verlag KG Stuttgart · New York.

High proportions of foods recommended for consumption by United States Dietary Guidance contain solid fats and added sugar: Results from the National Health and Nutrition Examination Survey (2007-2008)

USDA-ARS?s Scientific Manuscript database

The 2010 Dietary Guidelines for Americans (DGA) recommend that individuals older than one year reduce intakes of solid fats (SoF) and added sugars (AS; together SoFAS). MyPlate, illustrates the proportions of five major food groups to promote healthy eating (Vegetables, Grains, Protein Foods, Fruit...

High Resolution Diffusion Tensor Imaging of Cortical-Subcortical White Matter Tracts in TBI

DTIC Science & Technology

2010-10-01

by the individual (e.g., car full of lettuce ) or words that share phonemic qualities (e.g., chair/cat; sofa/soup). The observed bidirectional...subjective clustering score minus the expected subjective clustering score. An example is if the word pair car/ lettuce (subjective observed score of 1) is...adjusted subjective clustering formula of observed subjective clustering (car/ lettuce , subjective observed score of 1) minus expected subjective

HbA1c is outcome predictor in diabetic patients with sepsis.

PubMed

Gornik, Ivan; Gornik, Olga; Gasparović, Vladimir

2007-07-01

We have investigated predictive value of HbA1c for hospital mortality and length of stay (LOS) in patients with type 2 diabetes admitted because of sepsis. A prospective observational study was implemented in a university hospital, 286 patients with type 2 diabetes admitted with sepsis were included. Leukocyte count, CRP, admission plasma glucose, APACHE II and SOFA score were noted at admission, HbA1c was measured on the first day following admission. Hospital mortality and hospital length of stay (LOS) were the outcome measures. Admission HbA1c was significantly lower in surviving patients than in non-survivors (median 8.2% versus 9.75%, respectively; P<0.001). There was a significant correlation between admission HbA1c and hospital LOS of surviving patients (r=0.29; P<0.001). Logistic regression showed that HbA1c is an independent predictor of hospital mortality (odds ratio 1.36), together with female sex (OR 2.24), APACHE II score (OR 1.08) and SOFA score (OR 1.28). Multiple regression showed that HbA1c and APACHE II score are independently related to hospital LOS. According to our results, HbA1c is an independent predictive factor for hospital mortality and hospital LOS of diabetic patients with sepsis.

Mortality prediction in patients with severe septic shock: a pilot study using a target metabolomics approach.

PubMed

Ferrario, Manuela; Cambiaghi, Alice; Brunelli, Laura; Giordano, Silvia; Caironi, Pietro; Guatteri, Luca; Raimondi, Ferdinando; Gattinoni, Luciano; Latini, Roberto; Masson, Serge; Ristagno, Giuseppe; Pastorelli, Roberta

2016-02-05

Septic shock remains a major problem in Intensive Care Unit, with high lethality and high-risk second lines treatments. In this preliminary retrospective investigation we examined plasma metabolome and clinical features in a subset of 20 patients with severe septic shock (SOFA score >8), enrolled in the multicenter Albumin Italian Outcome Sepsis study (ALBIOS, NCT00707122). Our purpose was to evaluate the changes of circulating metabolites in relation to mortality as a pilot study to be extended in a larger cohort. Patients were analyzed according to their 28-days and 90-days mortality. Metabolites were measured using a targeted mass spectrometry-based quantitative metabolomic approach that included acylcarnitines, aminoacids, biogenic amines, glycerophospholipids, sphingolipids, and sugars. Data-mining techniques were applied to evaluate the association of metabolites with mortality. Low unsaturated long-chain phosphatidylcholines and lysophosphatidylcholines species were associated with long-term survival (90-days) together with circulating kynurenine. Moreover, a decrease of these glycerophospholipids was associated to the event at 28-days and 90-days in combination with clinical variables such as cardiovascular SOFA score (28-day mortality model) or renal replacement therapy (90-day mortality model). Early changes in the plasma levels of both lipid species and kynurenine associated with mortality have potential implications for early intervention and discovering new target therapy.

Mortality prediction in patients with severe septic shock: a pilot study using a target metabolomics approach

PubMed Central

Ferrario, Manuela; Cambiaghi, Alice; Brunelli, Laura; Giordano, Silvia; Caironi, Pietro; Guatteri, Luca; Raimondi, Ferdinando; Gattinoni, Luciano; Latini, Roberto; Masson, Serge; Ristagno, Giuseppe; Pastorelli, Roberta

2016-01-01

Septic shock remains a major problem in Intensive Care Unit, with high lethality and high-risk second lines treatments. In this preliminary retrospective investigation we examined plasma metabolome and clinical features in a subset of 20 patients with severe septic shock (SOFA score >8), enrolled in the multicenter Albumin Italian Outcome Sepsis study (ALBIOS, NCT00707122). Our purpose was to evaluate the changes of circulating metabolites in relation to mortality as a pilot study to be extended in a larger cohort. Patients were analyzed according to their 28-days and 90-days mortality. Metabolites were measured using a targeted mass spectrometry-based quantitative metabolomic approach that included acylcarnitines, aminoacids, biogenic amines, glycerophospholipids, sphingolipids, and sugars. Data-mining techniques were applied to evaluate the association of metabolites with mortality. Low unsaturated long-chain phosphatidylcholines and lysophosphatidylcholines species were associated with long-term survival (90-days) together with circulating kynurenine. Moreover, a decrease of these glycerophospholipids was associated to the event at 28-days and 90-days in combination with clinical variables such as cardiovascular SOFA score (28-day mortality model) or renal replacement therapy (90-day mortality model). Early changes in the plasma levels of both lipid species and kynurenine associated with mortality have potential implications for early intervention and discovering new target therapy. PMID:26847922

Fabric geometry distortion during composites processing

NASA Technical Reports Server (NTRS)

Chen, Julie

1994-01-01

Waviness and tow misalignment are often cited as possible causes of data scatter and lower compression stiffness and strength in textile composites. Strength differences of as much as 40 percent have been seen in composites that appear to have the same basic material and structural properties -- i.e., yarn orientation, yarn size, interlacing geometry. Fabric geometry distortion has been suggested as a possible reason for this discrepancy, but little quantitative data or substantial evidence exists. The focus of this research is to contribute to the present understanding of the causes and effects of geometric distortion in textile composites. The initial part of the study was an attempt to gather qualitative information on a variety of textile structures. Existing and new samples confirmed that structures with a significant direction presence would be more susceptible to distortion due to the compaction process. Thus, uniweaves (fiber vol frac: 54-72 percent) biaxial braids (vf: 34-58 percent) demonstrated very little fabric geometry distortion. In stitched panels, only slight buckling of z-direction stitches was observed, primarily near the surface. In contrast, for structures with high compaction ratios -- e.g., large cylindrical yarns (2.5:1) orpowder towpreg (4:1) -- there were visible distortions where previously smooth and periodic undulations were transformed to abrupt changes in direction. A controlled study of the effect of forming pressure on distortion was conducted on type 162 glass plain weave fabrics. Panels (6 x 6 in) were produced via a resin infusion type setup, but with an EPON 815 epoxy resin. Pressures ranging from hand layup to 200 psi were used (vf: 34-54 percent). Photomicrographs indicated that at pressures up to 50 psi, large changes in thickness were due primarily to resin squeeze out. At higher pressures, when intimate contact was made between the layers, there was some tow flattening and in-plane shifting to optimize nesting. However, even at 200 psi the period and amplitude of the tow undulation remained constant, suggesting that for this relatively fine fabric, distortions from compaction were not a problem. Because of the interest in using larger tows (to reduce cost) and more complex structures, tests were also run on 2D triaxial glass braid (113 yd/lb at 0, 225 yd/lb at +/- 45). Forming pressures of 20, 50, 200, and 500 psi were used, and short block compression tests were run. The 500 psi specimen had a 10 percent decrease in modulus and an almost 50 percent decrease in strength (vs. 20 psi). Because the total fiber wgt/panel was kept constant, the thickness varied from 0.32 to 0.22 in (49-70 percent vf). Yet, the strength value is clearly below what would be expected, even with the decrease in thickness. Photomicrographs of these samples will be taken to determine if more fabric distortion exists in the 500 psi specimens. Finally, because the ultimate goal is to be able to predict and control distortion in a variety of textile structures, a model compaction test was developed to directly measure the deformation of the tows during compaction. Layers of dry glass fabric were placed in a mold with a clear plexiglass window. The yarn amplitude and period was then calculated using image analysis of the videotaped deformation. Preliminary tests demonstrated the feasibility of this technique for simple fabrics with large tows.

[4,6-Dimethyl­pyrimidine-2(1H)-thione-κS]iodidobis(triphenyl­phosphane-κP)copper(I)

PubMed Central

Pakawatchai, Chaveng; Wattanakanjana, Yupa; Choto, Patcharanan; Nimthong, Ruthairat

2012-01-01

In the mononuclear title complex, [CuI(C6H8N2S)(C18H15P)2], the CuI ion is in a slightly distorted tetra­hedral coordination geometry formed by two P atoms from two triphenyl­phosphane ligands, one S atom from a 4,6-dimethyl­pyrimidine-2(1H)-thione ligand and one iodide ion. There is an intra­molecular N—H⋯I hydrogen bond. In the crystal, π–π stacking inter­actions [centroid–centroid distance = 3.594 (1) Å] are observed. PMID:22719327

Macular function and morphology in acute retinal pigment epithelitis.

PubMed

Gundogan, Fatih C; Diner, Oktay; Tas, Ahmet; Ilhan, Abdullah; Yolcu, Umit

2014-12-01

A 20-year-old man applied with vision loss in the left eye. Right eye examination was unremarkable. Best-corrected visual acuity (BCVA) in the left eye was 20/200. Fundus examination revealed a few yellow spots within a round-shaped macular lesion. Autofluorescence imaging showed hyperautofluorescence in the lesion. Central amplitudes in multifocal electroretinogram (mfERG) were depressed. The patient reported a rhinopharyngitis 7-10 days before the visual loss. The patient was diagnosed as acute retinal pigment epithelitis. BCVA improved gradually up to 20/20 in 4 weeks. mfERG amplitudes returned to normal. A slight pigmentary distortion was the only residual fundus finding.

[1,2-Bis(diisopropyl-phosphan-yl)ethane-κ(2) P,P'](carbonato-κ(2) O,O')nickel(II).

PubMed

Morales-Becerril, Illan; Flores-Alamo, Marcos; Garcia, Juventino J

2013-04-01

In the crystal of the title compound, [Ni(CO3)(C14H32P2)], the metal center in each of three independent mol-ecules shows slight tetra-hedral distortion from ideal square-planar coordination geometry, with angles between the normals to the planes defined by the cis-P-Ni-P and cis-O-Ni-O fragments of 3.92 (17), 0.70 (16) and 2.17 (14)° in the three mol-ecules. In the crystal, there are inter-molecular C-H⋯O hydrogen bonds that show a laminar growth in the ab plane.

Impacts of oil spills on altimeter waveforms and radar backscatter cross section

NASA Astrophysics Data System (ADS)

Cheng, Yongcun; Tournadre, Jean; Li, Xiaofeng; Xu, Qing; Chapron, Bertrand

2017-05-01

Ocean surface films can damp short capillary-gravity waves, reduce the surface mean square slope, and induce "sigma0 blooms" in satellite altimeter data. No study has ascertained the effect of such film on altimeter measurements due to lack of film data. The availability of Environmental Response Management Application (ERMA) oil cover, daily oil spill extent, and thickness data acquired during the Deepwater Horizon (DWH) oil spill accident provides a unique opportunity to evaluate the impact of surface film on altimeter data. In this study, the Jason-1/2 passes nearest to the DWH platform are analyzed to understand the waveform distortion caused by the spill as well as the variation of σ0 as a function of oil thickness, wind speed, and radar band. Jason-1/2 Ku-band σ0 increased by 10 dB at low wind speed (<3 m s-1) in the oil-covered area. The mean σ0 in Ku and C bands increased by 1.0-3.5 dB for thick oil and 0.9-2.9 dB for thin oil while the waveforms are strongly distorted. As the wind increases up to 6 m s-1, the mean σ0 bloom and waveform distortion in both Ku and C bands weakened for both thick and thin oil. When wind exceeds 6 m s-1, only does the σ0 in Ku band slightly increase by 0.2-0.5 dB for thick oil. The study shows that high-resolution altimeter data can certainly help better evaluate the thickness of oil spill, particularly at low wind speeds.

Prescription Patterns for Tigecycline in Severely Ill Patients for Non-FDA Approved Indications in a Developing Country: A Compromised Outcome

PubMed Central

Moghnieh, Rima A.; Abdallah, Dania I.; Fawaz, Ismail A.; Hamandi, Tarek; Kassem, Mohammad; El-Rajab, Nabila; Jisr, Tamima; Mugharbil, Anas; Droubi, Nabila; Al Tabah, Samaa; Sinno, Loubna; Ziade, Fouad; Daoud, Ziad; Ibrahim, Ahmad

2017-01-01

Introduction: With the rise in antibiotic resistance, tigecycline has been used frequently in off-label indications, based on its in-vitro activity against multidrug-resistant organisms. In this study, our aim was to assess its use in approved and unapproved indications. Materials and Methods: This is a retrospective chart review evaluating a 2-year experience of tigecycline use for > 72 h in 153 adult patients inside and outside critical care unit from January 2012 to December 2013 in a Lebanese tertiary-care hospital. Results: Tigecycline was mostly used in off-label indications (81%) and prescribed inside the critical care area, where the number of tigecycline cycles was 16/1,000 patient days. Clinical success was achieved in 43.4% of the patients. In the critically ill group, it was significantly higher in patients with a SOFA score <7 using multivariate analysis (Odds Ratio (OR) = 12.51 [4.29–36.51], P < 0.0001). Microbiological success was achieved in 43.3% of patients. Yet, the univariate and adjusted multivariate models failed to show a significant difference in this outcome between patients inside vs. outside critical care area, those with SOFA score <7 vs. ≥ 7, and in FDA-approved vs. off-label indications. Total mortality reached ~45%. It was significantly higher in critically ill patients with SOFA score ≥7 (OR = 5.17 [2.43–11.01], P < 0.0001) and in off-label indications (OR = 4.00 [1.30–12.31], P = 0.01) using an adjusted multivariate model. Gram-negative bacteria represented the majority of the clinical isolates (81%) and Acinetobacter baumannii predominated (28%). Carbapenem resistance was present in 85% of the recovered Acinetobacter, yet, more than two third of the carbapenem-resistant Acinetobacter species were still susceptible to tigecycline. Conclusion: In our series, tigecycline has been mostly used in off-label indications, specifically in severely ill patients. The outcome of such infections was not inferior to that of FDA-approved indications, especially inside critical care area. The use of this last resort antibiotic in complicated clinical scenarios with baseline microbiological epidemiology predominated by extensively-drug resistant pathogens ought to be organized. PMID:28396656

Liver Cirrhosis is Independently Associated With 90-Day Mortality in ARDS Patients.

PubMed

Gacouin, Arnaud; Locufier, Maxime; Uhel, Fabrice; Letheulle, Julien; Bouju, Pierre; Fillatre, Pierre; Le Tulzo, Yves; Tadié, Jean Marc

2016-01-01

In a few studies, cirrhosis has been associated with increased mortality in patients with acute respiratory distress syndrome (ARDS). These studies were, however, conducted mostly before 2000. Over the last 15 years, the prognosis of cirrhotic patients admitted to the intensive care unit (ICU) seems to have improved and major changes in the management of mechanical ventilation (MV) of ARDS have appeared. The aim of this study was to determine whether cirrhosis remains a factor for poor prognosis despite improvements in MV techniques and supportive therapies for ARDS. Retrospective analysis of data recorded from 232 patients (42 with cirrhosis and 290 without cirrhosis) who received lung-protective ventilation for ARDS defined according to American-European Consensus Conference criteria and admitted from 2006 to 2013. Alcohol was the most common aetiology of the cirrhosis. The end point was mortality at day-90 from the diagnosis of ARDS, survival was calculated using the Kaplan-Meier method, and we used a Cox-proportional hazard model to determine whether cirrhosis remained independently associated with mortality after adjustment for other prognostic variables for ARDS described previously. Organ dysfunctions were assessed based on the Sequential Organ Failure Assessment (SOFA) criteria, pulmonary and nonpulmonary dysfunctions were distinguished and compared between cirrhotic and non-cirrhotic patients on the first 3 days of VM. Comparison of survival curves showed that cirrhotic patients had a poorer 90-day prognosis than non-cirrhotic patients (P = 0.03 by the log-rank test). After adjusted analysis, cirrhosis remained independently associated with mortality at day 90 (adjusted hazard ratio 2.09, 95% CI, 1.27-3.45, P = 0.004). Non-pulmonary SOFA scores were significantly higher in cirrhotic patients than in non-cirrhotic patients on day 1 (P < 0.001), day 2 (P = 0.003), and day 3 (P = 0.002) of MV for ARDS whereas pulmonary SOFA scores did not differ significantly. Despite improvements in the management of cirrhotic patients admitted to the ICU and in the management of MV for the treatment of ARDS, cirrhosis remained associated with a poorer prognosis in ARDS patients. The prognosis of cirrhotic patients with ARDS appears related to extrapulmonary organ dysfunctions rather than pulmonary dysfunction.

One-pot hydrothermal synthesis of zeolite/sodium tantalate composite and its photodegradation of methyl orange

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gu, Xiaoli; Key Laboratory of Energy Thermal Conversion and Control of Ministry of Education, Southeast University, Nanjing 210096; Lu, Haiqiang

2015-08-15

Highlights: • Sodalite/NaTaO{sub 3} composite is prepared by a one-pot hydrothermal synthesis. • Enhanced photodegradation is achieved due to the heterogeneous doping effect. • Structure distortion is found for NaTaO{sub 3} after removing sodalite by acid washing. - Abstract: Sodalite/NaTaO{sub 3} composite was prepared by a one-pot hydrothermal synthesis method. Sodalite and NaTaO{sub 3} grow interpenetrated, and the resulting composites have similar morphology as the pure sodalite. The sodalite/NaTaO{sub 3} composite has a lower band gap of 3.35 eV due to the heterogeneous doping effect, and exhibits an enhanced photodegradation of methyl orange under UV irradiation as compared to themore » pure NaTaO{sub 3}. A slight structure distortion is found for NaTaO{sub 3} after removing sodalite by acid washing the sodalite/NaTaO{sub 3} composite, and such result further confirms the co-growth of the two crystals. This one-pot hydrothermal method opens up new avenues for the preparation of photocatalytic composites.« less

Crystal structure of cis-aqua­chlorido­bis­(1,10-phenanthroline-κ2 N,N′)chromium(III) tetra­chlorido­zincate monohydrate from synchrotron data

PubMed Central

Moon, Dohyun; Choi, Jong-Ha

2015-01-01

The structure of the title compound, [CrCl(C12H8N2)2(H2O)][ZnCl4]·H2O, has been determined from synchrotron data. The CrIII ion is bonded to four N atoms from two 1,10-phenanthroline (phen) ligands, one water mol­ecule and a Cl atom in a cis arrangement, displaying an overall distorted octa­hedral coordination environment. The Cr—N(phen) bond lengths are in the range of 2.0495 (18) to 2.0831 (18) Å, while the Cr—Cl and Cr—(OH2) bond lengths are 2.2734 (7) and 1.9986 (17) Å, respectively. The tetra­hedral [ZnCl4]2− anion is slightly distorted owing to its involvement in O—H⋯Cl hydrogen bonding with coordinating and non-coordinating water mol­ecules. The two types of water mol­ecules also inter­act through O—H⋯O hydrogen bonds. The observed hydrogen-bonding pattern leads to the formation of a three-dimensional network structure. PMID:25844190

Crystal structure of bis-[tetra-kis-(tetra-hydro-furan-κO)lithium] bis[μ-2,2',2''-methanetriyltris(4,6-di-tert-butylphenolato)-κ4O,O':O',O'']-dimagnesiate.

PubMed

Zhou, Hongyan; Wang, Lei

2017-07-01

The title ion-association metal complex, [Li(C 4 H 8 O) 4 ] 2 [Mg 2 (C 43 H 61 O 3 ) 2 ], has been synthesized from the tridentate phenolic ligand tris-(3,5-di- tert -butyl-2-hy-droxy-phen-yl)methane in tetra-hydro-furan (THF). The aryl-oxo magnesiate complex anion is binuclear with each Mg 2 O 4 complex unit inversion-related and bridged through the two tridentate chelating phenolate O-donors of the ligand. The complex centres have a distorted tetra-hedral stereochemistry [Mg-O range 1.8796 (17)-2.0005 (16) Å] and an Mg⋯Mg separation of 2.9430 (14) Å]. The LiO 4 coodination sphere of the cation comprises four THF O-donor atoms and has a slightly distorted tetra-hedral conformation [Li-O range 1.899 (5)- 1.953 (5) Å]. In the crystal, a number of stabilizing intra-anion C-H⋯O hydrogen-bonding inter-actions are present but no inter-species associations are found.

Surface Control of Cold Hibernated Elastic Memory Self-Deployable Structure

NASA Technical Reports Server (NTRS)

Sokolowski, Witold M.; Ghaffarian, Reza

2006-01-01

A new class of simple, reliable, lightweight, low packaging volume and cost, self-deployable structures has been developed for use in space and commercial applications. This technology called 'cold hibernated elastic memory' (CHEM) utilizes shape memory polymers (SMP)in open cellular (foam) structure or sandwich structures made of shape memory polymer foam cores and polymeric composite skins. Some of many potential CHEM space applications require a high precision deployment and surface accuracy during operation. However, a CHEM structure could be slightly distorted by the thermo-mechanical processing as well as by thermal space environment Therefore, the sensor system is desirable to monitor and correct the potential surface imperfection. During these studies, the surface control of CHEM smart structures was demonstrated using a Macro-Fiber Composite (MFC) actuator developed by the NASA LaRC and US Army ARL. The test results indicate that the MFC actuator performed well before and after processing cycles. It reduced some residue compressive strain that in turn corrected very small shape distortion after each processing cycle. The integrated precision strain gages were detecting only a small flat shape imperfection indicating a good recoverability of original shape of the CHEM test structure.

Policy Options and the U.S. Withdrawal from Iraq: An Analysis of the Way Ahead

DTIC Science & Technology

2009-08-01

Our specialists combine in-country experience, language skills, and the use of local primary-source data to produce empirically based work. All of...President Obama takes over, due to the supposed certitudes of the recently signed Status of Forces Agreement (SOFA); however, there are crucial decisions to...was ratified by the Iraqi parliament on November 27, 2008, and signed by the leaders of the two countries on December 14, 2008. This agreement

High veno-arterial carbon dioxide gradient is not predictive of worst outcome after an elective cardiac surgery: a retrospective cohort study.

PubMed

Morel, Jerome; Grand, Nathalie; Axiotis, Gregory; Bouchet, Jean Baptiste; Faure, Michael; Auboyer, Christian; Vola, Marco; Molliex, Serge

2016-12-01

Alteration of tissue perfusion is a main contributor of organ dysfunction. In cardiac surgery, the importance of organ dysfunction is associated with worse outcome. Central venous-arterial difference in CO 2 tension (ΔCO 2 ) has been proposed as a global marker of the adequacy of tissue perfusion in shock states. We hypothesized that ΔCO 2 could be increased in case of postoperative organ failure or worse outcome. In this monocentric retrospective cohort study, we retrieved, from our database, 220 consecutive patients admitted in intensive care after an elective cardiac surgery. Four time points were formed: ICU admission, and 6, 24 and 48 h after. A ΔCO 2 below 6 mmHg defined the normal range values. The SOFA score, intensive care unit and hospital length of stay, hospital and 6-month mortality rate were recorded. We compared patient with low ΔCO 2 (<6 mmHg) and high ΔCO 2 (≥6 mmHg). We included 55 (25 %) and 165 patients in low and high ΔCO 2 groups, respectively. The SOFA score, the hospital and 6 months mortality rate were higher in patients with low ΔCO 2 . Surprisingly, we did not find results previously published in other surgical settings. In cardiac surgery, ΔCO 2 has a low predictive value of outcome.

Early Stage Blood Purification for Paraquat Poisoning: A Multicenter Retrospective Study.

PubMed

Li, An; Li, Wenxiong; Hao, Fengtong; Wang, Haishi

2016-01-01

To evaluate the efficacy of conservative treatment vs. hemoperfusion (HP) vs. HP + continuous veno-venous hemofiltration (CVVH) for acute Paraquat (PQ) poisoning. This was a multicenter retrospective study of patients with PQ poisoning between January 2013 and June 2014. Clinical data and PQ serum levels were collected at baseline and after 24, 48, and 72 h of treatment. Seventy-five, 65, and 43 underwent conservative treatment only (conservative treatment group), conservative treatment + HP (HP group), and conservative treatment + HP + CVVH (HP + CVVH group), respectively. PQ serum levels decreased in all groups after 72 h of treatment (p < 0.001); meanwhile, these values decreased faster in the HP and HP + CVVH groups compared with the conservative treatment group. More importantly, PQ blood levels were significantly lower in the HP + CVVH group compared with the HP group at 24 h (p < 0.05). Sequential organ failure assessment (ΔSOFA) values in the HP and HP + CVVH groups were significantly lower compared with that obtained for the conservative treatment group (p < 0.05). The 60-day survival rates were 21.3, 43.1 and 46.5%, respectively. Multivariate analysis indicated that age, PQ dose, admission PQ levels, and admission SOFA score were independently associated with mortality. HP and HP + CVVH were protective factors. Early HP or HP + CVVH after PQ poisoning could decrease PQ blood levels, alleviate organ damage, and increase survival. © 2016 S. Karger AG, Basel.

Prognostic factors and scoring system for survival in colonic perforation.

PubMed

Komatsu, Shuhei; Shimomatsuya, Takumi; Nakajima, Masayuki; Amaya, Hirokazu; Kobuchi, Taketsune; Shiraishi, Susumu; Konishi, Sayuri; Ono, Susumu; Maruhashi, Kazuhiro

2005-01-01

No ideal and generally accepted prognostic factors and scoring systems exist to determine the prognosis of peritonitis associated with colonic perforation. This study was designed to investigate prognostic factors and evaluate the various scoring systems to allow identification of high-risk patients. Between 1996 and 2003, excluding iatrogenic and trauma cases, 26 consecutive patients underwent emergency operations for colorectal perforation and were selected for this retrospective study. Several clinical factors were analyzed as possible predictive factors, and APACHE II, SOFA, MPI, and MOF scores were calculated. The overall mortality was 26.9%. Compared with the survivors, non-survivors were found more frequently in Hinchey's stage III-IV, a low preoperative marker of pH, base excess (BE), and a low postoperative marker of white blood cell count, PaO2/FiO2 ratio, and renal output (24h). According to the logistic regression model, BE was a significant independent variable. Concerning the prognostic scoring systems, an APACHE II score of 19, a SOFA score of 8, an MPI score of 30, and an MOF score of 7 or more were significantly related to poor prognosis. Preoperative BE and postoperative white blood cell count were reliable prognostic factors and early classification using prognostic scoring systems at specific points in the disease process are useful to improve our understanding of the problems involved.

Multidrug Resistance Acinetobacter Bacteremia Secondary to Ventilator-Associated Pneumonia: Risk Factors and Outcome.

PubMed

Brotfain, Evgeni; Borer, Abraham; Koyfman, Leonid; Saidel-Odes, Lisa; Frenkel, Amit; Gruenbaum, Shaun E; Rosenzweig, Vsevolod; Zlotnik, Alexander; Klein, Moti

2017-10-01

Acinetobacter baumannii is a multidrug resistant (MDR), gram-negative bacterium commonly implicated in ventilator-associated pneumonia (VAP) in critically ill patients. Patients in the intensive care unit (ICU) with VAP often subsequently develop A baumannii bacteremia, which may significantly worsen outcomes. In this study, we retrospectively reviewed the clinical and laboratory records of 129 ICU patients spanning 6 years with MDR A baumannii VAP; 46 (35%) of these patients had concomitant MDR A baumannii bacteremia. The ICU mortality rate was higher in patients with VAP having A baumannii bacteremia compared to nonbacteremic patients (32.4% vs 9.6% respectively, P < .005). Age >65 years, an Acute Physiology and Chronic Health Evaluation II (APACHE-II) score higher than 20, a Sequential Organ Failure Assessment (SOFA) score higher than 7 on the day of bacteremia, and the presence of comorbid disease (chronic obstructive pulmonary disease [COPD] and chronic renal failure) were found to be independent risk factors for in-hospital mortality in this population. Multidrug resistant A baumannii was not an independent risk factor for mortality. Although the presence of comorbid diseases (COPD and chronic renal failure) and severity of disease (APACHE > 20 and SOFA >7) were found to be independent risk factors for ICU mortality, MDR A baumannii bacteremia was not an independent risk factor for mortality in our critically ill population.

Rethinking the concept of sepsis and septic shock.

PubMed

A Cabrita, Joana; Pinheiro, Isabel; Menezes Falcão, L

2018-06-16

Sepsis is a major global health problem and represents a challenge for physicians all over the world. The knowledge of sepsis and septic shock is a topic of interest among the scientific community and society in general. New guidelines for management of sepsis and septic shock were developed in 2016, providing an update on this area. In Sepsis-3 new definitions for sepsis and septic shock were published. The purpose of this narrative review is to discuss and compare the new criteria of 2016 with the old criteria, purposing at the same time an alternative approach for this topic. SOFA criteria (Sequential Organ Failure Assessment Score) are more complete, but too extensive and usually difficult to apply outside the intensive care units, therefore inducing potentially delay in the proper treatment. We purpose combined criteria for the selection of sepsis patients. Initially, we could apply qSOFA (quick Sepsis Related Organ Failure Assessment) criteria, due to its easy application, associated with the SIRS (systemic inflammatory response syndrome) criteria, allowing to select the patients who are infected and need faster treatment. In that way we would use the best of old and newest criteria, allowing the early selection of patients who are infected and require faster treatment, while the search for a better and faster tool continues. Copyright © 2018 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

Early prediction of intensive care unit-acquired weakness using easily available parameters: a prospective observational study.

PubMed

Wieske, Luuk; Witteveen, Esther; Verhamme, Camiel; Dettling-Ihnenfeldt, Daniela S; van der Schaaf, Marike; Schultz, Marcus J; van Schaik, Ivo N; Horn, Janneke

2014-01-01

An early diagnosis of Intensive Care Unit-acquired weakness (ICU-AW) using muscle strength assessment is not possible in most critically ill patients. We hypothesized that development of ICU-AW can be predicted reliably two days after ICU admission, using patient characteristics, early available clinical parameters, laboratory results and use of medication as parameters. Newly admitted ICU patients mechanically ventilated ≥2 days were included in this prospective observational cohort study. Manual muscle strength was measured according to the Medical Research Council (MRC) scale, when patients were awake and attentive. ICU-AW was defined as an average MRC score <4. A prediction model was developed by selecting predictors from an a-priori defined set of candidate predictors, based on known risk factors. Discriminative performance of the prediction model was evaluated, validated internally and compared to the APACHE IV and SOFA score. Of 212 included patients, 103 developed ICU-AW. Highest lactate levels, treatment with any aminoglycoside in the first two days after admission and age were selected as predictors. The area under the receiver operating characteristic curve of the prediction model was 0.71 after internal validation. The new prediction model improved discrimination compared to the APACHE IV and the SOFA score. The new early prediction model for ICU-AW using a set of 3 easily available parameters has fair discriminative performance. This model needs external validation.

New comparison of psychological meaning of colors in samples and objects with semantic ratings

NASA Astrophysics Data System (ADS)

Lee, Tien-Rein

2002-06-01

In color preference and color-meaning research, color chips are widely used as stimuli. Are meanings of isolated color chips generalizeable to contextualized colors? According to Taft (1996), few significant differences exist between chip and object ratings for the same color. A similar survey was performed on 192 college students. This article reports the results of the study comparing semantic rating of color applied to a variety of familiar objects. The objects were a cup, T-shirt, sofa, car, notebook, and MP3 player, all images that represent daily life familiar objects. Subjects rated a set of 16 color chips, against 6 bipolar, 7-step semantic differential scales. The scales consisted of beautiful-ugly, soft-hard, warm-cool, elegant-vulgar, loud- discreet, and masculine-feminine. Analyses performed on the data indicated that unlike Taft's findings on 1996, significant differences existed between chip and object rating for the same color in every scale. The results of the study have implications for the use of color chips in color planning which suggest they are not compatible with the generality of results of the earlier color meaning research. Generally, a color judged to be beautiful, elegant and warm when presented as a chip does not equal beautiful, elegant, and warm when applied to the surface of an object such as a cup, T-shirt, sofa, car.

Fuel cell end plate structure

DOEpatents

Guthrie, Robin J.; Katz, Murray; Schroll, Craig R.

1991-04-23

The end plates (16) of a fuel cell stack (12) are formed of a thin membrane. Pressure plates (20) exert compressive load through insulation layers (22, 26) to the membrane. Electrical contact between the end plates (16) and electrodes (50, 58) is maintained without deleterious making and breaking of electrical contacts during thermal transients. The thin end plate (16) under compressive load will not distort with a temperature difference across its thickness. Pressure plate (20) experiences a low thermal transient because it is insulated from the cell. The impact on the end plate of any slight deflection created in the pressure plate by temperature difference is minimized by the resilient pressure pad, in the form of insulation, therebetween.

High performance zinc anode for battery applications

NASA Technical Reports Server (NTRS)

Casey, John E., Jr. (Inventor)

1998-01-01

An improved zinc anode for use in a high density rechargeable alkaline battery is disclosed. A process for making the zinc electrode comprises electrolytic loading of the zinc active material from a slightly acidic zinc nitrate solution into a substrate of nickel, copper or silver. The substrate comprises a sintered plaque having very fine pores, a high surface area, and 80-85 percent total initial porosity. The residual porosity after zinc loading is approximately 25-30%. The electrode of the present invention exhibits reduced zinc mobility, shape change and distortion, and demonstrates reduced dendrite buildup cycling of the battery. The disclosed battery is useful for applications requiring high energy density and multiple charge capability.

Simple and versatile heterodyne whole-field interferometer for phase optics characterization.

PubMed

Silva, D M; Barbosa, E A; Wetter, N U

2012-10-01

A wavefront sensor for thermally induced lens and passive lens characterization based on low-coherence digital speckle interferometry was developed and studied. By illuminating the optical setup with two slightly detuned red diode lasers, whole-field contour interference fringes were generated according to the resulting synthetic wavelength. For fringe pattern visualization the optical setup used the light transmitted through a ground glass plate as object beam. The performance of the sensor was investigated and its versatility was demonstrated by measuring the thermal lens induced in an Er-doped glass sample pumped by a 1.76-W diode laser emitting at 976 nm and by evaluating the wavefront distortion introduced by an ophthalmic progressive lens.

Thymic cystic degeneration, pseudoepitheliomatous hyperplasia, and hemorrhage in a dog with brodifacoum toxicosis.

PubMed

Rickman, B H; Gurfield, N

2009-05-01

Thymic cysts with pseudoepitheliomatous hyperplasia are described in a 7-month-old female American Eskimo Dog that died of complications from brodifacoum poisoning. Grossly, there was hemothorax with marked cranial mediastinal hemorrhage. Histologically, thymic lobules were expanded and distorted by irregular cysts, lined by single to multiple layers of plump to slightly attenuated polygonal squamous epithelial cells supported by a basement membrane (pseudoepitheliomatous hyperplasia). The thymus had a paucity of lymphocytes and lacked corticomedullary differentiation. Extensive hemorrhage within the cysts and thymic parenchyma extended into the adjacent adipose tissue. To the authors' knowledge, this is the first report of cystic thymic degeneration with pseudoepitheliomatous hyperplasia in a nonhuman species.

4-[2-(4-cyanophenyl)ethenyl]-N-methylpyridinium tetraphenylborate.

PubMed

Jin, Dan; Zhang, De Chun

2005-11-01

In the title compound, C(15)H(13)N(2)(+).C(24)H(20)B(-), the pyridyl ring of the cation makes a dihedral angle of 1.6 degrees with the benzene ring. Each is rotated in the same direction with respect to the central -C-CH=CH-C- linkage, by 3.8 and 5.3 degrees, respectively. The anions have a slightly distorted tetrahedral geometry. Molecular packing analysis was carried out using the packing energy portioning scheme in the program OPEC. Around each anion in the crystal structure there are eight anions, which interact with the central anion through C-H...pi interactions. The cations are hydrogen bonded in a head-to-tail fashion, forming chains along [101].

[1,2-Bis(diisopropyl­phosphan­yl)ethane-κ2 P,P′](carbonato-κ2 O,O′)nickel(II)

PubMed Central

Morales-Becerril, Illan; Flores-Alamo, Marcos; Garcia, Juventino J.

2013-01-01

In the crystal of the title compound, [Ni(CO3)(C14H32P2)], the metal center in each of three independent mol­ecules shows slight tetra­hedral distortion from ideal square-planar coordination geometry, with angles between the normals to the planes defined by the cis-P—Ni—P and cis-O—Ni—O fragments of 3.92 (17), 0.70 (16) and 2.17 (14)° in the three mol­ecules. In the crystal, there are inter­molecular C—H⋯O hydrogen bonds that show a laminar growth in the ab plane. PMID:23633999

cis-Bis(O-methyl­dithio­carbonato-κ2 S,S′)bis­(tri­phenyl­phosphane-κP)ruthenium(II)

PubMed Central

Valerio-Cárdenas, Cintya; Hernández-Ortega, Simón; Reyes-Martínez, Reyna; Morales-Morales, David

2013-01-01

In the title compound, [Ru(CH3OCS2)2(C18H15P)2], the RuII atom is in a distorted octa­hedral coordination by two xanthate anions (CH3OCS2) and two tri­phenyl­phosphane (PPh3) ligands. Both bidentate xanthate ligands coordinate the RuII atom with two slightly different Ru—S bond lengths but with virtually equal bite angles [71.57 (4) and 71.58 (3)°]. The packing of the complexes is assured by C—H⋯O and C—H⋯π inter­actions. PMID:24046578

[Formulation of combined predictive indicators using logistic regression model in predicting sepsis and prognosis].

PubMed

Duan, Liwei; Zhang, Sheng; Lin, Zhaofen

2017-02-01

To explore the method and performance of using multiple indices to diagnose sepsis and to predict the prognosis of severe ill patients. Critically ill patients at first admission to intensive care unit (ICU) of Changzheng Hospital, Second Military Medical University, from January 2014 to September 2015 were enrolled if the following conditions were satisfied: (1) patients were 18-75 years old; (2) the length of ICU stay was more than 24 hours; (3) All records of the patients were available. Data of the patients was collected by searching the electronic medical record system. Logistic regression model was formulated to create the new combined predictive indicator and the receiver operating characteristic (ROC) curve for the new predictive indicator was built. The area under the ROC curve (AUC) for both the new indicator and original ones were compared. The optimal cut-off point was obtained where the Youden index reached the maximum value. Diagnostic parameters such as sensitivity, specificity and predictive accuracy were also calculated for comparison. Finally, individual values were substituted into the equation to test the performance in predicting clinical outcomes. A total of 362 patients (218 males and 144 females) were enrolled in our study and 66 patients died. The average age was (48.3±19.3) years old. (1) For the predictive model only containing categorical covariants [including procalcitonin (PCT), lipopolysaccharide (LPS), infection, white blood cells count (WBC) and fever], increased PCT, increased WBC and fever were demonstrated to be independent risk factors for sepsis in the logistic equation. The AUC for the new combined predictive indicator was higher than that of any other indictor, including PCT, LPS, infection, WBC and fever (0.930 vs. 0.661, 0.503, 0.570, 0.837, 0.800). The optimal cut-off value for the new combined predictive indicator was 0.518. Using the new indicator to diagnose sepsis, the sensitivity, specificity and diagnostic accuracy rate were 78.00%, 93.36% and 87.47%, respectively. One patient was randomly selected, and the clinical data was substituted into the probability equation for prediction. The calculated value was 0.015, which was less than the cut-off value (0.518), indicating that the prognosis was non-sepsis at an accuracy of 87.47%. (2) For the predictive model only containing continuous covariants, the logistic model which combined acute physiology and chronic health evaluation II (APACHE II) score and sequential organ failure assessment (SOFA) score to predict in-hospital death events, both APACHE II score and SOFA score were independent risk factors for death. The AUC for the new predictive indicator was higher than that of APACHE II score and SOFA score (0.834 vs. 0.812, 0.813). The optimal cut-off value for the new combined predictive indicator in predicting in-hospital death events was 0.236, and the corresponding sensitivity, specificity and diagnostic accuracy for the combined predictive indicator were 73.12%, 76.51% and 75.70%, respectively. One patient was randomly selected, and the APACHE II score and SOFA score was substituted into the probability equation for prediction. The calculated value was 0.570, which was higher than the cut-off value (0.236), indicating that the death prognosis at an accuracy of 75.70%. The combined predictive indicator, which is formulated by logistic regression models, is superior to any single indicator in predicting sepsis or in-hospital death events.

An Overview of Major Terrestrial, Celestial, and Temporal Coordinate Systems for Target Tracking

DTIC Science & Technology

2016-08-10

interp and Subroutines) http://hpiers.obspm.fr/eop-pc/index.php?index=models General Software for Astronomy and Time Conversions The IAU’s Standards...of Fundamental Astronomy Software [146] http://www.iausofa.org Software for Optimal 2D Assignment An overview of 2D assignment algorithms; the... Astronomy (SOFA) library were used to change the epoch of the data. The points in red are at the epoch of the Hipparcos catalog (1994.25 TT), and 20

Twenty-Fifth Annual Conference on the Physics and Chemistry of Semiconductor Interfaces. Volume 16, Number 4

DTIC Science & Technology

1998-08-01

Shigefusa Chichibu, Takayuki Sofa, Kazumi Wada, and Shuji Nakamura Dynamics of localized excitons in InGaN/GaN quantum wells ,. 0 _ _ . w 7onn...Electron. Electron Phys. 11, 413 (1959). 2E. G. Bylander, J. Appl. Phys. 49, 1188 (1978). 3M. Hiraki et al., J. Lumin. 12/13, 941 (1976). 4A. O...University of Tokyo, Noda, Chiba 278-8510, Japan Takayuki Sotab) TT . . . Department of Electrical, Electronics, and Computer Engineering, Waseda

Policy Options and the U.S. Withdrawal from Iraq: An Analysis of the Way Ahead

DTIC Science & Technology

2009-02-01

specialists combine in-country experience, language skills, and the use of local primary-source data to produce empirically based work. All of our...due to the supposed certitudes of the recently signed Status of Forces Agreement (SOFA); however, there are crucial decisions to be made, and made...Iraqi parliament on November 27, 2008, and signed by the leaders of the two countries on December 14, 2008. This agreement replaces the UN mandate on

Policy Options and the U.S. Withdrawal from Iraq: An Analysis of the Way Ahead

DTIC Science & Technology

2009-07-01

country experience, language skills, and the use of local primary-source data to produce empirically based work. All of our analysts have advanced...the supposed certitudes of the recently signed Status of Forces Agreement (SOFA); however, there are crucial decisions to be made, and made quickly...parliament on November 27, 2008, and signed by the leaders of the two countries on December 14, 2008. This agreement replaces the UN mandate on the first

[Atmospheric parameter estimation for LAMOST/GUOSHOUJING spectra].

PubMed

Lu, Yu; Li, Xiang-Ru; Yang, Tan

2014-11-01

It is a key task to estimate the atmospheric parameters from the observed stellar spectra in exploring the nature of stars and universe. With our Large Sky Area Multi-Object Fiber Spectroscopy Telescope (LAMOST) which begun its formal Sky Survey in September 2012, we are obtaining a mass of stellar spectra in an unprecedented speed. It has brought a new opportunity and a challenge for the research of galaxies. Due to the complexity of the observing system, the noise in the spectrum is relatively large. At the same time, the preprocessing procedures of spectrum are also not ideal, such as the wavelength calibration and the flow calibration. Therefore, there is a slight distortion of the spectrum. They result in the high difficulty of estimating the atmospheric parameters for the measured stellar spectra. It is one of the important issues to estimate the atmospheric parameters for the massive stellar spectra of LAMOST. The key of this study is how to eliminate noise and improve the accuracy and robustness of estimating the atmospheric parameters for the measured stellar spectra. We propose a regression model for estimating the atmospheric parameters of LAMOST stellar(SVM(lasso)). The basic idea of this model is: First, we use the Haar wavelet to filter spectrum, suppress the adverse effects of the spectral noise and retain the most discrimination information of spectrum. Secondly, We use the lasso algorithm for feature selection and extract the features of strongly correlating with the atmospheric parameters. Finally, the features are input to the support vector regression model for estimating the parameters. Because the model has better tolerance to the slight distortion and the noise of the spectrum, the accuracy of the measurement is improved. To evaluate the feasibility of the above scheme, we conduct experiments extensively on the 33 963 pilot surveys spectrums by LAMOST. The accuracy of three atmospheric parameters is log Teff: 0.006 8 dex, log g: 0.155 1 dex, [Fe/H]: 0.104 0 dex.

Deflection and Distortion of CME internal magnetic flux rope due to the interaction with a structured solar wind

NASA Astrophysics Data System (ADS)

Shiota, D.; Iju, T.; Hayashi, K.; Fujiki, K.; Tokumaru, M.; Kusano, K.

2016-12-01

CMEs are the most violent driver of geospace disturbances, and therefore their arrival to the Earth position is an important factor in space weather forecast. The dynamics of CME propagation is strongly affected by the interaction with background solar wind. To understand the interaction between a CME and background solar wind, we performed three-dimensional MHD simulations of the propagation of a CME with internal twisted magnetic flux rope into a structured bimodal solar wind. We compared three different cases in which an identical CME is launched into an identical bimodal solar wind but the launch dates of the CME are different. Each position relative to the boundary between slow and fast solar winds becomes almost in the slow wind stream region, almost in the fast wind stream region, or in vicinity of the boundary of the fast and slow solar wind stream (that grows to CIR). It is found that the CME is most distorted and deflected eastward in the case near the CIR, in contrast to the other two cases. The maximum strength of southward magnetic field at the Earth position is also highest in the case near CIR. The results are interpreted that the dynamic pressure gradient due to the back reaction from pushing the ahead slow wind stream and due to the collision behind fast wind stream hinders the expansion of the CME internal flux rope into the direction of the solar wind velocity gradient. As a result, the expansion into the direction to the velocity gradient is slightly enhanced and results in the enhanced deflection and distortion of the CME and its internal flux rope. These results support the pileup accident hypothesis proposed by Kataoka et al. (2015) to form unexpectedly geoeffective solar wind structure.

Do the Most Massive Black Holes at z = 2 Grow via Major Mergers?

NASA Astrophysics Data System (ADS)

Mechtley, M.; Jahnke, K.; Windhorst, R. A.; Andrae, R.; Cisternas, M.; Cohen, S. H.; Hewlett, T.; Koekemoer, A. M.; Schramm, M.; Schulze, A.; Silverman, J. D.; Villforth, C.; van der Wel, A.; Wisotzki, L.

2016-10-01

The most frequently proposed model for the origin of quasars holds that the high accretion rates seen in luminous active galactic nuclei (AGN) are primarily triggered during major mergers between gas-rich galaxies. While plausible for decades, this model has only begun to be tested with statistical rigor in the past few years. Here, we report on a Hubble Space Telescope study to test this hypothesis for z = 2 quasars with high supermassive black hole masses ({M}{BH}={10}9{--}{10}10 {M}⊙ ), which dominate cosmic black hole growth at this redshift. We compare Wide Field Camera 3 F160W (rest-frame V-band) imaging of 19 point source-subtracted quasar hosts to a matched sample of 84 inactive galaxies, testing whether the quasar hosts have greater evidence for strong gravitational interactions. Using an expert ranking procedure, we find that the quasar hosts are uniformly distributed within the merger sequence of inactive galaxies, with no preference for quasars in high-distortion hosts. Using a merger/non-merger cutoff approach, we recover distortion fractions of {f}{{m},{qso}}=0.39+/- 0.11 for quasar hosts and {f}{{m},{gal}}=0.30+/- 0.05 for inactive galaxies (distribution modes, 68% confidence intervals), with both measurements subjected to the same observational conditions and limitations. The slight enhancement in distorted fraction for quasar hosts over inactive galaxies is not significant, with a probability that the quasar fraction is higher P({f}{{m},{qso}}\\gt {f}{{m},{gal}})=0.78 (0.78σ ), in line with results for lower mass and lower z AGN. We find no evidence that major mergers are the primary triggering mechanism for the massive quasars that dominate accretion at the peak of cosmic quasar activity.

Synthesis, characterization and electrochemical studies of heterometallic manganese(IV)-zinc(II) and manganese(IV)-copper(II) complexes derived from bis(2-hydroxy-1-naphthaldehyde)oxaloyldihydrazone

NASA Astrophysics Data System (ADS)

Koch, Angira; Phukan, Arnab; Chanu, Oinam B.; Kumar, A.; Lal, R. A.

2014-02-01

Five manganese(IV) complexes [Mn(L)(bpy)] (1) and heterobimetallic complexes [MMn(L)Cl2(H2O)4]·1.5H2O (M = ZnII(2), CuII(3)) and [MnM(L)(bpy)Cl2] (M = ZnII(4), CuII(5)] have been synthesized from bis(2-hydroxy-1-naphthaldehyde)oxaloyldihydrazone (H4L) in methanol medium. The composition of the complexes have been established based on the data obtained from analytical, thermoanalytical and mass spectral studies. The structures of the complexes have been discussed in the light of molar conductance, magnetic moment, electronic, EPR, IR, FT-IR spectroscopic studies and transmission electron microscopies. The molar conductance values of these complexes in DMSO suggest their non-electrolytic nature. The μeff value for the complexes (1), (2) and (4) fall in the range 3.82-4.12 BM characteristic of the presence of the manganese(IV) in them. The complex (3) has μeff value of 3.70 BM at RT indicating considerable antiferromagnetic interaction between Mn(IV) and Cu(II). The μeff value of 4.72 BM for complex (5) is slightly lower than 4.90 BM for S = 2 ground state. In the complex (1) to (3), the ligand is coordinated to the metal centres as tetradentate ligand while in the complexes (4) and (5) as hexadentate ligand. Manganese(IV) has distorted octahedral stereochemistry in all complexes. Copper(II) has distorted octahedral and square planar stereochemistry in complexes (3) and (5) while zinc has distorted octahedral and tetrahedral stereochemistry, respectively. EPR studies of the complexes are also reported. The electron transfer reactions of the complexes have also been investigated by cyclic voltammetry.

Changing Definitions of Sepsis

PubMed Central

Gül, Fethi; Arslantaş, Mustafa Kemal; Cinel, İsmail; Kumar, Anand

2017-01-01

Sepsis is one of the main causes of morbidity and mortality in critically ill patients despite the use of modern antibiotics and resuscitation therapies. Outcomes in sepsis have improved overall, probably because of an enhanced focus on early diagnosis and other improvements in supportive care, but mortality rates still remain unacceptably high. The diagnosis and definition of sepsis is a critical problem due to the heterogeneity of this disease process. Although it is apparent that much more needs to be done to advance our understanding, sepsis and related terms remain difficult to define. A 1991 consensus conference developed initial definitions that systemic inflammatory response syndrome (SIRS) to infection would be called sepsis. Definitions of sepsis and septic shock were revised in 2001 to incorporate the threshold values for organ damage. In early 2016, the new definitions of sepsis and septic shock have changed dramatically. Sepsis is now defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. The consensus document describes organ dysfunction as an acute increase in total Sequential Organ Failure Assessment (SOFA) score two points consequently to the infection. A significant change in the new definitions is the elimination of any mention of SIRS. The Sepsis-3 Task Force also introduced a new bedside index, called the qSOFA, to identify outside of critical care units patients with suspected infection who are likely to develop sepsis. Recently updated the consensus definitions improved specificity compared with the previous descriptions. PMID:28752002

Prognostic value of the reactive oxygen species in severe sepsis and septic shock patients: a pilot study.

PubMed

Montini, Luca; DE Sole, Pasquale; Pennisi, Mariano A; Rossi, Cristina; Scatena, Roberto; DE Pascale, Gennaro; Bello, Giuseppe; Cutuli, Salvatore L; Antonelli, Massimo

2016-12-01

Reactive oxygen species (ROS) have been shown to play a role in the pathophysiology of sepsis. The aim of this study was to investigate ROS production over time in critically ill with sepsis patients and its correlation with outcome. This was a pilot single-centre prospective, observational study of patients consecutively admitted to our 18-general ICU. Over a period of 6 months all the consecutive patients with recent-onset of severe sepsis or septic shock were enrolled. Clinical and demographic characteristics of all patients were recorded. ROMs (ROS metabolites), reduced sulfhydryl groups (SH) and plasmatic lactate levels were collected at enrollment in the study and then every 5-7 days over 28 days or until sepsis resolution or death during sepsis. ROMs were analysed spectrophotometrically by the d-ROMs test (Diacron-Italia). SH were assayed in plasma by Ellman's reaction by spectrophotometric method. Septic shock-related mortality was defined as death that occurred during the follow up period, when the signs of shock remained, and death could not be attributed to causes other than septic shock by the attending physician. Twenty-five patients were studied. The SOFA score and the plasmatic lactate levels significantly correlated with the ROMs plasmatic levels. The mortality rate was higher in patients whose ROMs plasmatic levels decreased during septic shock evolution. Serial measurements of the ROMs plasmatic levels together with the SOFA score and lactate levels could help to identify septic shock patients with a very high probability of death.

Epidemiology, clinical characteristics, and risk factors for mortality of early- and late-onset invasive candidiasis in intensive care units in China

PubMed Central

Yang, Yi; Guo, Fengmei; Kang, Yan; Zang, Bin; Cui, Wei; Qin, Bingyu; Qin, Yingzhi; Fang, Qiang; Qin, Tiehe; Jiang, Dongpo; Cai, Bojing; Li, Ruoyu; Qiu, Haibo

2017-01-01

Abstract To identify the epidemiology, treatments, outcomes, and risk factors for patients with early- or late-onset invasive candidiasis (EOIC or LOIC) in intensive care units in China. Patients were classified as EOIC (≤10 days) or LOIC (>10 days) according to the time from hospital admission to IC onset to identify distinct clinical characteristics. There were 105 EOIC cases and 201 LOIC cases in this study. EOIC was related to more severe clinical conditions at ICU admission or prior to IC. Significantly, more cases of Candida parapsilosis infection were found in patients with LOIC than in those with EOIC. The mortality of EOIC was significantly lower than that for LOIC. Sequential Organ Failure Assessment (SOFA) score at ICI diagnosis in the EOIC group and the interval from ICU admission to ICI occurrence in the LOIC group were identified as risk factors for mortality. Susceptibility to the first-line agent was associated with a lower risk of mortality in the LOIC group. The mortality rate was significantly lower in the EOIC group, and there were more cases of non-albicans infection in the LOIC group. Susceptibility to the first-line agent was an important predictor of mortality in the LOIC group. SOFA score at ICI diagnosis in the EOIC group and interval from ICU admission to ICI occurrence in the LOIC group were identified as risk factors for mortality. PMID:29049184

[Manufacture of upholstered furniture and work-related upper limb musculoskeletal disorders: an industrial sector prevention project].

PubMed

Di Leone, G; Carino, M; Nicoletti, S; Trani, G; Ambrosi, L

2008-01-01

In cooperation with the IRCCS Fondazione Maugeri and the IRCCS Fondazione Ospedale Maggiore Policlinico - EPM-CEMOC, of Milan, the Local Health Unit in Bari, Italy carried out a research project, sponsored partly by the Italian Ministry of Health, on upper limb work-related musculoskeletal disorders (UL-WMSDs) in a specific manufacturing sector, the upholstered furniture industry. This "sofa district" is widely represented with approximately 14,000 workers and 500 factories over a wide geographic area of southern Italy. Advanced technology in the manufacturing process is combined with workers performing intensive arm-hand tasks. The aim of the study included: a) assessment of exposure to repetitive strain and movements of the upper limb in a representative sample of the factories using the OCRA method, b) analysis of the annual prevalence and incidence rates, c) definition of possible improvement via ergonomic solutions in the various factories. Via a network of occupational physicians a total of more than 6000 subjects were examined over a 5-year period. Case-definition was assessed through standardized procedures. A detailed description of the manufacturing process of the upholstered furniture industry and of the characteristics of the working population is provided Exposed groups at risk were:filling preparation workers, leather-cutting operators, sewing and upholstery-assembly workers. Data collected in private companies of different size in this extensive industrial "sofa area" emphasize the importance of prevention through adequate ergonomic solutions and the need to improve training programmes covering the whole area.

Subjective time runs faster under the influence of bright rather than dim light conditions during the forenoon.

PubMed

Morita, Takeshi; Fukui, Tomoe; Morofushi, Masayo; Tokura, Hiromi

2007-05-16

The study investigated if 6 h morning bright light exposure, compared with dim light exposure, could influence time sense (range: 5-15 s). Eight women served as participants. The participant entered a bioclimatic chamber at 10:00 h on the day before the test day, where an ambient temperature and relative humidity were controlled at 25 degrees C and 60%RH. She sat quietly in a sofa in 50 lx until 22:00 h, retired at 22:00 h and then slept in total darkness. She rose at 07:00 h the following morning and again sat quietly in a sofa till 13:00 h, either in bright (2500 lx) or dim light (50 lx), the order of light intensities between the two occasions being randomized. The time-estimation test was performed from 13:00 to 13:10 h in 200 lx. The participant estimated the time that had elapsed between two buzzers, ranging over 5-15 s, and inputting the estimate into a computer. The test was carried out separately upon each individual. Results showed that the participants estimated higher durations of the given time intervals after previous exposure to 6 h of bright rather than dim light. The finding is discussed in terms of different load errors (difference between the actual core temperature and its thermoregulatory set-point) following 6-h exposure to bright or dim light in the morning.

Predisposing factors for critical illness polyneuromyopathy in a multidisciplinary intensive care unit.

PubMed

Nanas, S; Kritikos, K; Angelopoulos, E; Siafaka, A; Tsikriki, S; Poriazi, M; Kanaloupiti, D; Kontogeorgi, M; Pratikaki, M; Zervakis, D; Routsi, C; Roussos, C

2008-09-01

To investigate risk factors of critical illness polyneuromyopathy (CIPM) in a general multidisciplinary intensive care unit (ICU). Prospective observational study in a 28-bed university multidisciplinary ICU. Four hundred and seventy-four (323 M/151 F, age 55 +/- 19) consecutive patients were prospectively evaluated. All patients were assigned admission Acute Physiology and Chronic Health Evaluation (APACHE II; 15 +/- 7) and Sequential Organ Failure Assessment (SOFA; 6 +/- 3) scores and were subsequently evaluated for newly developed neuromuscular weakness. Other potential causes of new-onset weakness after ICU admission were excluded before CIPM was diagnosed. Forty-four (23.8%) of 185 patients developed generalized weakness that met the criteria for CIPM. Patients with CIPM had higher APACHE II (18.9 +/- 6.6 vs 15.6 +/- 6.4, P = 0.004) and SOFA scores (8.4 +/- 2.9 vs 7.1 +/- 2.9, P = 0.013). According to multivariate logistic regression analysis, the following risk factors were independently associated with the development of CIPM: severity of illness at the time of ICU admission, administration of aminoglycoside antibiotics and high blood glucose levels. Analysis according to severity of illness stratification revealed the emergence of Gram (-) bacteremia as the most important independent predisposing factor for CIPM development in less severely ill patients. CIPM has a high incidence in the ICU setting. Our study revealed the association of aminoglycosides, hyperglycemia and illness severity with CIPM development, as well as the association between Gram (-) bacteremia and development of CIPM in less severely ill patient population.

Recombinant human erythropoietin reduces plasminogen activator inhibitor and ameliorates pro-inflammatory responses following trauma

PubMed Central

Shiehmorteza, M.; Ahmadi, A.; Abdollahi, M.; Nayebpour, M.; Mohammadi, M.; Hamishehkar, H.; Najafi, A.; Pazoki, M.; Mojtahedzadeh, M.

2011-01-01

Background and the purpose of the study sBesides its hematopoietic effects, erythropoietin (EPO) by mobilization of iron and modulation of some inflammatory cytokines has antioxidant and anti-inflammatory properties. The purpose of this study was to evaluate these effects of erythropoietin and its impact on organ function in traumatized patients. Methods Twenty-six ICU-admitted traumatized patients within 24 hrs after trauma were randomly assigned to the EPO (received EPO, 300 units/Kg/day) and Control (not received EPO) groups. The inflammatory biomarkers including Tumor Necrosis Factor alpha (TNF-α), Interleukin 1 (IL-1), Plasminogen Activator Inhibitor 1 (PAI-1) and Nitrotyrosine were recorded at the admission, 3, 6 and 9 days thereafter. Acute Physiology and Chronic Health Evaluation (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores were also recorded. Results Among 12 patients (EPO group) TNF-α level at the day of 9 (P=0.046), and within EPO group at the days of 3 (P=0.026 ameliorate), 6 (P=0.016), and 9 (P=0.052) were significantly lowered. Level of IL-1 and PAI-1 decreased significantly at days of 3, 6 and 9 post intervention. Also there were significant differences between two groups in the SOFA score during three measured time intervals (the first, third and seventh days). Conclusion From the results of this study it seems that injection of erythrocyte stimulating agent is well tolerated and inhibits the inflammatory response and oxidative stress following trauma. PMID:22615653

Masses of the visual components and black holes in X-ray novae: Effects of proximity of the components

NASA Astrophysics Data System (ADS)

Petrov, V. S.; Antokhina, E. A.; Cherepashchuk, A. M.

2017-05-01

It is shown that the approximation of the complex, tidally distorted shape of a star as a circular disc with local line profiles and a linear limb-darkening law, which is usually applied when deriving equatorial stellar rotation velocities from line profiles, leads to overestimation of the equatorial velocity V rot sin i and underestimation of the component mass ratio q = M x / M v . A formula enabling correction of the effect of these simplifying assumptions on the shape of a star is used to re-determine the mass ratios q and the masses of the black holes M x and visual components M v in low-mass X-ray binary systems containing black holes. Taking into account the tidal-rotational distortion of the stellar shape can significantly increase the mass ratios q = M x / M v , reducing M v , while M x changes only slightly. The resulting distribution of M v attains its maximum near M v ≃ 0.35 M ⊙, in disagreement with the results of population synthesis computations realizing standard models for Galactic X-ray novae with black holes. Possible ways to overcome this inconsistency are discussed. The derived distribution of M x also differs strongly from the mass distribution for massive stars in the Galaxy.

Crystal structure and Hirshfeld surface analysis of aqua-bis-(nicotinamide-κN)bis-(4-sulfamoylbenzoato-κO1)copper(II).

PubMed

Hökelek, Tuncer; Yavuz, Vijdan; Dal, Hakan; Necefoğlu, Hacali

2018-01-01

In the crystal of the title complex, [Cu(C 7 H 6 NO 4 S) 2 (C 6 H 6 N 2 O) 2 (H 2 O)], the Cu II cation and the O atom of the coordinated water mol-ecule reside on a twofold rotation axis. The Cu II ion is coordinated by two carboxyl-ate O atoms of the two symmetry-related 4-sulfamoylbenzoate (SB) anions and by two N atoms of the two symmetry-related nicotinamide (NA) mol-ecules at distances of 1.978 (2) and 2.025 (3) Å, respectively, forming a slightly distorted square-planar arrangement. The distorted square-pyramidal coordination environment is completed by the water O atom in the axial position at a distance of 2.147 (4) Å. In the crystal, the mol-ecules are linked via O-H⋯O and N-H⋯O hydrogen bonds with R 2 2 (8) and R 2 2 (18) ring motifs, forming a three-dimensional architecture. The Hirshfeld surface analysis of the crystal structure indicates that the most important contributions for the crystal packing are from H⋯O/O⋯H (42.2%), H⋯H (25.7%) and H⋯C/C⋯H (20.0%) inter-actions.

A parallel approach of COFFEE objective function to multiple sequence alignment

NASA Astrophysics Data System (ADS)

Zafalon, G. F. D.; Visotaky, J. M. V.; Amorim, A. R.; Valêncio, C. R.; Neves, L. A.; de Souza, R. C. G.; Machado, J. M.

2015-09-01

The computational tools to assist genomic analyzes show even more necessary due to fast increasing of data amount available. With high computational costs of deterministic algorithms for sequence alignments, many works concentrate their efforts in the development of heuristic approaches to multiple sequence alignments. However, the selection of an approach, which offers solutions with good biological significance and feasible execution time, is a great challenge. Thus, this work aims to show the parallelization of the processing steps of MSA-GA tool using multithread paradigm in the execution of COFFEE objective function. The standard objective function implemented in the tool is the Weighted Sum of Pairs (WSP), which produces some distortions in the final alignments when sequences sets with low similarity are aligned. Then, in studies previously performed we implemented the COFFEE objective function in the tool to smooth these distortions. Although the nature of COFFEE objective function implies in the increasing of execution time, this approach presents points, which can be executed in parallel. With the improvements implemented in this work, we can verify the execution time of new approach is 24% faster than the sequential approach with COFFEE. Moreover, the COFFEE multithreaded approach is more efficient than WSP, because besides it is slightly fast, its biological results are better.

Induced polarization: Simulation and inversion of nonlinear mineral electrodics

NASA Astrophysics Data System (ADS)

Agunloye, Olu

1983-02-01

Graph-theoretic representations are used to model nonlinear electrodics, while forward and inverse simulations are based on reaction rate theory. The electrodic responses are presented as distorted elliptical Lissajous shapes obtained from dynamic impedance over a full cycle. Simulations show that asymmetry in reaction energy barrier causes slight asymmetry in the shape of the response ellipse and hardly affects the phase angle of the complex electrode impedance. The charge transfer resistance and the diffusion constraints tend to have opposite effects. The former causes reduction in the phase angle, tending to make the impedance purely resistive. Both of these mechanisms show saturation effects. Charge transfer resistance at its limit forces a thin S-type symmetry on the Lissajous patterns, while with diffusion control the size of the Lissajous patterns begins to reduce after saturation. The fixed layer causes substantial increase in the phase angle and tends to “enlarge” the Lissajous patterns. It is responsible for the hysteresis-like shapes of the Lissajous patterns when superimposed on strong charge transfer resistance. This study shows that it is quite possible to deduce the mechanisms that control the electrodic processes by inverting electrodic parameters from “observed” distorted, nonelliptical Lissajous patterns characteristic of nonlinear electrodics. The results and qualities of the inversion technique are discussed.

Spectroscopic characterization, antioxidant and antitumour studies of novel bromo substituted thiosemicarbazone and its copper(II), nickel(II) and palladium(II) complexes

NASA Astrophysics Data System (ADS)

Jagadeesh, M.; Lavanya, M.; Kalangi, Suresh K.; Sarala, Y.; Ramachandraiah, C.; Varada Reddy, A.

2015-01-01

A new, slightly distorted octahedral complex of copper(II), square planar complexes of nickel(II) and palladium(II) with 2,4‧-dibromoacetophenone thiosemicarbazone (DBAPTSC) are synthesized. The ligand and the complexes are characterized by FT-IR, FT-Raman, powder X-ray diffraction studies. The IR and Raman data are correlated for the presence of the functional groups which specifically helped in the confirmation of the compounds. In addition, the free ligand is unambiguously characterized by 1H and 13C NMR spectroscopy while the copper(II) complex is characterized by electron paramagnetic resonance spectroscopy (EPR). The g values for the same are found to be 2.246 (g1), 2.012 (g2) and 2.005 (g3) which suggested rhombic distortions. The HOMO-LUMO band gap calculations for these compounds are found to be in between 0.5 and 4.0 eV and these compounds are identified as semiconducting materials. The synthesized ligand and its copper(II), nickel(II) and palladium(II) complexes are subjected to antitumour activity against the HepG2 human hepatoblastoma cell lines. Among all the compounds, nickel(II) complex is found to exert better antitumour activity with 57.6% of cytotoxicity.

Effects of contralateral white noise stimulation on distortion product otoacoustic emissions in myasthenic patients.

PubMed

Di Girolamo, S; d'Ecclesia, A; Quaranta, N; Garozzo, A; Evoli, A; Paludetti, G

2001-12-01

Myasthenia gravis (MG) induces a reduction of transient evoked otoacoustic emissions (TEOAEs) and distortion product otoacoustic emissions (DPOAEs) that reverses partially after administration of an acetylcholinesterase (AChE) inhibitor. In normal subjects a contralateral acoustic stimulation (CAS) produces an amplitude reduction of TEOAEs and DPOAEs. This effect, called contralateral suppression (CS), is mediated by the efferent auditory system. Twenty subjects affected by MG underwent DPOAE recording with and without contralateral white noise in a drug-free baseline period ('basal') and 1 h ('post') after administration of a reversible AChE inhibitor. In 'basal' condition CAS did not induce significant DPOAE amplitude changes but a paradoxical slight increase was observed. After drug administration, CAS produced a significant decrease of DPOAE amplitudes for middle frequencies (f(2) between 1306 and 2600 Hz). In normal controls CAS caused a significant decrease (P<0.001) for all frequencies. The amount of CS in controls and in the MG 'post' condition was not significantly different. The increased acetylcholine (ACh) availability following drug consumption seems to partially restore outer hair cell function and enhances their electromotility; a further influx of ACh due to CAS yields to restoration of the CS. These findings also suggest that DPOAEs may be useful in the diagnosis of MG and for monitoring the effectiveness of treatment.

Heme Structural Perturbation of PEG-Modified Horseradish Peroxidase C in Aromatic Organic Solvents Probed by Optical Absorption and Resonance Raman Dispersion Spectroscopy

PubMed Central

Huang, Qing; Al-Azzam, Wasfi; Griebenow, Kai; Schweitzer-Stenner, Reinhard

2003-01-01

The heme structure perturbation of poly(ethylene glycol)-modified horseradish peroxidase (HRP-PEG) dissolved in benzene and toluene has been probed by resonance Raman dispersion spectroscopy. Analysis of the depolarization ratio dispersion of several Raman bands revealed an increase of rhombic B1g distortion with respect to native HRP in water. This finding strongly supports the notion that a solvent molecule has moved into the heme pocket where it stays in close proximity to one of the heme's pyrrole rings. The interactions between the solvent molecule, the heme, and the heme cavity slightly stabilize the hexacoordinate high spin state without eliminating the pentacoordinate quantum mixed spin state that is dominant in the resting enzyme. On the contrary, the model substrate benzohydroxamic acid strongly favors the hexacoordinate quantum mixed spin state and induces a B2g-type distortion owing to its position close to one of the heme methine bridges. These results strongly suggest that substrate binding must have an influence on the heme geometry of HRP and that the heme structure of the enzyme-substrate complex (as opposed to the resting state) must be the key to understanding the chemical reactivity of HRP. PMID:12719258

Phase and amplitude beam shaping with two deformable mirrors implementing input plane and Fourier plane phase modifications.

PubMed

Wu, Chensheng; Ko, Jonathan; Rzasa, John R; Paulson, Daniel A; Davis, Christopher C

2018-03-20

We find that ideas in optical image encryption can be very useful for adaptive optics in achieving simultaneous phase and amplitude shaping of a laser beam. An adaptive optics system with simultaneous phase and amplitude shaping ability is very desirable for atmospheric turbulence compensation. Atmospheric turbulence-induced beam distortions can jeopardize the effectiveness of optical power delivery for directed-energy systems and optical information delivery for free-space optical communication systems. In this paper, a prototype adaptive optics system is proposed based on a famous image encryption structure. The major change is to replace the two random phase plates at the input plane and Fourier plane of the encryption system, respectively, with two deformable mirrors that perform on-demand phase modulations. A Gaussian beam is used as an input to replace the conventional image input. We show through theory, simulation, and experiments that the slightly modified image encryption system can be used to achieve arbitrary phase and amplitude beam shaping within the limits of stroke range and influence function of the deformable mirrors. In application, the proposed technique can be used to perform mode conversion between optical beams, generate structured light signals for imaging and scanning, and compensate atmospheric turbulence-induced phase and amplitude beam distortions.

Capping Parallel β-Sheets of Acetyl(Ala)6NH2 with an Acetyl(Ala)5ProNH2 Can Arrest the Growth of the Sheet, Suggesting a Potential for Curtailing Amyloid Growth. An ONIOM and Density Functional Theory Study

PubMed Central

2015-01-01

We present ONIOM calculations using B3LYP/d95(d,p) as the high level and AM1 as the medium level on parallel β-sheets containing four strands of Ac-AAAAAA-NH2 capped with either Ac-AAPAAA-NH2 or Ac-AAAPAA-NH2. Because Pro can form H-bonds from only one side of the peptide linkage (that containing the C=O H-bond acceptor), only one of the two Pro-containing strands can favorably add to the sheet on each side. Surprisingly, when the sheet is capped with AAPAAA-NH2 at one edge, the interaction between the cap and sheet is slightly more stabilizing than that of another all Ala strand. Breaking down the interaction enthalpies into H-bonding and distortion energies shows the favorable interaction to be due to lower distortion energies in both the strand and the four-stranded sheet. Because another strand would be inhibited for attachment to the other side of the capping (Pro-containing) strand, we suggest the possible use of Pro residues in peptides designed to arrest the growth of many amyloids. PMID:24422496

New highly linear tunable transconductor circuits with low number of MOS transistors

NASA Astrophysics Data System (ADS)

Yucel, Firat; Yuce, Erkan

2016-08-01

In this article, two new highly linear tunable transconductor circuits are proposed. The transconductors employ only six MOS transistors operated in saturation region. The second transconductor is derived from the first one with a slight modification. Transconductance of both transconductors can be tuned by a control voltage. Both of the transconductors do not need any additional bias voltages and currents. Another important feature of the transconductors is their high input and output impedances for cascadability with other circuits. Besides, total harmonic distortions are less than 1.5% for both transconductors. A positive lossless grounded inductor simulator with a grounded capacitor is given as an application example of the transconductors. Simulation and experimental test results are included to show effectiveness of the proposed circuits.

Tetra­chlorido[(diphenyl­phosphino)diphenyl­phosphine oxide-κO]zirconium(IV) benzene monosolvate

PubMed Central

Ogawa, Takahiko; Kajita, Yuji; Masuda, Hideki

2009-01-01

In the title centrosymmetric mononuclear ZrIV compound, [ZrCl4{P(O)(C6H5)2P(C6H5)2}2]·C6H6, the central ZrIV ion is coordinated by two O atoms from two symmetry-related (diphenyl­phosphino)diphenyl­phosphine ligands and four Cl atoms in a distorted octahedral geometry with the four Cl atoms in the equatorial positions. The mol­ecule lies about a center of inversion and the benzene solvent mol­ecule about another center of inversion. The P=O bond [1.528 (2) Å] is slightly longer than a typical P=O double bond (average 1.500 ). PMID:21577468

Tetra­kis(1,1,1-trifluoro­acetyl­acetonato-κ2 O,O′)hafnium(IV) toluene disolvate

PubMed Central

Viljoen, J. Augustinus; Muller, Alfred; Roodt, Andreas

2008-01-01

In the title compound, [Hf(C5H4F3O2)4]·2C7H8, the HfIV atom, lying on a twofold rotation axis, is coordinated by eight O atoms from four 1,1,1-trifluoro­acetyl­acetonate ligands with an average Hf—O distance of 2.173 (1) Å and O—Hf—O bite angles of 75.69 (5) and 75.54 (5)°. The coordination polyhedron shows a slightly distorted Archimedean square antiprismatic geometry. The asymmetric unit contains a toluene solvent mol­ecule. The crystal structure involves C—H⋯.F hydrogen bonds. PMID:21202519

Magnetic vortex excitation as spin torque oscillator and its unusual trajectories

NASA Astrophysics Data System (ADS)

Natarajan, Kanimozhi; Muthuraj, Ponsudana; Rajamani, Amuda; Arumugam, Brinda

2018-05-01

We report an interesting observation of unusual trajectories of vortex core oscillations in a spin valve pillar. Micromagnetic simulation in the composite free layer spin valve nano-pillar shows magnetic vortex excitation under critical current density. When current density is slightly increased and wave vector is properly tuned, for the first time we observe a star like and square gyration. Surprisingly this star like and square gyration also leads to steady, coherent and sustained oscillations. Moreover, the frequency of gyration is also very high for this unusual trajectories. The power spectral analysis reveals that there is a marked increase in output power and frequency with less distortions. Our investigation explores the possibility of these unusual trajectories to exhibit spin torque oscillations.

Tetra­kis(aceto­nitrile)copper(I) hydrogen oxalate–oxalic acid–aceto­nitrile (1/0.5/0.5)

PubMed Central

Royappa, A. Timothy; Stepherson, Jacob R.; Vu, Oliver D.; Royappa, Andrew D.; Stern, Charlotte L.; Müller, Peter

2013-01-01

In the title compound, [Cu(CH3CN)4](C2HO4)·0.5C2H2O4·0.5CH3CN, the CuI ion is coordinated by the N atoms of four aceto­nitrile ligands in a slightly distorted tetra­hedral environment. The oxalic acid mol­ecule lies across an inversion center. The aceto­nitrile solvent mol­ecule is disordered across an inversion center and was refined with half occupancy. In the crystal, the hydrogen oxalate anions and oxalic acid mol­ecules are linked via O—H⋯O hydrogen bonds, forming chains along [010]. PMID:24098175

Fish-eye view of Williams, Searfoss and Pawelczyk on middeck during meal

NASA Image and Video Library

1998-05-15

STS090-351-009 (17 April - 3 May 1998) --- Three members of the Neurolab crew were photographed during off-duty time on the mid-deck aboard the Earth-orbiting Space Shuttle Columbia. Left to right are James A. (Jim) Pawelczyk, payload specialist, and astronauts Richard A. Searfoss, mission commander; and Richard M. Linnehan, payload commander. Linnehan is in the hatchway of the tunnel that connected the crew members to the Spacelab Science Module in Columbia's cargo bay. A "fish-eye" lens on a 35mm camera gives the scene a slightly distorted look. Five NASA astronauts and two payload specialists went on to spend a little more than 16-days in Earth-orbit in support of the Neurolab mission.

K2Ho(PO4)(WO4)

PubMed Central

Terebilenko, Katherina V.; Zatovsky, Igor V.; Baumer, Vyacheslav N.; Slobodyanik, Nikolay S.; Shishkin, Oleg V.

2008-01-01

A new compound, dipotassium holmium(III) phosphate(V) tungstate(VI), K2Ho(PO4)(WO4), has been obtained during investigation of the K2O–P2O5–WO3–HoF3 phase system using the flux technique. The compound is isotypic with K2Bi(PO4)(WO4). Its framework structure consists of flat ∞ 2[HoPO4] layers parallel to (100) that are made up of ∞ 1[HoO8] zigzag chains inter­linked via slightly distorted PO4 tetra­hedra. WO4 tetra­hedra are attached above and below these layers, leaving space for the K+ counter-cations. The HoO8, PO4 and WO4 units exhibit 2 symmetry. PMID:21580811

Crystal structure of the co-crystal fac-tri-aqua-tris(thio-cyanato-κN)iron(III)-2,3-di-methyl-pyrazine (1/3).

PubMed

Kucheriv, Olesia I; Shylin, Sergii I; Ilina, Tetiana A; Dechert, Sebastian; Gural'skiy, Il'ya A

2015-04-01

In the crystal of the title compound, [Fe(NCS)3(H2O)3]·3C6H8N2, the Fe(III) cation is located on a threefold rotation axis and is coordinated by three N atoms of the thiocyanate anions and three water mol-ecules in a fac arrangement, forming a slightly distorted N3O3 octa-hedron. Stabilization within the crystal structure is provided by O-H⋯N hydrogen bonds; the H atoms from coordinating water mol-ecules act as donors to the N atoms of guest 2,3-di-methyl-pyrazine mol-ecules, leading to a three-dimensional supra-molecular framework.

1′-Methyl-4′-(1-naphth­yl)-3′′-(1-naphthyl­methyl­ene)acenaphthene-1-spiro-2′-pyrrolidine-3′-spiro-1′′-cyclo­hexane-2,2′′-dione

PubMed Central

Athimoolam, S.; Radha, V. Anu; Bahadur, S. Asath; Kumar, R. Ranjith; Perumal, S.

2008-01-01

In the title compound, C42H33NO2, the six-membered cyclo­hexa­none ring adopts a slightly distorted chair conformation and the five-membered pyrrolidine ring is in an envelope conformation. The mol­ecular structure features four intra­molecular C—H⋯O inter­actions and an intra­molecular C—H⋯π inter­action. Furthermore, the crystal packing is stabilized by an inter­molecular C—H⋯O and three inter­molecular C—H⋯π inter­actions. PMID:21200972

Highly mobile type II twin boundary in Ni-Mn-Ga five-layered martensite

DOE Office of Scientific and Technical Information (OSTI.GOV)

Sozinov, A.; Lanska, N.; Soroka, A.

2011-09-19

Twin relationships and stress-induced reorientation were studied in Ni{sub 2}Mn{sub 1.14}Ga{sub 0.86} single crystal with five-layered modulated martensite crystal structure. Very low twinning stress of about 0.1 MPa was found for twin boundaries which deviated a few degrees from the (011) crystallographic plane. However, twin boundaries oriented exactly parallel to the (011) plane exhibited considerably higher level of twinning stress, above 1 MPa. X-ray diffraction experiments and calculations based on approximation of the martensite crystal lattice as a tetragonal lattice with a slight monoclinic distortion identified the two different kinds of twin interfaces as type II and type I twinmore » boundaries.« less

High pressure synthesis, crystal growth and magnetic properties of TiOF

NASA Astrophysics Data System (ADS)

Cumby, J.; Burchell, M. B.; Attfield, J. P.

2018-06-01

Polycrystalline samples of TiOF have been prepared at 1300 °C and 8 GPa, with small single crystals grown at the same conditions. The crystal structure remains tetragonal rutile-type down to at least 90 K (space group P42/mnm, a = 4.6533 (2) Å and c = 3.0143 (2) Å at 90 K) and the Ti(O,F)6 octahedra are slightly compressed, consistent with Jahn-Teller distortion of 3d1 Ti3+. Diffuse scattering reveals disordered structural correlations that may arise from local cis-order of oxide anions driven by covalency. TiOF is paramagnetic down to 5 K and observation of a small paramagnetic moment and a substantial Pauli term indicates that the d-electrons are partially delocalised.

APCAP--activated protein C in acute pancreatitis: a double-blind randomized human pilot trial.

PubMed

Pettilä, Ville; Kyhälä, Lea; Kylänpää, Marja-Leena; Leppäniemi, Ari; Tallgren, Minna; Markkola, Antti; Puolakkainen, Pauli; Repo, Heikki; Kemppainen, Esko

2010-01-01

Previous human studies have shown low activity of protein C (APC) in severe acute pancreatitis (SAP). This, together with the findings in animal models, suggests that activated protein C (APC) may protect against pancreatic injury and ameliorate the disease. We, therefore, evaluated its effect on multiple organ dysfunction (MOD) measured by the SOFA (Sequential Organ Failure Assessment) and on organ-failure-free days, and the safety of APC in SAP. A prospective double blind randomized pilot study was use. The study occurred in one university hospital tertiary intensive care unit (ICU) with eight beds. The patients were chosen according to the following inclusion criteria: 1) Those admitted to the hospital < 96 h from the onset of pain, 2) Those who had a three-fold increase in serum amylase over normal upper range or/and in whom computed tomography (CT) verification of SAP was noted, 3) Those who had one or more organ dysfunction (OD), and 4) Those in whom less than 48 hours had passed since their first OD. Of a total of 215 adult patients with SAP screened between June 2003 and August 2007, 158 fulfilled the study inclusion criteria. After exclusions 32 patients were randomized to the study. The intervention consisted of APC (N = 16) administered intravenously for 96 hours with a dose of 24 μg/kg/hour or placebo (N = 16) with a similar infusion rate. The sample size for the study was calculated according to the primary end-point: the change in SOFA during study drug infusion (Days 0 and 5). Comparisons between the study groups were performed using patient-related changes and calculation of difference in means (DIM, 95% CIs) and regarding categorical variables with Fisher's exact test. For all comparisons P < 0.05 was considered significant. No serious bleeding was detected clinically or by CT scans in either group. No significant difference in SOFA score change between the APC and placebo groups was found (difference in means (DIM) +2.3, 95% CI -0.7 to +5.3). Treatment with APC was associated with an increase in serum levels of both total and conjugated bilirubin. No differences in ventilator-free days, in renal replacement therapy-free days, in vasopressor-free days, or in days alive outside the hospital were detected. No serious bleeding or differences in the evolution of MOD were detected between APC and the placebo. Instead we found an increase in serum bilirubin in the APC group compared to the placebo group in patients with SAP. ClinicalTrials.gov NCT01017107.

Mortality prediction in patients with acute kidney injury requiring renal replacement therapy after cardiac surgery.

PubMed

Skarupskienė, Inga; Adukauskienė, Dalia; Kuzminskienė, Jurgita; Rimkutė, Laima; Balčiuvienė, Vilma; Žiginskienė, Edita; Kuzminskis, Vytautas; Adukauskaitė, Agnė; Pentiokinienė, Daiva; Bumblytė, Inga Arūnė

2017-01-01

Acute kidney injury (AKI) is a common and potentially serious postoperative complication after cardiac surgery, and it remains a cause of major morbidity and mortality. The aim of our study was to assess the prognostic illness severity score and to estimate the significant risk factors for poor outcome of patients with AKI requiring renal replacement therapy (RRT) after cardiac surgery. We retrospectively analyzed data of adult (>18 years) patients (n=111) who underwent open heart surgery and had developed AKI with need for RRT. Prognostic illness severity scores were calculated and perioperative risk factors of lethal outcome were assessed at the RRT initiation time. We defined three illness severity scores: Acute Physiology and Chronic Health Evaluation (APACHE II) as a general score, Sequential Organ Failure Assessment (SOFA) as an organ failure score, and Liano score as a kidney-specific disease severity score. Logistic regression was also used for the multivariate analysis of mortality risk factors. Hospital mortality was 76.5%. More than 7% of patients remained dialysis-dependent after their discharge from the hospital. The prognostic abilities of the scores were assessed for their discriminatory power. The area under the receiver-operating characteristic (ROC) curve of SOFA score was 0.719 (95% CI, 0.598-0.841), of Liano was 0.661 (95% CI, 0.535-0.787) and 0.668 (95% CI, 0.550-0.785) of APACHE II scores. From 16 variables analyzed for model selection, we reached a final logistic regression model, which demonstrated four variables significantly associated with patients' mortality. Glasgow coma score<14 points (OR=3.304; 95% CI, 1.130-9.662; P=0.003), mean arterial blood pressure (MAP)<63.5mmHg (OR=3.872; 95% CI, 1.011-13.616; P=0.035), serum creatinine>108.5μmol/L (OR=0.347; 95% CI, 0.123-0.998; P=0.046) and platelet count<115×10 9 /L (OR=3.731; 95% CI, 1.259-11.054; P=0.018) were independent risk factors for poor patient outcome. Our study demonstrated that SOFA score estimation is the most accurate to predict the fatal outcome in patients with AKI requiring RRT after cardiac surgery. Lethal patient outcome is related to Glasgow coma score, mean arterial blood pressure, preoperative serum creatinine and postoperative platelet count. Copyright © 2017 The Lithuanian University of Health Sciences. Production and hosting by Elsevier Sp. z o.o. All rights reserved.

Relationship Between Beta Cell Dysfunction and Severity of Disease Among Critically Ill Children: A STROBE-Compliant Prospective Observational Study.

PubMed

Liu, Ping-Ping; Lu, Xiu-Lan; Xiao, Zheng-Hui; Qiu, Jun; Zhu, Yi-Min

2016-05-01

Although beta cell dysfunction has been proved to predict prognosis among humans and animals, its prediction on severity of disease remains unclear among children. The present study was aimed to examine the relationship between beta cell dysfunction and severity of disease among critically ill children.This prospective study included 1146 critically ill children, who were admitted to Pediatric Intensive Care Unit (PICU) of Hunan Children's Hospital from November 2011 to August 2013. Information on characteristics, laboratory tests, and prognostic outcomes was collected. Homeostasis model assessment (HOMA)-β, evaluating beta cell function, was used to divide all participants into 4 groups: HOMA-β = 100% (group I, n = 339), 80% ≤ HOMA-β < 100% (group II, n = 71), 40% ≤ HOMA-β < 80% (group III, n = 293), and HOMA-β < 40% (group IV, n = 443). Severity of disease was assessed using the worst Sequential Organ Failure Assessment (SOFA) score, Pediatric Risk of Mortality (PRISM) III score, incidence of organ damage, septic shock, multiple organ dysfunction syndrome (MODS), mechanical ventilation (MV) and mortality. Logistic regression analysis was used to evaluate the risk of developing poor outcomes among patients in different HOMA-β groups, with group I as the reference group.Among 1146 children, incidence of HOMA-β < 100% was 70.41%. C-peptide and insulin declined with the decrement of HOMA-β (P < 0.01). C-reactive protein and procalcitonin levels, rather than white blood cell, were significantly different among 4 groups (P < 0.01). In addition, the worst SOFA score and the worst PRISMIII score increased with declined HOMA-β. For example, the worst SOFA score in group I, II, III, and IV was 1.55 ± 1.85, 1.71 ± 1.93, 1.92 ± 1.63, and 2.18 ± 1.77, respectively. Furthermore, patients with declined HOMA-β had higher risk of developing septic shock, MODS, MV, and mortality, even after adjusting age, gender, myocardial injury, and lung injury. For instance, compared with group I, the multivariate-adjusted odds ratio (95% confidence interval) for developing septic shock was 2.17 (0.59, 8.02), 2.94 (2.18, 6.46), and 2.76 (1.18, 6.46) among patients in group II, III, and IV, respectively.Beta cell dysfunction reflected the severity of disease among critically ill children. Therefore, assessment of beta cell function is critically important to reduce incidence of adverse events in PICU.

The validity and reliability of the Arabic version of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU): A prospective cohort study.

PubMed

Selim, Abeer; Kandeel, Nahed; Elokl, Mohamed; Khater, Mohamed Shawky; Saleh, Ashraf Nabil; Bustami, Rami; Ely, E Wesley

2018-04-01

Accurate diagnosis for Arabic speaking critically ill patients suffering from delirium is limited by the need for a valid/reliable translation of a standardized delirium instrument such as the Confusion Assessment Method for the ICU (CAM-ICU). To determine the validity and reliability of the Arabic version of the CAM-ICU. A prospective cohort study design was used to conduct the current study. Data collection took place in Geriatric, Emergency and Surgical intensive care units. Fifty-eight adult patients met the inclusion criteria and participated in the study. Among the participants 22(38%) patients were on mechanical ventilation. After translating the CAM-ICU into Arabic language, the Arabic CAM-ICU was administered by two well-trained critical care nurses and compared with reference standard assessments by delirium experts using the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM -IV-TR), along with assessment of severity of illness using Sequential Organ Failure Assessment (SOFA). Concurrent validity was assessed by calculating sensitivity, specificity and positive and negative predictive value (PPV and NPV) for the two Arabic CAM-ICU raters, where calculations were based on considering the DSM-IV-TR criterion as the reference standard. The convergent validity of the Arabic CAM-ICU was explored by comparing the Arabic CAM-ICU ratings and the total score of SOFA (severity of illness) and MMSE (cognitive impairment). A total of 58 ICU patients were included, of whom 27 (47%) were diagnosed with delirium during their ICU stay via DSM-IV criteria. Interrater reliability for the Arabic CAM-ICU, overall and for mechanically ventilated patients assessed using Cohen's kappa (κ) were 0.82 and 1, respectively, p < 0.001. The sensitivities (95% CI) for the two critical care nurses when using the Arabic CAM-ICU compared with the reference standard were 81% (60%-93%) and 85% (65%-95%), respectively, whereas specificity (95% CI) was 81%(62%-92%) for both nurses. High sensitivity and specificity measures were also observed across subgroups; 100% for mechanically ventilated patients, 88% (60%-98%) and 79% (49%-94%) for those aged 65 years or older and 82% (56%-95%) and 75% (43%-93%) for those with SOFA scores at or above the median value. The Arabic CAM-ICU appeared to be valid and reliable tool for diagnosing delirium. Future investigations may lead to a better understanding of the prevalence, predictors, and consequences of delirium among critically ill Arabic speaking patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

Usefulness of midregional pro-adrenomedullin as a marker of organ damage and predictor of mortality in patients with sepsis.

PubMed

Bernal-Morell, Enrique; García-Villalba, Eva; Vera, Maria Del Carmen; Medina, Blanca; Martinez, Monica; Callejo, Victoria; Valero, Salvador; Cinesi, Cesar; Piñera, Pascual; Alcaraz, Antonia; Marin, Irene; Muñoz, Angeles; Cano, Alfredo

2018-03-01

Midregional proadrenomedullin (MR-proADM) is a prognostic biomarker in patients with community-acquired pneumonia (CAP) and sepsis. In this paper, we examined the ability of MR-proADM to predict organ damage and long-term mortality in sepsis patients, compared to that of procalcitonin, C-reactive protein and lactate. This was a prospective observational cohort, enrolling severe sepsis or septic shock patients admitted to internal service department. The association between biomarkers and 90-day mortality was assessed by Cox regression analysis and Kaplan-Meier curves. The accuracy of biomarkers for mortality was determined by area under the receiver operating characteristic curve (AUROC) analysis. A total of 148 patients with severe sepsis, according to the criteria of the campaign to survive sepsis, were enrolled. Eighty-five (57.4%) had sepsis according to the new criteria of Sepsis-3. MR-proADM showed the best AUROC to predict sepsis as defined by the Sepsis-3 criteria (AUROC of 0.771, 95% CI 0.692-0.850, p <0.001) and was the only marker independently associated with Sepsis-3 criteria (OR = 4.78, 95% CI 2.25-10.14; p < 0.001) in multivariate analysis. MR-proADM was the biomarker with the best AUROC to predict mortality in 90 days (AUROC of 0.731, CI 95% 0.612-0.850, p <0.001) and was the only marker that kept its independence [hazard ratio (HR) of 1.4, 95% CI 1.2-1.64, p <0.001] in multivariate analysis. The cut-off point of MR-proADM of 1.8 nmol/L (HR of 4.65, 95% CI 6.79-10.1, p < 0.001) was the one that had greater discriminative capacity to predict 90 days mortality. All patients with MR-proADM concentrations ≤0.60 nmol/L survived up to 90 days. In patients with SOFA ≤ 6, the addition of MR-proADM to SOFA score increased the ability of SOFA to identify non-survivors, AUROC of 0.65 (CI 95% 0.537-0.764) and AUROC of 0.700 (CI 95% 0.594-0.800), respectively (p < 0.05 for both). MR-proADM is a good biomarker in the early identification of high risk septic patients and may contribute to improve the predictive capacity of SOFA scale, especially when scores are low. Copyright © 2017 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Crystal structure of catena-poly[[aquadi-n-propyl­tin(IV)]-μ-oxalato

PubMed Central

Reichelt, Martin; Reuter, Hans

2014-01-01

The title compound, [Sn(C3H7)2(H2O)(C2O4)]n, represents the first diorganotin(IV) oxalate hydrate to be structurally characterized. The tin(IV) atom of the one-dimensional coordination polymer is located on a twofold rotation axis and is coordinated by two chelating oxalate ligands with two slightly different Sn—O bond lengths of 2.290 (2) and 2.365 (2) Å, two symmetry-related n-propyl groups with a Sn—C bond lengths of 2.127 (3) Å, and a water mol­ecule with a Sn—O bond length of 2.262 (2) Å. The coordination polyhedron around the SnIV atom is a slightly distorted penta­gonal bipyramid with a nearly linear axis between the trans-oriented n-propyl groups [C—Sn—C = 176.8 (1)°]. The bond angles between the oxygen atoms of the equatorial plane range from 70.48 (6)° to 76.12 (8)°. A one-dimensional coordination polymer results from the less asymmetric bilateral coordination of the centrosymmetric oxalate anion, inter­nally reflected by two slightly different C—O bond lengths of 1.248 (3) and 1.254 (3) Å. The chains of the polymer propagate parallel to [001] and are held together by hydrogen bonds between water mol­ecules and oxalate anions of neighboring chains, leading to a two-dimensional network parallel to (100). PMID:25249862

Real-valued composite filters for correlation-based optical pattern recognition

NASA Technical Reports Server (NTRS)

Rajan, P. K.; Balendra, Anushia

1992-01-01

Advances in the technology of optical devices such as spatial light modulators (SLMs) have influenced the research and growth of optical pattern recognition. In the research leading to this report, the design of real-valued composite filters that can be implemented using currently available SLMs for optical pattern recognition and classification was investigated. The design of real-valued minimum average correlation energy (RMACE) filter was investigated. Proper selection of the phase of the output response was shown to reduce the correlation energy. The performance of the filter was evaluated using computer simulations and compared with the complex filters. It was found that the performance degraded only slightly. Continuing the above investigation, the design of a real filter that minimizes the output correlation energy and the output variance due to noise was developed. Simulation studies showed that this filter had better tolerance to distortion and noise compared to that of the RMACE filter. Finally, the space domain design of RMACE filter was developed and implemented on the computer. It was found that the sharpness of the correlation peak was slightly reduced but the filter design was more computationally efficient than the complex filter.

A Two-Step Bayesian Approach for Propensity Score Analysis: Simulations and Case Study.

PubMed

Kaplan, David; Chen, Jianshen

2012-07-01

A two-step Bayesian propensity score approach is introduced that incorporates prior information in the propensity score equation and outcome equation without the problems associated with simultaneous Bayesian propensity score approaches. The corresponding variance estimators are also provided. The two-step Bayesian propensity score is provided for three methods of implementation: propensity score stratification, weighting, and optimal full matching. Three simulation studies and one case study are presented to elaborate the proposed two-step Bayesian propensity score approach. Results of the simulation studies reveal that greater precision in the propensity score equation yields better recovery of the frequentist-based treatment effect. A slight advantage is shown for the Bayesian approach in small samples. Results also reveal that greater precision around the wrong treatment effect can lead to seriously distorted results. However, greater precision around the correct treatment effect parameter yields quite good results, with slight improvement seen with greater precision in the propensity score equation. A comparison of coverage rates for the conventional frequentist approach and proposed Bayesian approach is also provided. The case study reveals that credible intervals are wider than frequentist confidence intervals when priors are non-informative.

1-[(6-Chloro-3-pyrid­yl)meth­yl]-5-eth­oxy-8-nitro-1,2,3,5,6,7-hexa­hydro­imidazo[1,2-a]pyridine

PubMed Central

Tian, Zhongzhen; Li, Dongmei; Li, Zhong

2009-01-01

In the title compound, C15H19ClN4O3, an active agrochemical possessing insecticidal activity, the dihedral angle between the mean planes passing through the pyridine ring and the five-membered ring is 87.3 (2)°. The fused pyridine ring adopts a twisted sofa conformation. The mol­ecular structure features close intra­molecular C—H⋯N and C—H⋯O hydrogen bonding. PMID:21577964

The impact of duration of organ dysfunction on the outcome of patients with severe sepsis and septic shock.

PubMed

Freitas, Flávio G R; Salomão, Reinaldo; Tereran, Nathalia; Mazza, Bruno Franco; Assunção, Murillo; Jackiu, Mirian; Fernandes, Haggeas; Machado, Flávia Ribeiro

2008-08-01

This study aimed to assess the impact of the duration of organ dysfunction on the outcome of patients with severe sepsis or septic shock. Clinical data were collected from hospital charts of patients with severe sepsis and septic shock admitted to a mixed intensive care unit from November 2003 to February 2004. The duration of organ dysfunction prior to diagnosis was correlated with mortality. Results were considered significant if p<0.05. Fifty-six patients were enrolled. Mean age was 55.6+/-20.7 years, mean APACHE II score was 20.6+/-6.9, and mean SOFA score was 7.9+/-3.7. Thirty-six patients (64.3%) had septic shock. The mean duration of organ dysfunction was 1.9+/-1.9 days. Within the univariate analysis, the variables correlated with hospital mortality were: age (p=0.015), APACHE II (p=0.008), onset outside the intensive care unit (p=0.05), blood glucose control (p=0.05) and duration of organ dysfunction (p=0.0004). In the multivariate analysis, only a duration of organ dysfunction persisting longer than 48 hours correlated with mortality (p=0.004, OR: 8.73 (2.37-32.14)), whereas the APACHE II score remained only a slightly significant factor (p=0.049, OR: 1.11 (1.00-1.23)). Patients who received therapeutic interventions within the first 48 hours after the onset of organ dysfunction exhibited lower mortality (32.1% vs. 82.1%, p=0.0001). These findings suggest that the diagnosis of organ dysfunction is not being made in a timely manner. The time elapsed between the onset of organ dysfunction and initiation of therapeutic intervention can be quite long, and this represents an important determinant of survival in cases of severe sepsis and septic shock.

Trends in intakes and sources of solid fats and added sugars among US children and adolescents: 1994-2010

PubMed Central

Slining, Meghan M.; Popkin, Barry M.

2013-01-01

Objective There are increasing global concerns about improving the dietary intakes of children and adolescents. In the United States (U.S.) the focus is on reducing energy from foods and beverages that provide empty calories from solid fats and added sugars (SoFAS). We examine trends in intakes and sources of solid fat and added sugars among U.S. 2- to 18- year olds from 1994-2010. Methods Data from five nationally representative surveys, the Continuing Survey of Food Intakes by Individuals Surveys (1994-1996) and the What We Eat In America, National Health and Nutrition Examination Surveys (2003-2004, 2005-2006, 2007-2008 and 2009-2010) were used to examine key food sources and energy from solid fats and added sugars. Sample sizes ranged from 2,594 to 8,259 per survey period, for a total of 17,268 observations across the five surveys. Food files were linked over time to create comparable food groups and nutrient values. Differences were examined by age, race/ethnicity and family income. Results Daily intake of energy from SoFAS among U.S. 2-18 year olds decreased from 1994-2010, with declines primarily detected in the recent time periods. Solid fats accounted for a greater proportion of total energy intake than did added sugars. Conclusions Although the consumption of solid fats and added sugars among children and adolescents in the United States decreased between 1994–1998 and 2009–2010, mean intakes continue to exceed recommended limits. PMID:23554397

Extracorporeal cytokine elimination as rescue therapy in refractory septic shock: a prospective single-center study.

PubMed

Friesecke, Sigrun; Stecher, Stephanie-Susanne; Gross, Stefan; Felix, Stephan B; Nierhaus, Axel

2017-09-01

Sepsis is the most common cause of death in medical intensive care units (ICU). If sepsis progresses to refractory septic shock, mortality may reach 90-100% despite optimum current therapy. Extracorporeal cytokine adsorption in addition to regular therapy was studied prospectively in refractory septic shock patients on a medical ICU. Refractory shock was defined as increasing vasopressor dose required to maintain mean arterial blood pressure above 65 mmHg or increasing lactate levels despite protocol-guided shock therapy for 6 h. We analysed noradrenaline requirements after 6 and 12 h (primary endpoint), lactate clearance after 6 and 12 h, SOFA-scores in the first days and achievement of shock reversal (i.e., normalization of lactate concentrations and sustained discontinuation of vasopressors; secondary endpoints). Twenty consecutive patients with refractory septic shock were included; CytoSorb ® treatment was started after 7.8 ± 3.7 h of shock therapy. Following the initiation of adsorption therapy, noradrenaline dose could be significantly reduced after 6 (-0.4 µg/kg/min; p = 0.03) and 12 h (-0.6 µg/kg/min; p = 0.001). Lactate clearance improved significantly. SOFA-scores on day 0, 1 and 2 remained unchanged. Shock reversal was achieved in 13 (65%) patients; 28-day survival was 45%. In severe septic shock unresponsive to standard treatment, haemodynamic stabilization was achieved using cytokine adsorption therapy, resulting in shock reversal in two-thirds of these patients. The study was registered in the German Register for Clinical Trials (DRKS) No. 00005149.

Ventilator-associated pneumonia in surgical emergency intensive care unit.

PubMed

Ertugrul, Bulent M; Yildirim, Ayse; Ay, Pinar; Oncu, Serkan; Cagatay, Atahan; Cakar, Nahit; Ertekin, Cemalettin; Ozsut, Halit; Eraksoy, Haluk; Calangu, Semra

2006-01-01

To investigate the incidence, risk factors and the etiology of ventilator-associated pneumonia (VAP) in surgical emergency intensive care unit (ICU) patients. We conducted this prospective cohort study in the surgical emergency ICU of Istanbul Medical Faculty between December 1999 and May 2001. We included 100 mechanically ventilated patients in this study. We diagnosed VAP according to the current diagnostic criteria. We identified the etiology of VAP cases by both quantitative cultures of endotracheal aspiration and blood cultures. To analyze the predisposing factors for the development of VAP, we recorded the following variables: age, gender, acute physiology and chronic health evaluation (APACHE) II score, Glasgow coma scale (GCS), sequential organ failure assessment (SOFA) score, serum albumin level, duration of mechanical ventilation (MV) prior to the development of VAP, and underlying diseases. We determined the VAP incidence rate as 28%. We found the APACHE II score and the duration of MV to be statistically significant variables for the development of VAP. There were no significant differences regarding age, gender, GCS, SOFA score, albumin level, or underlying diseases for the development of VAP. The isolated bacteria among VAP cases were as follows: Staphylococcus aureus (n=12, 43%), Acinetobacter spp. (n=6, 21%), coagulase-negative Staphylococci (n=4, 15%), Pseudomonas aeruginosa (n=3, 10.7%) and Klebsiella pneumoniae (n=3, 10.7%). Ventilator-associated pneumonia is a common infection, and certain interventions might affect the incidence of VAP. The ICU clinicians should be aware of the risk factors for VAP, which could prove useful in identifying patients at high risk for VAP, and modifying patient care to minimize the risk of VAP.

[Evolution in muscle strength in critical patients with invasive mechanical ventilation].

PubMed

Via Clavero, G; Sanjuán Naváis, M; Menéndez Albuixech, M; Corral Ansa, L; Martínez Estalella, G; Díaz-Prieto-Huidobro, A

2013-01-01

To assess the evolution of muscle strength in critically ill patients with mechanical ventilation (MV) from withdrawal of sedatives to hospital discharge. A cohort study was conducted in two intensive care units in the Hospital Universitari de Bellvitge from November 2011 to March 2012. Consecutive patients with MV > 72h. Dependent outcome: Muscle strength measured with the Medical Research Council (MRC) scale beginning on the first day the patient was able to answer 3 out of 5 simple orders (day 1), every week, at ICU discharge and at hospital discharge or at day 60 Independent outcomes: factors associated with muscle strength loss, ventilator-free days, ICU length of stay and hospital length of stay. The patients were distributed into two groups (MRC< 48, MRC ≥ 48) after the first measurement. Thirty-four patients were assessed. Independent outcomes associated with muscle strength weakness were: days with cardiovascular SOFA >2 (P<.001) and days with costicosteroids (P<.001). Initial MRC in MRC<48 group was 38 (27-43), and 52 (50-54) in MRC ≥ 48. The largest muscle strength gain was obtained the first week (31% versus 52%). A MRC < 48 value was associated with more MV days (P<.007) and a longer ICU stay. (P<.003). The greatest muscle strength gain after withdrawing of the sedatives was achieved in the first week. Muscle strength loss was associated with a cardiovascular SOFA > 2 and costicosteroids. Patients with a MRC < 48 required more days with MV and a longer ICU stay. Copyright © 2013 Elsevier España, S.L. y SEEIUC. All rights reserved.

[Contraindications to succinylcholine in the intensive care unit. A prevalence study].

PubMed

Muñoz-Martínez, T; Garrido-Santos, I; Arévalo-Cerón, R; Rojas-Viguera, L; Cantera-Fernández, T; Pérez-González, R; Díaz-Garmendia, E

2015-03-01

To determine the prevalence of contraindications to succinylcholine in patients admitted to the ICU. An observational study was carried out, describing the frequency of succinylcholine contraindication by stays, and associating the contraindications to population variables. The adult general ICU of a reference hospital. Clinical-surgical critically ill patients. Thirty consecutive days were analyzed. None. Population variables: age, sex, APACHE II and SOFA scores, illness, days of hospitalization, mechanical ventilation and renal replacement therapy. hyperkalemia, bedridden patients, rhabdomyolysis, muscle trauma, burns, infusion of neuromuscular blocking agents, acute renal failure, chronic renal failure, intraocular hypertension, intracranial hypertension, statin use, malignant hyperthermia, neuromuscular disease, spinal cord sectioning, bradycardia < 50 bpm, succinylcholine allergy, and pseudo-cholinesterase deficiency. A total of 102 patients were admitted, aged 60 ± 16 years (56.9% males), with the generation of 657 stays. Main diseases: elective heart surgery (33%), respiratory failure (22%) and sepsis (14%). We documented 466 stays (70.9%) with contraindications, particularly bedridden patients (n=140), neuromuscular blocking agents (n=101), acute renal failure (n=126), statin use (n=167), neuromuscular disease (n=159) and bradycardia (n=76). We recorded 74 stays (11.3%) at high risk of complications, secondary to hyperkalemic risk associated to receptor dysregulation. A high risk of complications was associated to advanced age, prolonged hospitalization, prolonged length of stay in the ICU, higher APACHE II and SOFA scores, mechanical ventilation and renal replacement therapy. Given the high prevalence of contraindications to succinylcholine observed, we discourage its use in patients admitted to the ICU. Copyright © 2014 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

An initial investigation of abnormal bodily phenomena in subjects at ultra high risk for psychosis: Their prevalence and clinical implications.

PubMed

Madeira, Luis; Bonoldi, Ilaria; Rocchetti, Matteo; Samson, Carly; Azis, Matilda; Queen, Beverly; Bossong, Matthijs; Perez, Jesus; Stone, James; Allen, Paul; Howes, Oliver D; McGuire, Philip; Raballo, Andrea; Fusar-Poli, Paolo; Ballerini, Massimo; Stanghellini, Giovanni

2016-04-01

Contemporary phenomenological research has considered abnormal bodily phenomena (ABP) to be a phenotypic trait of subjects with schizophrenia in their first psychotic episode. Yet the prevalence of ABP and their clinical significance in subjects at Ultra High Risk (UHR) of psychosis remain unidentified. This study is an exploratory investigation of ABP in UHR subjects and matched healthy controls (HCs) examining their relation to clinical features and basic self-disturbances. A sample of 26 UHR and 14 HC subjects from three prodromal and early intervention clinics in South London, West London and Cambridge was assessed with the Abnormal Bodily Phenomena questionnaire (ABPq), Comprehensive Assessment of At-Risk Mental States (CAARMS), the Positive and Negative Syndrome Scale (PANSS), the Social and Occupational Functioning Assessment Scale (SOFAS) and the Examination of Anomalous Self Experiences (EASE) checklist. In our sample ABP occurred in 73.1% of UHR subjects and prominent ABP (proABP) were referred in 53.8% of them. No HC subject reported ABP. The UHR group with proABP had lower CAARMS total score (t=-9.265, p=0.006). There were no differences in PANSS total score (t=-1.235, p=0.277), SOFAS score (H(2) 22.27, p=0.666) and EASE total scores (z=8.565, adjusted p=0.185) in the UHR subjects with prominent ABP versus those that did not. This initial investigation suggests that ABP could be a prevalent phenotypic feature of UHR subjects. Copyright © 2015 Elsevier Inc. All rights reserved.

PROTEIN NEEDS OF CRITICALLY ILL PATIENTS RECEIVING PARENTERAL NUTRITION.

PubMed

Germano Borges de Oliveira Nascimento Freitas, Renata; Negrão Nogueira, Roberto José; Hessel, Gabriel

2015-07-01

assess whether the current protein intake recommendations may improve the biochemical parameters of critical patients receiving parenteral nutrition. longitudinal study with three evaluations made (during the first 72 hours, on the 7th and the 14th days of PN). The following tests were applied: albumin, C-reactive protein, prealbumin, total cholesterol, HDL, triglycerides, lymphocytes, and glutathione peroxidase. The severity was determined by SOFA. The statistical analysis included the Spearman and Mann-Whitney tests, as well as ANOVA (analysis of variance). among the 53 patients evaluated, 20 (37.74%) died. The mean calorie was 24.68 ± 9.78 kcal/kg (beginning of PN), 26.49 ± 8.89 kcal/kg (3rd to 7th days of PN), and 30.9 ± 12.19 kcal/kg (7th to 14th days of PN). The mean protein was 1.19 ± 0.44 g/kcal/kg (first 72 hours of PN), 1.29 ± 0.44 g/kcal/kg (3rd to 7th days of PN) and 1.49 ± 0.69 g/kcal/kg (7th to 14th days of PN). Prealbumin, albumin, total cholesterol and HDL were below the reference values, while the CRP levels were high. Throughout the three evaluation times, there was no a significant improvement on the levels of laboratory examinations. A strong and negative correlation was found between SOFA and prealbumin (r = -0.64, p = 0.05). the protein offer, according to the traditional recommendations, was not enough to improve the biochemical parameters of critical patients undergoing parenteral nutrition. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Trends in intakes and sources of solid fats and added sugars among U.S. children and adolescents: 1994-2010.

PubMed

Slining, M M; Popkin, B M

2013-08-01

There are increasing global concerns about improving the dietary intakes of children and adolescents. In the United States (U.S.), the focus is on reducing energy from foods and beverages that provide empty calories from solid fats and added sugars (SoFAS). We examine trends in intakes and sources of solid fat and added sugars among U.S. 2-18 year olds from 1994 to 2010. Data from five nationally representative surveys, the Continuing Survey of Food Intakes by Individuals Surveys (1994-1996) and the What We Eat In America, National Health and Nutrition Examination Surveys (2003-2004, 2005-2006, 2007-2008 and 2009-2010) were used to examine key food sources and energy from solid fats and added sugars. Sample sizes ranged from 2594 to 8259 per survey period, for a total of 17 268 observations across the five surveys. Food files were linked over time to create comparable food groups and nutrient values. Differences were examined by age, race/ethnicity and family income. Daily intake of energy from SoFAS among U.S. 2-18 year olds decreased from 1994 to 2010, with declines primarily detected in the recent time periods. Solid fats accounted for a greater proportion of total energy intake than did added sugars. Although the consumption of solid fats and added sugars among children and adolescents in the U.S. decreased between 1994-1998 and 2009-2010, mean intakes continue to exceed recommended limits. © 2013 The Authors. Pediatric Obesity © 2013 International Association for the Study of Obesity.

Insight as a social identity process in the evolution of psychosocial functioning in the early phase of psychosis.

PubMed

Klaas, H S; Clémence, A; Marion-Veyron, R; Antonietti, J-P; Alameda, L; Golay, P; Conus, P

2017-03-01

Awareness of illness (insight) has been found to have contradictory effects for different functional outcomes after the early course of psychosis. Whereas it is related to psychotic symptom reduction and medication adherence, it is also associated with increased depressive symptoms. In this line, the specific effects of insight on the evolution of functioning over time have not been identified, and social indicators, such as socio-occupational functioning have barely been considered. Drawing from social identity theory we investigated the impact of insight on the development of psychosocial outcomes and the interactions of these variables over time. The participants, 240 patients in early phase of psychosis from the Treatment and Early Intervention in Psychosis Program (TIPP) of the University Hospital of Lausanne, Switzerland, were assessed at eight time points over 3 years. Cross-lagged panel analyses and multilevel analyses were conducted on socio-occupational and general functioning [Social and Occupational Functioning Assessment Scale (SOFAS) and Global Assessment of Functioning (GAF)] with insight, time and depressive symptoms as independent variables. Results from multilevel analyses point to an overall positive impact of insight on psychosocial functioning, which increases over time. Yet the cross-lagged panel analysis did not reveal a systematic positive and causal effect of insight on SOFAS and GAF scores. Depressive symptoms seem only to be relevant in the beginning of the treatment process. Our results point to a complex process in which the positive impact of insight on psychosocial functioning increases over time, even when considering depressive symptoms. Future studies and treatment approaches should consider the procedural aspect of insight.

An investigation of a possible relationship between olfactory identification deficits at first episode and four-year outcomes in patients with psychosis.

PubMed

Good, Kimberley P; Tibbo, Philip; Milliken, Heather; Whitehorn, David; Alexiadis, Maria; Robertson, Nancy; Kopala, Lili C

2010-12-01

Olfactory identification deficits are found in a significant proportion of patients with schizophrenia spectrum psychotic disorders and appear to be predictive of incomplete remission of negative and cognitive symptoms. In the current study, we examined whether patients with first episode psychosis who have olfactory identification deficits (microsmic) have poorer functional outcome than those whose olfactory status is normal (normosmic). Sixty-six (66) first episode psychosis patients (46 M and 20 F) were assessed with the University of Pennsylvania Smell Identification Test (UPSIT) at baseline. UPSIT scores served to classify patients into subgroups. The patients' psychiatrists completed the Social and Occupational Functioning Assessment Scale (SOFAS) and the Levels of Functioning Scale (LOFS) after at least 6 months of treatment. The Premorbid Assessment Scale (PAS) was rated by a parent at baseline. Thirty-eight percent (38%) of the sample was identified as 'microsmic'. LOFS and SOFAS scores were significantly lower in the microsmic group than in the normosmic group. Symptoms were significantly worse in the microsmic group in comparison to the normosmic group. PAS scores did not differ between groups. First episode patients identified as microsmic at baseline assessment went on to demonstrate poorer functional outcome compared to normosmic patients despite no differences in premorbid adjustment. Olfactory identification deficits at first episode may provide a marker for poorer outcome. Testing olfaction is simple and inexpensive, and could provide clinically valuable information at first episode to identify those patients who might benefit from more intensive interventions promoting functional recovery. Copyright © 2010 Elsevier B.V. All rights reserved.

EPR Studies of the Binding Properties, Guest Dynamics, and Inner-Space Dimensions of a Water-Soluble Resorcinarene Capsule.

PubMed

Ayhan, Mehmet Menaf; Casano, Gilles; Karoui, Hakim; Rockenbauer, Antal; Monnier, Valérie; Hardy, Micaël; Tordo, Paul; Bardelang, David; Ouari, Olivier

2015-11-09

Nitroxide free radicals have been used to study the inner space of one of Rebek's water-soluble capsules. EPR and (1) H NMR spectroscopy, ESI-MS, and DFT calculations showed a preference for the formation of 1:2 complexes. EPR titrations allowed us to determine binding constants (Ka ) in the order of 10(7)  M(-2) . EPR spectral-shape analysis provided information on the guest rotational dynamics within the capsule. The interplay between optimum hydrogen bonding upon capsule formation and steric strain for guest accommodation highlights some degree of flexibility for guest inclusion, particularly at the center of the capsule where the hydrogen bond seam can be barely distorted or slightly disturbed. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Crystal structure of (pyridine-κN)bis(quinolin-2-olato-κ2 N,O)copper(II) monohydrate

PubMed Central

Hawks, Benjamin; Yan, Jingjing; Basa, Prem; Burdette, Shawn

2015-01-01

The title complex, [Cu(C9H6NO)2(C5H4N)]·H2O, adopts a slightly distorted square-pyramidal geometry in which the axial pyridine ligand exhibits a long Cu—N bond of 2.305 (3) Å. The pyridine ligand forms dihedral angles of 79.5 (5) and 88.0 (1)° with the planes of the two quinolin-2-olate ligands, while the dihedral angle between the quinoline groups of 9.0 (3)° indicates near planarity. The water mol­ecule connects adjacent copper complexes through O—H⋯O hydrogen bonds to phenolate O atoms, forming a network inter­connecting all the complexes in the crystal lattice. PMID:25878845

Shadow of noncommutative geometry inspired black hole

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wei, Shao-Wen; Cheng, Peng; Zhong, Yi

2015-08-01

In this paper, the shadow casted by the rotating black hole inspired by noncommutative geometry is investigated. In addition to the dimensionless spin parameter a/M{sub 0} with M{sub 0} black hole mass and inclination angle i, the dimensionless noncommutative parameter √θ/M{sub 0} is also found to affect the shape of the black hole shadow. The result shows that the size of the shadow slightly decreases with the parameter √θ/M{sub 0}, while the distortion increases with it. Compared to the Kerr black hole, the parameter √θ/M{sub 0} increases the deformation of the shadow. This may offer a way to distinguish noncommutativemore » geometry inspired black hole from Kerr one via astronomical instruments in the near future.« less

Structural characterization and antioxidant properties of Cu(II) and Ni(II) complexes derived from dicyandiamide

NASA Astrophysics Data System (ADS)

Kertmen, Seda Nur; Gonul, Ilyas; Kose, Muhammet

2018-01-01

New Cu(II) and Ni(II) complexes derived from dicyandiamide were synthesized and characterised by spectroscopic and analytical methods. Molecular structures of the complexes were determined by single crystal X-ray diffraction studies. In the complexes, the Cu(II) or Ni(II) ions are four-coordinate with a slight distorted square planar geometry. The ligands (L-nPen and L-iPen) derived from dicyandiamide formed via nucleophilic addition of alcohol solvent molecule in the presence Cu(II) or Ni(II) ions. Complexes were stabilised by intricate array of hydrogen bonding interactions. Antioxidant activity of the complexes was evaluated by DPPH radical scavenging and CUPRAC methods. The complexes exhibit antioxidant activity, however, their activities were much lower than standard antioxidants (Vitamin C and trolox).

Measured performance of a 1089 K (1500 deg F) heat storage device for sun-shade orbital missions

NASA Technical Reports Server (NTRS)

Namkoong, D.

1972-01-01

Tubes designed for a solar heat receiver to serve as an energy source for a Brayton power system were tested for 2002 hours and 1251 sun-shade cycles. The tubes were designed to transfer a constant thermal input to the Brayton system during an orbit. Excess solar energy during a sun period is stored as heat of fusion of lithium fluoride. The niobium - 1% zirconium tubes accommodate the 23 percent volume decrease of LiF during freezing. Test results showed slight, local distortions. The gas discharge temperature varied from 16 K (29 F) below to 28 K (50 F) above the nominal value of 1089 K (1500 F). The tube surface temperatures ranged from 1039 K (1410 F) to 1183 K (1670 F).

Low loss depressed cladding waveguide inscribed in YAG:Nd single crystal by femtosecond laser pulses.

PubMed

Okhrimchuk, Andrey; Mezentsev, Vladimir; Shestakov, Alexander; Bennion, Ian

2012-02-13

A depressed cladding waveguide with record low loss of 0.12 dB/cm is inscribed in YAG:Nd(0.3at.%) crystal by femtosecond laser pulses with an elliptical beam waist. The waveguide is formed by a set of parallel tracks which constitute the depressed cladding. It is a key element for compact and efficient CW waveguide laser operating at 1064 nm and pumped by a multimode laser diode. Special attention is paid to mechanical stress resulting from the inscription process. Numerical calculation of mode distribution and propagation loss with the elasto-optical effect taken into account leads to the conclusion that the depressed cladding is a dominating factor in waveguide mode formation, while the mechanical stress only slightly distorts waveguide modes.

Manipulating femtosecond pulse shape using liquid crystals infiltrated one-dimensional graded index photonic crystal waveguides composed of coupled-cavities

NASA Astrophysics Data System (ADS)

Fathollahi Khalkhali, T.; Bananej, A.

2017-10-01

In this paper, we investigate the transmission of a 10-femtosecond pulse through an ordinary and graded index coupled-cavity waveguide, using finite-difference time-domain and transfer matrix method. The ordinary structure is composed of dielectric/liquid crystal layers in which four defect layers are placed symmetrically. Next, we introduce a graded structure based on the ordinary system in which dielectric refractive index slightly increases with a constant step value from the beginning to the end of the structure while liquid crystal layers are maintained unchanged. Simulation results reveal that by applying an external static electric field and controlling liquid crystal refractive index in graded structure, it is possible to transmit an ultrashort pulse with negligible distortion and attenuation.

Synthesis and crystal structure of the rhodium(I) cyclooctadiene complex with bis(3-tert-butylimidazol-2-ylidene)borate ligand

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chen, F.; Shao, K.-J.; Xiao, Y.-C.

2015-12-15

The rhodium(I) cyclooctadiene complex with the bis(3-tert-butylimidazol-2-ylidene)borate ligand [H{sub 2}B(Im{sup t}Bu){sup 2}]Rh(COD) C{sup 22}H{sup 36}BN{sup 4}Rh, has been prepared, and its crystal structure is determined by X-ray diffraction. Complex exhibits slightly distorted square planar configurations around the metal center, which is coordinated by the bidentate H{sup 2}B(Im{sup t}Bu){sub 2} and one cyclooctadiene group. The Rh–C{sub carbene} bond lengths are 2.043(4) and 2.074(4) Å, and the bond angle C–Rh1–C is 82.59°. The dihedral angle between two imidazol-2-ylidene rings is 67.30°.

Size dependence of magneto-optical activity in silver nanoparticles with dimensions between 10 and 60 nm studied by MCD spectroscopy.

PubMed

Shiratsu, Taisuke; Yao, Hiroshi

2018-02-07

Size-dependent magneto-optical activity in Ag nanoparticles with dimensions from 10 to 60 nm is demonstrated with magnetic circular dichroism (MCD) spectroscopy. The Ag nanoparticles are prepared on the basis of a seeded-growth strategy using sodium citrate and/or tannic acid as reducing agents in aqueous solution. The obtained nanoparticles are roughly spherical, but those larger than ∼28 nm have a slight diversity of shapes with quasi-spherical polyhedrons. They exhibit a derivative-like MCD response in the localized surface plasmon resonance (LSPR) region, which originates from two circular modes of surface magnetoplasmons. With an increase in the nanoparticle diameter, the bisignated MCD signal is strongly distorted and weakened. Such a distortion for large-sized Ag nanoparticles can be phenomenologically simulated on the basis of both spectral inhomogeneity and MCD signal lobe asymmetry. Then the maximum value of MCD amplitude (MCD max ), which is obtained by normalization of the amplitude to the LSPR peak absorbance, first increases with increasing particle diameter and then decreases with a maximum for the 23 nm nanoparticle. Interestingly, the MCD max values are inversely correlated with the spectral bandwidth of LSPR extinction. This behaviour is discussed from a viewpoint of inhomogeneous effects of both spectral and size/shape distributions. We believe the present results will advance the design and application of optical devices based on magnetoplasmonics.

Evaluating Continuous-Time Slam Using a Predefined Trajectory Provided by a Robotic Arm

NASA Astrophysics Data System (ADS)

Koch, B.; Leblebici, R.; Martell, A.; Jörissen, S.; Schilling, K.; Nüchter, A.

2017-09-01

Recently published approaches to SLAM algorithms process laser sensor measurements and output a map as a point cloud of the environment. Often the actual precision of the map remains unclear, since SLAMalgorithms apply local improvements to the resulting map. Unfortunately, it is not trivial to compare the performance of SLAMalgorithms objectively, especially without an accurate ground truth. This paper presents a novel benchmarking technique that allows to compare a precise map generated with an accurate ground truth trajectory to a map with a manipulated trajectory which was distorted by different forms of noise. The accurate ground truth is acquired by mounting a laser scanner on an industrial robotic arm. The robotic arm is moved on a predefined path while the position and orientation of the end-effector tool are monitored. During this process the 2D profile measurements of the laser scanner are recorded in six degrees of freedom and afterwards used to generate a precise point cloud of the test environment. For benchmarking, an offline continuous-time SLAM algorithm is subsequently applied to remove the inserted distortions. Finally, it is shown that the manipulated point cloud is reversible to its previous state and is slightly improved compared to the original version, since small errors that came into account by imprecise assumptions, sensor noise and calibration errors are removed as well.

Distortion-product otoacoustic emission reflection-component delays and cochlear tuning: estimates from across the human lifespan.

PubMed

Abdala, Carolina; Guérit, François; Luo, Ping; Shera, Christopher A

2014-04-01

A consistent relationship between reflection-emission delay and cochlear tuning has been demonstrated in a variety of mammalian species, as predicted by filter theory and models of otoacoustic emission (OAE) generation. As a step toward the goal of studying cochlear tuning throughout the human lifespan, this paper exploits the relationship and explores two strategies for estimating delay trends-energy weighting and peak picking-both of which emphasize data at the peaks of the magnitude fine structure. Distortion product otoacoustic emissions (DPOAEs) at 2f1-f2 were recorded, and their reflection components were extracted in 184 subjects ranging in age from prematurely born neonates to elderly adults. DPOAEs were measured from 0.5-4 kHz in all age groups and extended to 8 kHz in young adults. Delay trends were effectively estimated using either energy weighting or peak picking, with the former method yielding slightly shorter delays and the latter somewhat smaller confidence intervals. Delay and tuning estimates from young adults roughly match those obtained from SFOAEs. Although the match is imperfect, reflection-component delays showed the expected bend (apical-basal transition) near 1 kHz, consistent with a break in cochlear scaling. Consistent with other measures of tuning, the term newborn group showed the longest delays and sharpest tuning over much of the frequency range.

Crystal structure and Hirshfeld surface analysis of aqua­bis­(nicotinamide-κN)bis­(4-sulfamoylbenzoato-κO 1)copper(II)

PubMed Central

Hökelek, Tuncer; Yavuz, Vijdan; Dal, Hakan; Necefoğlu, Hacali

2018-01-01

In the crystal of the title complex, [Cu(C7H6NO4S)2(C6H6N2O)2(H2O)], the CuII cation and the O atom of the coordinated water mol­ecule reside on a twofold rotation axis. The CuII ion is coordinated by two carboxyl­ate O atoms of the two symmetry-related 4-sulfamoylbenzoate (SB) anions and by two N atoms of the two symmetry-related nicotinamide (NA) mol­ecules at distances of 1.978 (2) and 2.025 (3) Å, respectively, forming a slightly distorted square-planar arrangement. The distorted square-pyramidal coordination environment is completed by the water O atom in the axial position at a distance of 2.147 (4) Å. In the crystal, the mol­ecules are linked via O—H⋯O and N—H⋯O hydrogen bonds with R 2 2(8) and R 2 2(18) ring motifs, forming a three-dimensional architecture. The Hirshfeld surface analysis of the crystal structure indicates that the most important contributions for the crystal packing are from H⋯O/O⋯H (42.2%), H⋯H (25.7%) and H⋯C/C⋯H (20.0%) inter­actions. PMID:29416889

Crystal structure of bis­[trans-(ethane-1,2-di­amine-κ2 N,N′)bis­(thio­cyanato-κN)chromium(III)] tetra­chlorido­zincate from synchrotron data

PubMed Central

Moon, Dohyun; Choi, Jong-Ha

2015-01-01

The structure of the title compound, [Cr(NCS)2(C2H8N2)2]2[ZnCl4], has been determined from synchrotron data. In the asymmetric unit, there are four independent halves of the CrIII complex cations, each of which lies on an inversion centre, and one tetra­chlorido­zincate anion in a general position. The CrIII atoms are coordinated by the four N atoms of two ethane-1,2-di­amine (en) ligands in the equatorial plane and two N-bound NCS− anions in a trans arrangement, displaying a slightly distorted octa­hedral geometry with crystallographic inversion symmetry. The Cr—N(en) and Cr—N(NCS) bond lengths range from 2.0653 (10) to 2.0837 (10) Å and from 1.9811 (10) to 1.9890 (10) Å, respectively. The five-membered metalla-rings are in stable gauche conformations. The [ZnCl4]2− anion has a distorted tetra­hedral geometry. The crystal structure is stabilized by inter­molecular hydrogen bonds involving the en NH2 or CH2 groups as donors and chloride ligands of the anion and S atoms of NCS− ligands as acceptors. PMID:25705463

Synchrotron-based XAS on structure investigation of La0.99-xSrx(Na, K, Ba)0.01MnO3 nanoparticles: Evidence of magnetic properties

NASA Astrophysics Data System (ADS)

Daengsakul, Sujittra; Saengplot, Saowalak; Kidkhunthod, Pinit; Pimsawat, Adulphan; Maensiri, Santi

2018-04-01

This work presents the structural study of La0.99-xSrx(Na, K, Ba)0.01MnO3 or LSAM nanoparticles synthesized using thermal-hydro decomposition method where A denotes Na, K, Sr and Ba, respectively. The effect of ionic radii size of A dopants or rA from the substitution of A for La and Sr on the MnO6 octrahedral structure, where the average size of the cations occupying in A-site or 〈rA〉 is fixed at ∼ 1.24 Å, is focused. The LSAM nanoparticles are carefully studied using X-ray diffraction (XRD) including Rietveld refinement and X-ray Absorption Spectroscopy (XAS) including X-ray Absorption Near edge Structure (XANES) and X-ray Absorption Fine Structure (EXAFS). The Rietveld refinement shows all nano-powder samples have rhombohedral structure. By XANES technique we found that the effect of A substitutions at A-site causes a slight change of mean oxidation state of Mn between 3.54 and 3.60. Furthermore, the structural distortion of MnO6 octrahedral in samples is analysed and obtained from EXAFS. The observed trend of ferromagnetism for all LSAM samples can be clearly explained by evidences of A-site doping, structural distortion around Mn atoms and mixing Mn3+/Mn4+ valence states.

Asymmetric bubble collapse

NASA Astrophysics Data System (ADS)

Lai, Lipeng; Turitsyn, Konstantin S.; Zhang, Wendy W.

2008-11-01

Recent studies reveal that an inertial implosion, analogous to the collapse of a large cavity in water, governs how a submerged air bubble disconnects from a nozzle. For the bubble, slight asymmetries in the initial neck shape give rise to vibrations that grow pronounced over time. These results motivate our study of the final stage of asymmetric cavity collapse. We are particularly interested in the generic situation where the initial condition is sufficiently well-focused that a cavity can implode inwards energetically. Yet, because the initial condition is not perfectly symmetric, the implosion fails to condense all the energy. We consider cavity shapes in the slender-body limit, for which the collapse dynamics is quasi two-dimensional. In this limit, each cross-section of the cavity evolves as if it were a distorted void immersed in an inviscid and irrotational fluid. Simulations of a circular void distorted by an elongation-compression vibrational mode reveal that a variety of outcomes are possible in the 2D problem. Opposing sides of the void surface can curve inwards and contact smoothly in a finite amount of time. Depending on the phase of the vibration excited, the contact can be either north-south or east-west. Phase values that lie in the transition zone from one orientation to the other give rise to final shapes with large lengthscale separation. We show also that the final outcome varies non-monotonically with the initial amplitude of the vibrational mode.

Inference Control Mechanism for Statistical Database: Frequency-Imposed Data Distortions.

ERIC Educational Resources Information Center

Liew, Chong K.; And Others

1985-01-01

Introduces two data distortion methods (Frequency-Imposed Distortion, Frequency-Imposed Probability Distortion) and uses a Monte Carlo study to compare their performance with that of other distortion methods (Point Distortion, Probability Distortion). Indications that data generated by these two methods produce accurate statistics and protect…

AST: World Coordinate Systems in Astronomy

NASA Astrophysics Data System (ADS)

Berry, David S.; Warren-Smith, Rodney F.

2014-04-01

The AST library provides a comprehensive range of facilities for attaching world coordinate systems to astronomical data, for retrieving and interpreting that information in a variety of formats, including FITS-WCS, and for generating graphical output based on it. Core projection algorithms are provided by WCSLIB (ascl:1108.003) and astrometry is provided by the PAL (ascl:1606.002) and SOFA (ascl:1403.026) libraries. AST bindings are available in Python (pyast), Java (JNIAST) and Perl (Starlink::AST). AST is used as the plotting and astrometry library in DS9 and GAIA, and is distributed separately and as part of the Starlink software collection.

The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)

PubMed Central

Singer, Mervyn; Deutschman, Clifford S.; Seymour, Christopher Warren; Shankar-Hari, Manu; Annane, Djillali; Bauer, Michael; Bellomo, Rinaldo; Bernard, Gordon R.; Chiche, Jean-Daniel; Coopersmith, Craig M.; Hotchkiss, Richard S.; Levy, Mitchell M.; Marshall, John C.; Martin, Greg S.; Opal, Steven M.; Rubenfeld, Gordon D.; van der Poll, Tom; Vincent, Jean-Louis; Angus, Derek C.

2016-01-01

IMPORTANCE Definitions of sepsis and septic shock were last revised in 2001. Considerable advances have since been made into the pathobiology (changes in organ function, morphology, cell biology, biochemistry, immunology, and circulation), management, and epidemiology of sepsis, suggesting the need for reexamination. OBJECTIVE To evaluate and, as needed, update definitions for sepsis and septic shock. PROCESS A task force (n = 19) with expertise in sepsis pathobiology, clinical trials, and epidemiology was convened by the Society of Critical Care Medicine and the European Society of Intensive Care Medicine. Definitions and clinical criteria were generated through meetings, Delphi processes, analysis of electronic health record databases, and voting, followed by circulation to international professional societies, requesting peer review and endorsement (by 31 societies listed in the Acknowledgment). KEY FINDINGS FROMEVIDENCE SYNTHESIS Limitations of previous definitions included an excessive focus on inflammation, the misleading model that sepsis follows a continuum through severe sepsis to shock, and inadequate specificity and sensitivity of the systemic inflammatory response syndrome (SIRS) criteria. Multiple definitions and terminologies are currently in use for sepsis, septic shock, and organ dysfunction, leading to discrepancies in reported incidence and observed mortality. The task force concluded the term severe sepsis was redundant. RECOMMENDATIONS Sepsis should be defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. For clinical operationalization, organ dysfunction can be represented by an increase in the Sequential [Sepsis-related] Organ Failure Assessment (SOFA) score of 2 points or more, which is associated with an in-hospital mortality greater than 10%. Septic shock should be defined as a subset of sepsis in which particularly profound circulatory, cellular, and metabolic abnormalities are associated with a greater risk of mortality than with sepsis alone. Patients with septic shock can be clinically identified by a vasopressor requirement to maintain a mean arterial pressure of 65 mm Hg or greater and serum lactate level greater than 2 mmol/L (>18 mg/dL) in the absence of hypovolemia. This combination is associated with hospital mortality rates greater than 40%. In out-of-hospital, emergency department, or general hospital ward settings, adult patients with suspected infection can be rapidly identified as being more likely to have poor outcomes typical of sepsis if they have at least 2 of the following clinical criteria that together constitute a new bedside clinical score termed quickSOFA (qSOFA): respiratory rate of 22/min or greater, altered mentation, or systolic blood pressure of 100 mm Hg or less. CONCLUSIONS AND RELEVANCE These updated definitions and clinical criteria should replace previous definitions, offer greater consistency for epidemiologic studies and clinical trials, and facilitate earlier recognition and more timely management of patients with sepsis or at risk of developing sepsis. PMID:26903338

The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3).

PubMed

Singer, Mervyn; Deutschman, Clifford S; Seymour, Christopher Warren; Shankar-Hari, Manu; Annane, Djillali; Bauer, Michael; Bellomo, Rinaldo; Bernard, Gordon R; Chiche, Jean-Daniel; Coopersmith, Craig M; Hotchkiss, Richard S; Levy, Mitchell M; Marshall, John C; Martin, Greg S; Opal, Steven M; Rubenfeld, Gordon D; van der Poll, Tom; Vincent, Jean-Louis; Angus, Derek C

2016-02-23

Definitions of sepsis and septic shock were last revised in 2001. Considerable advances have since been made into the pathobiology (changes in organ function, morphology, cell biology, biochemistry, immunology, and circulation), management, and epidemiology of sepsis, suggesting the need for reexamination. To evaluate and, as needed, update definitions for sepsis and septic shock. A task force (n = 19) with expertise in sepsis pathobiology, clinical trials, and epidemiology was convened by the Society of Critical Care Medicine and the European Society of Intensive Care Medicine. Definitions and clinical criteria were generated through meetings, Delphi processes, analysis of electronic health record databases, and voting, followed by circulation to international professional societies, requesting peer review and endorsement (by 31 societies listed in the Acknowledgment). Limitations of previous definitions included an excessive focus on inflammation, the misleading model that sepsis follows a continuum through severe sepsis to shock, and inadequate specificity and sensitivity of the systemic inflammatory response syndrome (SIRS) criteria. Multiple definitions and terminologies are currently in use for sepsis, septic shock, and organ dysfunction, leading to discrepancies in reported incidence and observed mortality. The task force concluded the term severe sepsis was redundant. Sepsis should be defined as life-threatening organ dysfunction caused by a dysregulated host response to infection. For clinical operationalization, organ dysfunction can be represented by an increase in the Sequential [Sepsis-related] Organ Failure Assessment (SOFA) score of 2 points or more, which is associated with an in-hospital mortality greater than 10%. Septic shock should be defined as a subset of sepsis in which particularly profound circulatory, cellular, and metabolic abnormalities are associated with a greater risk of mortality than with sepsis alone. Patients with septic shock can be clinically identified by a vasopressor requirement to maintain a mean arterial pressure of 65 mm Hg or greater and serum lactate level greater than 2 mmol/L (>18 mg/dL) in the absence of hypovolemia. This combination is associated with hospital mortality rates greater than 40%. In out-of-hospital, emergency department, or general hospital ward settings, adult patients with suspected infection can be rapidly identified as being more likely to have poor outcomes typical of sepsis if they have at least 2 of the following clinical criteria that together constitute a new bedside clinical score termed quickSOFA (qSOFA): respiratory rate of 22/min or greater, altered mentation, or systolic blood pressure of 100 mm Hg or less. These updated definitions and clinical criteria should replace previous definitions, offer greater consistency for epidemiologic studies and clinical trials, and facilitate earlier recognition and more timely management of patients with sepsis or at risk of developing sepsis.

A simple scoring system based on neutrophil count in sepsis patients.

PubMed

Ueda, Takahiro; Aoyama-Ishikawa, Michiko; Nakao, Atsunori; Yamada, Taihei; Usami, Makoto; Kotani, Joji

2014-03-01

The assessment of critically ill patients is often a challenge for clinicians. There are a number of scoring systems such as Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA) and C-reactive protein test (CRP), which have been shown to correlate with outcome in a variety of Intensive Care Unit (ICU) patients. Therefore, use of repeated measures of these preexisting scores over time is a reasonable attempt to assess the severity of organ dysfunction and predict outcome in critically ill patients. Several reports suggest that the neutrophil is a useful marker of sepsis. However, since both a large number and a small number of neutrophils indicate a severe situation, neutrophil count is difficult to use to directly predict patients'. We proposed a novel scoring system identify predictive factors using a simple blood cell count that may be associated with mortality in ICU patients. Our novel scoring system (n-score) was calculated as follows: ranges of neutrophils of 0-4999 cells/mm(3) and 5000-9999 cells/mm(3) were defined as 3 and 1 points, respectively. When the neutrophil count was over 10,000 cells/mm(3), the score was calculated by dividing the number of cells by 10,000. Then, 1 or 2 points were added when patients were female or male, respectively. We hypothesize that n-score may be a simple and easy scoring system to estimate mortality of the patients with sepsis and severe sepsis/septic shock without requirement of special methods or special measuring equipment, and may be as reliable as the APACHE II score or SOFA score. The retrospective evaluation was conducted at the Department of Emergency, Disaster and Critical Care Medicine at the Hyogo College of Medicine. Seventy-seven patients who were admitted to the emergency center and diagnosed sepsis or severe sepsis/septic shock between June 2007 and December 2012 and gave informed consent were enrolled. The n-score was significantly higher in non-survivors of sepsis and severe sepsis/septic shock (p<0.01, t-test) than in survivors. The ROC curve showed a sensitivity of 61.5% and a specificity of 80.4% at an n-score of 3.8 points; the area under the curve was 0.736. In addition, n-score correlated with APACHE II score (p<0.01, R=0.378) and SOFA score (p<0.05, R=0.256) on admission. Based on these preliminary evaluations, we hypothesize that n-score may be a useful scoring system to detect risk of death in sepsis and severe sepsis/septic shock. Copyright © 2014 Elsevier Ltd. All rights reserved.

Using continuous renal replacement therapy to manage patients of shock and acute renal failure

PubMed Central

Soni, Sachin S; Nagarik, Amit P; Adikey, Gopal Kishan; Raman, Anuradha

2009-01-01

Background: The incidence of acute renal failure (ARF) in the hospital setting is increasing. It portends excessive morbidity and mortality and a considerable burden on hospital resources. Extracorporeal therapies show promise in the management of patients with shock and ARF. It is said that the potential of such therapy goes beyond just providing renal support. The aim of our study was to analyze the clinical setting and outcomes of critically ill ARF patients managed with continuous renal replacement therapy (CRRT). Patients and Methods: Ours was a retrospective study of 50 patients treated between January 2004 and November 2005. These 50 patients were in clinical shock and had concomitant ARF. All of these patients underwent CVVHDF (continuous veno-venous hemodiafiltration) in the intensive care unit. For the purpose of this study, shock was defined as systolic BP < 100 mm Hg in spite of administration of one or more inotropic agents. SOFA (Sequential Organ Failure Assessment) score before initiation of dialysis support was recorded in all cases. CVVHDF was performed using the Diapact® (Braun) CRRT machine. The vascular access used was as follows: femoral in 32, internal jugular in 8, arteriovenous fistula (AVF) in 4, and subclavian in 6 patients. We used 0.9% or 0.45% (half-normal) saline as a prefilter replacement, with addition of 10% calcium gluconate, magnesium sulphate, sodium bicarbonate, and potassium chloride in separate units, while maintaining careful monitoring of electrolytes. Anticoagulation of the extracorporeal circuit was achieved with systemic heparin in 26 patients; frequent saline flushes were used in the other 24 patients. Results: Of the 50 patients studied, 29 were males and 21 females (1.4:1). The average age was 52.88 years (range: 20–75 years). Causes of ARF included sepsis in 24 (48%), hemodynamically mediated renal failure (HMRF) in 18 (36%), and acute over chronic kidney disease in 8 (16%) patients. The overall mortality was 74%. The average SOFA score was 14.31. The variables influencing mortality on multivariate analysis were: age [odds ratio (OR):1.65; 95% CI: 1.35 to 1.92; P = 0.04], serum creatinine (OR:1.68; 95% CI: 1.44 to 1.86; P = 0.03), and serum bicarbonate (OR: 0.76; 95% CI: 0.55 to 0.94; P = 0.01). On univariate analysis the SOFA score was found to be a useful predictor of mortality. Conclusions: Despite advances in treating critically ill patients with newer extracorporeal therapies, mortality is dismally high. Multiorgan dysfunction adversely affects outcome of CRRT. Older age, level of azotemia, and severity of metabolic acidosis are important predictors of adverse outcome. PMID:19561951

Cell Free DNA and Procalcitonin as Early Markers of Complications in ICU Patients with Multiple Trauma and Major Surgery.

PubMed

Ahmed, Asmaa I; Soliman, Randa A; Samir, Shereif

2016-12-01

Cell free DNA (cfDNA) was recently suggested as a new marker of sepsis and poor outcome in ICU patients. Procalcitonin has also been the focus of attention as an early marker for systemic inflammation and sepsis. cfDNA, procalcitonin (PCT), C-reactive protein (CRP), and lactate levels were measured in 30 ICU patients with multiple trauma or after major surgery on the first day of admission and on 5th and 7th days for PCT, CRP, and lactate. cfDNA was measured by real-time PCR, PCT by ELISA, CRP immunoturbidimetrically, and lactate spectrophotometrically. SOFA score and Injury Severity Score (ISS) for trauma patients were calculated. Significantly higher levels of cfDNA were observed in non-survivor patients in comparison to survivors and in patients with sepsis in comparison to those without sepsis (p = 0.002 and p = 0.02, respectively). The ROC curve was calculated for cfDNA as a predictor of outcome, the area under the curve (AUC) was 0.847 (95% CI: 0.669 - 0.952), at a cutoff value of 15500 ng/µL, sensitivity = 83.3%, specificity = 77.8% (p < 0.0001). As a prognostic marker of sepsis, the AUC for cfDNA was 0.788 (95% CI: 0.601 - 0.915), sensitivity = 56.25%, specificity = 100% (p = 0.0007). Day 5 PCT levels significantly correlated with SOFA scores on day 5, ISS on admission (p < 0.001 and p = 0.028, respectively), and a significant elevation of its levels was observed in non-survivor patients compared to survivors (p = 0.001). As a predictor of sepsis, PCT showed a sensitivity of 81.3%, specificity of 100% on day 5, (AUC: 0.987, 95% CI: 0.955 - 1.00); at a cutoff value of 202.90 pg/mL (p = 0.001). As a predictor of outcome, PCT on day 5 showed a sensitivity of 94.0% and a specificity of 78.0% at a cutoff value of 194.40 pg/mL (p = 0.001). Day 1 CRP correlated with ISS on admission, and on day 5 it correlated with SOFA score 5, while lactate correlated with length of stay on days 1, 5, and 7, and its levels were significantly higher in non-survivors on days 5 and 7. cfDNA is a good predictor of patient outcome in ICU and to a lesser extent as a marker of sepsis. PCT is another promising marker that can complement cfDNA to reach better patient management. Other markers can help in less severe cases.

Generic distortion model for metrology under optical microscopes

NASA Astrophysics Data System (ADS)

Liu, Xingjian; Li, Zhongwei; Zhong, Kai; Chao, YuhJin; Miraldo, Pedro; Shi, Yusheng

2018-04-01

For metrology under optical microscopes, lens distortion is the dominant source of error. Previous distortion models and correction methods mostly rely on the assumption that parametric distortion models require a priori knowledge of the microscopes' lens systems. However, because of the numerous optical elements in a microscope, distortions can be hardly represented by a simple parametric model. In this paper, a generic distortion model considering both symmetric and asymmetric distortions is developed. Such a model is obtained by using radial basis functions (RBFs) to interpolate the radius and distortion values of symmetric distortions (image coordinates and distortion rays for asymmetric distortions). An accurate and easy to implement distortion correction method is presented. With the proposed approach, quantitative measurement with better accuracy can be achieved, such as in Digital Image Correlation for deformation measurement when used with an optical microscope. The proposed technique is verified by both synthetic and real data experiments.

Influence of global and local distortion on magnetic properties of cubic La0.6Ba0.4-xCaxCoO3

NASA Astrophysics Data System (ADS)

Chang, Hong; Gao, Yu; Wu, Qiang; Dong, Xiaohua; Li, Yunfei; Pang, Yanbo

2015-12-01

The magnetic and structural study of the La0.6Ba0.4-xCaxCoO3 (x=0.0, 0.1, 0.2, 0.3, and 0.4) compounds with the lowest global or local distortion are studied. The compounds with x=0, 0.1, 0.2 and 0.3 is crystallized in the structure with the space group Pm-3m, and that with x=0.4 is Pnma. A ferromagnetic-like transition is observed and the Curie temperature, ranging from 235 K to 220 K, decreases slightly with the increasing Ca2+ content for x≤0.3, and the transition temperature is as low as 175 K with x=0.4. A hump, with the hump temperature slightly increase with the Ca2+ content, is observed in the thermal magnetization curves of all of the compounds at the ZFC state, and it is owing to the magnetic frustration because of the coexistence of the FM and the AFM interaction. Above the transition temperature, the magnetic susceptibility versus the temperature is fitted with the ferromagnetic Curie-Weiss law for the compounds with x≤0.3, and that with x=0.4 coincides with the ferrimagnetic Weiss-mean-field model. The absolute values of the exchange constants J1 in the compounds with x≤0.3 and those of J CO 3+CO 3+ ,J CO 3+CO4+ ,JCO4+CO4+ of La0.6Ca0.4CoO3 are deduced from the fitting. The results indicate that (i) the ferromagnetic exchange constants J1 increases with the Ca2+ content x≤0.3; (ii) the ferromagnetic interaction, JCo3+Co4+, plays a main role in the magnetic properties of La0.6Ca0.4CoO3; (iii) the antiferromagnetic interactions, JCo3+Co3+, JCo4+Co4+, are not negligible in the compound x=0.4. The unsaturated magnetization at 70 kOe and the high coercive field in the hysteretic magnetization curve supports the existence of the antiferromagnetic interaction, and the percentage of the antiferromagnetic domain is calculated.

SU-G-TeP2-11: Initial Evaluation of a Novel Split-Filter Dual-Energy CT for Use in Radiation Oncology

DOE Office of Scientific and Technical Information (OSTI.GOV)

Miller, J; Huang, J; Szczykutowicz, T

2016-06-15

Purpose: To perform an initial evaluation of a novel split-filter dual-energy CT (DECT) system with the goal of understanding the clinical utility and limitations of the system for radiation therapy. Methods: Several phantoms were imaged using the split-filter DECT technique on the Siemens Edge CT scanner using a range of clinically-relevant doses. The optimum-contrast reconstruction, the mixed reconstruction, and the monoenergetic reconstructions (ranging from 40 keV to 190 keV) were evaluated. Each image was analyzed for CT number accuracy, uniformity, noise, low-contrast visibility (LCV), spatial resolution and geometric distortion. For comparison purposes, all parameters were evaluated on 120 kVp single-energymore » CT (SECT) scans used for treatment planning, as well as, a sequential-scan DECT technique for corresponding doses. Results: For all DECT reconstructions no observable geometric distortion was found. Both the optimal-contrast and mixed images demonstrated slight improvements in LCV and noise when compared to the SECT, and slight reductions in CT number accuracy and spatial resolution. The CT numbers trended as expected for the monoenergetic reconstructions, with CT number accuracy within 50 HU for materials of density <2 g/cm3. Spatial resolution increased with energy, and for monoenergetic reconstructions >70 keV the spatial resolution exceeded that of the SECT. The noise in the monoenergetic reconstructions increased with decreasing energy. Thus, the image uniformity, signal-to-noise ratio and LCV were diminished at lower energies (70 keV). Applying iterative reconstruction techniques to the low-energy images reduced noise and improved LCV. The signal-to-noise ratio was stable for energies >100 keV. Conclusion: The initial commissioning of the novel split-filter DECT technology demonstrated favorable results for clinical implementation. The mixed reconstruction showed potential as a replacement for the treatment planning SECT. The image parameters for the monoenergetic reconstructions varied appropriately with energy. This work provides an initial understanding of the limitations and potential applications for monoenergetic imaging.« less

Distortions in memory for visual displays

NASA Technical Reports Server (NTRS)

Tversky, Barbara

1989-01-01

Systematic errors in perception and memory present a challenge to theories of perception and memory and to applied psychologists interested in overcoming them as well. A number of systematic errors in memory for maps and graphs are reviewed, and they are accounted for by an analysis of the perceptual processing presumed to occur in comprehension of maps and graphs. Visual stimuli, like verbal stimuli, are organized in comprehension and memory. For visual stimuli, the organization is a consequence of perceptual processing, which is bottom-up or data-driven in its earlier stages, but top-down and affected by conceptual knowledge later on. Segregation of figure from ground is an early process, and figure recognition later; for both, symmetry is a rapidly detected and ecologically valid cue. Once isolated, figures are organized relative to one another and relative to a frame of reference. Both perceptual (e.g., salience) and conceptual factors (e.g., significance) seem likely to affect selection of a reference frame. Consistent with the analysis, subjects perceived and remembered curves in graphs and rivers in maps as more symmetric than they actually were. Symmetry, useful for detecting and recognizing figures, distorts map and graph figures alike. Top-down processes also seem to operate in that calling attention to the symmetry vs. asymmetry of a slightly asymmetric curve yielded memory errors in the direction of the description. Conceptual frame of reference effects were demonstrated in memory for lines embedded in graphs. In earlier work, the orientation of map figures was distorted in memory toward horizontal or vertical. In recent work, graph lines, but not map lines, were remembered as closer to an imaginary 45 deg line than they had been. Reference frames are determined by both perceptual and conceptual factors, leading to selection of the canonical axes as a reference frame in maps, but selection of the imaginary 45 deg as a reference frame in graphs.

Distortion and Residual Stress Control in Integrally Stiffened Structure Produced by Direct Metal Deposition

NASA Technical Reports Server (NTRS)

Lin, Shih-Yung; Hoffman, Eric K.; Domack, Marcia S.

2007-01-01

2-D thermo-mechanical model developed to characterize distortion and residual stresses in integral structure produced by DMD. Demonstrated as a tool to guide experimental development of DMD fabrication process for aero structures. Distortion and residual stresses are local to deposit. Most distortion develops during deposition of the first few layers; Little change in distortion or residual stresses after fifth deposit layer Most of distortion is localized just beneath the build. Thicker build plates and the use of build lands results in greatest decrease in levels of distortion. Pre-straining shown to reduce distortion. Difficult to implement, particularly for complex stiffener arrays. Clamp position has complex effect on distortion and stresses. Overall distortion reduced with decreasing clamp clearance. Larger clamp clearances induce bending. Use of pre-heat and active cooling show minor influence on panel distortion. Generate changes in thermal gradients in the build plate.

Detection and Rectification of Distorted Fingerprints.

PubMed

Si, Xuanbin; Feng, Jianjiang; Zhou, Jie; Luo, Yuxuan

2015-03-01

Elastic distortion of fingerprints is one of the major causes for false non-match. While this problem affects all fingerprint recognition applications, it is especially dangerous in negative recognition applications, such as watchlist and deduplication applications. In such applications, malicious users may purposely distort their fingerprints to evade identification. In this paper, we proposed novel algorithms to detect and rectify skin distortion based on a single fingerprint image. Distortion detection is viewed as a two-class classification problem, for which the registered ridge orientation map and period map of a fingerprint are used as the feature vector and a SVM classifier is trained to perform the classification task. Distortion rectification (or equivalently distortion field estimation) is viewed as a regression problem, where the input is a distorted fingerprint and the output is the distortion field. To solve this problem, a database (called reference database) of various distorted reference fingerprints and corresponding distortion fields is built in the offline stage, and then in the online stage, the nearest neighbor of the input fingerprint is found in the reference database and the corresponding distortion field is used to transform the input fingerprint into a normal one. Promising results have been obtained on three databases containing many distorted fingerprints, namely FVC2004 DB1, Tsinghua Distorted Fingerprint database, and the NIST SD27 latent fingerprint database.

Studies of the spin Hamiltonian parameters and local structure for ZnO:Cu2+.

PubMed

Wu, Shao-Yi; Wei, Li-Hua; Zhang, Zhi-Hong; Wang, Xue-Feng; Hu, Yue-Xia

2008-12-15

The spin Hamiltonian parameters (the g factors and the hyperfine structure constants) and local structure for ZnO:Cu2+ are theoretically studied from the perturbation formulas of these parameters for a 3d9 ion under trigonally distorted tetrahedra. The ligand orbital and spin-orbit coupling contributions are taken into account from the cluster approach due to the significant covalency of the [CuO4](6-) cluster. According to the investigations, the impurity Cu2+ is suggested not to locate on the ideal Zn2+ site in ZnO but to undergo a slight outward displacement (approximately 0.01 angstroms) away from the ligand triangle along C3 axis. The calculated spin Hamiltonian parameters are in good agreement with the observed values. The validity of the above impurity displacement is also discussed.

Ultrasensitive ppb-level NO2 gas sensor based on WO3 hollow nanosphers doped with Fe

NASA Astrophysics Data System (ADS)

Zhang, Ziyue; haq, Mahmood; Wen, Zhen; Ye, Zhizhen; Zhu, Liping

2018-03-01

WO3 mesoporous hollow nanospheres doped with Fe synthesized by a facile method have mesoporous hollow nanospherical like morphology, small grain size (10 nm), high crystalline quality and ultrahigh surface area (165 m2/g). XRD spectra and Raman spectra indicate the Fe doping leading to the smaller cell parameters as compared to pure WO3, and the slight distortion in the crystal lattice produces a number of defects, making it a better candidate for gas sensing. XPS analysis shows that Fe-doped WO3 mesoporous hollow nanospheres have more oxygen vacancies than pure WO3, which is beneficial to the adsorption of oxygen and NO2 and its surface reaction. The gas sensor based on Fe-WO3 exhibited excellent low ppb-level (10 ppb) NO2 detecting performance and outstanding selectivity.

Investigating interfacial contact configuration and behavior of single-walled carbon nanotube-based nanodevice with atomistic simulations

NASA Astrophysics Data System (ADS)

Cui, Jianlei; Zhang, Jianwei; He, Xiaoqiao; Mei, Xuesong; Wang, Wenjun; Yang, Xinju; Xie, Hui; Yang, Lijun; Wang, Yang

2017-03-01

Carbon nanotubes (CNTs), including single-walled carbon nanotubes (SWNTs) and multi-walled carbon nanotubes (MWNTs), are considered to be the promising candidates for next-generation interconnects with excellent physical and chemical properties ranging from ultrahigh mechanical strength, to electrical properties, to thermal conductivity, to optical properties, etc. To further study the interfacial contact configurations of SWNT-based nanodevice with a 13.56-Å diameter, the corresponding simulations are carried out with the molecular dynamic method. The nanotube collapses dramatically into the surface with the complete collapse on the Au/Ag/graphite electrode surface and slight distortion on the Si/SiO2 substrate surface, respectively. The related dominant mechanism is studied and explained. Meanwhile, the interfacial contact configuration and behavior, depended on other factors, are also analyzed in this article.

A structural analysis of small vapor-deposited 'multiply twinned' gold particles

NASA Technical Reports Server (NTRS)

Yang, C. Y.; Heinemann, K.; Yacaman, M. J.; Poppa, H.

1979-01-01

High resolution selected zone dark field, Bragg reflection imaging and weak beam dark field techniques of transmission electron microscopy were used to determine the structure of small gold particles vapor deposited on NaCl substrates. Attention was focused on the analysis of those particles in the 50-150 A range that have pentagonal or hexagonal bright field profiles. These particles have been previously described as multiply twinned crystallites composed of face-centered cubic tetrahedra. The experimental evidence of the present studies can be interpreted on the assumption that the particle structure is a regular icosahedron or decahedron for the hexagonal or the pentagonal particles respectively. The icosahedron is a multiply twinned rhombohedral crystal and the decahedron is a multiply twinned body-centered orthorhombic crystal, each of which constitutes a slight distortion from the face-centered cubic structure.

Bis(tetra­phenyl­phospho­nium) tris­[N-(methyl­sulfon­yl)dithio­carbimato(2−)-κ2 S,S′]stannate(IV)

PubMed Central

Barolli, João P.; Oliveira, Marcelo R. L.; Corrêa, Rodrigo S.; Ellena, Javier

2009-01-01

In the title complex, (C24H20P)2[Sn(C2H3NO2S3)3], the SnIV atom is coordinated by three N-(methyl­sulfon­yl)dithio­carbimate bidentate ligands through the anionic S atoms in a slightly distorted octa­hedral coordination geometry. There is one half-mol­ecule in the asymmetric unit; the complex is located on a crystallographic twofold rotation axis passing through the cation and bis­ecting one of the (non-symmetric) ligands, which appears thus disordered over two sites of equal occupancy. In the crystal structure, weak inter­molecular C—H⋯O and C—H⋯S inter­actions contribute to the packing stabilization. PMID:21577695

Bis(tetraphenylarsonium) hexachloridozirconate(IV) acetonitrile tetrasolvate

DOE PAGES

Borjas, Rosendo; Mariappan Balasekaran, Samundeeswari; Poineau, Frederic

2018-04-06

The bis(tetraphenylarsonium) hexachloridozirconate(IV) salt, (AsPh 4 ) 2 [ZrCl 6 ] (Ph = C 6 H 5 ), was prepared more than 25 years ago [Esmadi & Sutcliffe (1991). Indian J. Chem. 30 A , 99–101], but its crystal structure was never reported. By following a similar experimental procedure, the compound was synthesized and its crystal structure was investigated as a acetonitrile tetrasolvate, (As(C 6 H 5 ) 4 ) 2 [ZrCl 6 ]·4CH 3 CN, by single-crystal X –ray diffraction. The [ZrCl 6 ] 2− anion adopts a slightly distorted octahedral coordination sphere, with Zr—Cl bond lengths of 2.4586 (6), 2.4723 (6),more » and 2.4818 (5) Å, and Cl—Zr—Cl angles ranging from 89.602 (19) to 90.397 (19)°.« less

New observational constraints on f ( R ) gravity from cosmic chronometers

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nunes, Rafael C.; Pan, Supriya; Saridakis, Emmanuel N.

We use the recently released cosmic chronometer data and the latest measured value of the local Hubble parameter, combined with the latest joint light curves of Supernovae Type Ia, and Baryon Acoustic Oscillation distance measurements, in order to impose constraints on the viable and most used f ( R ) gravity models. We consider four f ( R ) models, namely the Hu-Sawicki, the Starobinsky, the Tsujikawa, and the exponential one, and we parametrize them introducing a distortion parameter b that quantifies the deviation from ΛCDM cosmology. Our analysis reveals that a small but non-zero deviation from ΛCDM cosmology ismore » slightly favored, with the corresponding fittings exhibiting very efficient AIC and BIC Information Criteria values. Clearly, f ( R ) gravity is consistent with observations, and it can serve as a candidate for modified gravity.« less

A minimax technique for time-domain design of preset digital equalizers using linear programming

NASA Technical Reports Server (NTRS)

Vaughn, G. L.; Houts, R. C.

1975-01-01

A linear programming technique is presented for the design of a preset finite-impulse response (FIR) digital filter to equalize the intersymbol interference (ISI) present in a baseband channel with known impulse response. A minimax technique is used which minimizes the maximum absolute error between the actual received waveform and a specified raised-cosine waveform. Transversal and frequency-sampling FIR digital filters are compared as to the accuracy of the approximation, the resultant ISI and the transmitted energy required. The transversal designs typically have slightly better waveform accuracy for a given distortion; however, the frequency-sampling equalizer uses fewer multipliers and requires less transmitted energy. A restricted transversal design is shown to use the least number of multipliers at the cost of a significant increase in energy and loss of waveform accuracy at the receiver.

Bis(tetraphenylarsonium) hexachloridozirconate(IV) acetonitrile tetrasolvate

DOE Office of Scientific and Technical Information (OSTI.GOV)

Borjas, Rosendo; Mariappan Balasekaran, Samundeeswari; Poineau, Frederic

The bis(tetraphenylarsonium) hexachloridozirconate(IV) salt, (AsPh 4 ) 2 [ZrCl 6 ] (Ph = C 6 H 5 ), was prepared more than 25 years ago [Esmadi & Sutcliffe (1991). Indian J. Chem. 30 A , 99–101], but its crystal structure was never reported. By following a similar experimental procedure, the compound was synthesized and its crystal structure was investigated as a acetonitrile tetrasolvate, (As(C 6 H 5 ) 4 ) 2 [ZrCl 6 ]·4CH 3 CN, by single-crystal X –ray diffraction. The [ZrCl 6 ] 2− anion adopts a slightly distorted octahedral coordination sphere, with Zr—Cl bond lengths of 2.4586 (6), 2.4723 (6),more » and 2.4818 (5) Å, and Cl—Zr—Cl angles ranging from 89.602 (19) to 90.397 (19)°.« less

Illustration of TRAPPIST-1 Planets as of Feb. 2018

NASA Image and Video Library

2018-02-05

This illustration shows the seven Earth-size planets of TRAPPIST-1, an exoplanet system about 40 light-years away, based on data current as of February 2018. The image shows the planets' relative sizes but does not represent their orbits to scale. The art highlights possibilities for how the surfaces of these intriguing worlds might look based on their newly calculated properties. The seven planets of TRAPPIST-1 are all Earth-sized and terrestrial. TRAPPIST-1 is an ultra-cool dwarf star in the constellation Aquarius, and its planets orbit very close to it. In the background, slightly distorted versions the familiar constellations of Orion and Taurus are shown as they would appear from the location of TRAPPIST-1 (courtesy of California Academy of Sciences/Dan Tell). https://photojournal.jpl.nasa.gov/catalog/PIA22097

Effects of Mn substitution on the thermoelectric properties of the electron-doped perovskite Sr1-xLaxTiO3

NASA Astrophysics Data System (ADS)

Okuda, T.; Hata, H.; Eto, T.; Nishina, K.; Kuwahara, H.; Nakamura, M.; Kajimoto, R.

2014-12-01

We have tried to improve the n-type thermoelectric properties of the electron- doped Perovskite Sr1-xLaxTiO3 by a Mn substitution. The 1 ~ 2 % Mn substitution enhances the Seebeck coefficient (S) and reduces the thermal conductivity (κ) by about 50 % at room temperature (RT) without largely increasing the resistivity for the 5 % electron-doped SrTiO3. Consequently, the power factor at RT keeps a large value comparable to that of Bi2Te3 and the dimensionless figure-of-merits at RT increases twofold by the slight Mn substitution. Such a large reduction of κ at RT is perhaps due to the effect of Jahn-Teller active Mn3+ ions, around which dynamical local lattice distortion may occur.

Bis[4-(4-pyridyl)pyridinium] (4-carboxy­pyridine-2,6-dicarboxyl­ato-κ3 O 2,N,O 6)(pyridine-2,4,6-tricarboxyl­ato-κ3 O 2,N,O 6)ferrate(III) trihydrate

PubMed Central

Zhao, Li; Dong, You-Ren; Xie, Hong-Zhen

2009-01-01

In the title salt, (C10H9N2)2[Fe(C8H2NO6)(C8H3NO6)]·3H2O, the FeIII atom is O,N,O′-chelated by dianionic and trianionic ligands in a slightly distorted octa­hedral coordination geometry. The cations and ferrate anions are linked into a layered structure; the layers are connected through the uncoordinated water mol­ecules into a hydrogen-bonded three-dimensional supra­molecular structure. One of the uncoordinated water molecules is disordered around an inversion centre and was refined with half-occupancy for each position. PMID:21582387

Pathogens and outcomes in pediatric septic shock patients supported by extracorporeal membrane oxygenation.

PubMed

Chang, Tu-Hsuan; Wu, En-Ting; Lu, Chun-Yi; Huang, Shu-Chien; Yang, Tzu-I; Wang, Ching-Chia; Chen, Jong-Min; Lee, Ping-Ing; Huang, Li-Min; Chang, Luan-Yin

2017-08-04

Refractory septic shock is the leading cause of mortality in children. There is limited evidence to support extracorporeal membrane oxygenation (ECMO) use in pediatric septic shock. We described the etiology and outcomes of septic patients in our institution and attempted to find predictive factors. We retrospectively reviewed 55 pediatric patients with septic shock who required ECMO support in a tertiary medical center from 2008 to 2015. Septic shock was defined as culture proved or clinical suspected sepsis with hypotension or end-organ hypoperfusion. ECMO would be applied when pediatric advanced life support steps were performed thoroughly without clinical response. Patient's demographics, laboratory parameters before and after ECMO, and outcomes were analyzed. Among 55 children with ECMO support, 31% of them survived on discharge. For 25 immunocompromised patients, causal pathogens were found in 17 patients: 7 due to bacteremia, 9 with preexisting virus infections and one with invasive fungal infection. Among 30 previously healthy patients, causal pathogens were found in 18 patients: 10 due to bacteremia (the most common was pneumococcus), 7 with preexisting virus infections including influenza (n = 4), adenovirus (n = 2), RSV, and 1 patient had mixed virus and bacterial infections. Predictive factors associated with death were arterial blood gas pH, CO 2 and Glasgow Coma Scale (p < 0.05). SOFA score was a valuable predictive scoring system for outcome prediction (p < 0.05). Pediatric patients with refractory septic shock had high mortality rate and ECMO could be used as a rescue modality, and SOFA score could be applied to predict outcomes. Copyright © 2017. Published by Elsevier B.V.

Comparison of the Nosocomial Pneumonia Mortality Prediction (NPMP) model with standard mortality prediction tools.

PubMed

Srinivasan, M; Shetty, N; Gadekari, S; Thunga, G; Rao, K; Kunhikatta, V

2017-07-01

Severity or mortality prediction of nosocomial pneumonia could aid in the effective triage of patients and assisting physicians. To compare various severity assessment scoring systems for predicting intensive care unit (ICU) mortality in nosocomial pneumonia patients. A prospective cohort study was conducted in a tertiary care university-affiliated hospital in Manipal, India. One hundred patients with nosocomial pneumonia, admitted in the ICUs who developed pneumonia after >48h of admission, were included. The Nosocomial Pneumonia Mortality Prediction (NPMP) model, developed in our hospital, was compared with Acute Physiology and Chronic Health Evaluation II (APACHE II), Mortality Probability Model II (MPM 72  II), Simplified Acute Physiology Score II (SAPS II), Multiple Organ Dysfunction Score (MODS), Sequential Organ Failure Assessment (SOFA), Clinical Pulmonary Infection Score (CPIS), Ventilator-Associated Pneumonia Predisposition, Insult, Response, Organ dysfunction (VAP-PIRO). Data and clinical variables were collected on the day of pneumonia diagnosis. The outcome for the study was ICU mortality. The sensitivity and specificity of the various scoring systems was analysed by plotting receiver operating characteristic (ROC) curves and computing the area under the curve for each of the mortality predicting tools. NPMP, APACHE II, SAPS II, MPM 72  II, SOFA, and VAP-PIRO were found to have similar and acceptable discrimination power as assessed by the area under the ROC curve. The AUC values for the above scores ranged from 0.735 to 0.762. CPIS and MODS showed least discrimination. NPMP is a specific tool to predict mortality in nosocomial pneumonia and is comparable to other standard scores. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Withholding or withdrawing of life-sustaining therapy in older adults (≥ 80 years) admitted to the intensive care unit.

PubMed

Guidet, Bertrand; Flaatten, Hans; Boumendil, Ariane; Morandi, Alessandro; Andersen, Finn H; Artigas, Antonio; Bertolini, Guido; Cecconi, Maurizio; Christensen, Steffen; Faraldi, Loredana; Fjølner, Jesper; Jung, Christian; Marsh, Brian; Moreno, Rui; Oeyen, Sandra; Öhman, Christina Agwald; Pinto, Bernardo Bollen; Soliman, Ivo W; Szczeklik, Wojciech; Valentin, Andreas; Watson, Ximena; Zafeiridis, Tilemachos; De Lange, Dylan W

2018-05-17

To document and analyse the decision to withhold or withdraw life-sustaining treatment (LST) in a population of very old patients admitted to the ICU. This prospective study included intensive care patients aged ≥ 80 years in 309 ICUs from 21 European countries with 30-day mortality follow-up. LST limitation was identified in 1356/5021 (27.2%) of patients: 15% had a withholding decision and 12.2% a withdrawal decision (including those with a previous withholding decision). Patients with LST limitation were older, more frail, more severely ill and less frequently electively admitted. Patients with withdrawal of LST were more frequently male and had a longer ICU length of stay. The ICU and 30-day mortality were, respectively, 29.1 and 53.1% in the withholding group and 82.2% and 93.1% in the withdrawal group. LST was less frequently limited in eastern and southern European countries than in northern Europe. The patient-independent factors associated with LST limitation were: acute ICU admission (OR 5.77, 95% CI 4.32-7.7), Clinical Frailty Scale (CFS) score (OR 2.08, 95% CI 1.78-2.42), increased age (each 5 years of increase in age had a OR of 1.22 (95% CI 1.12-1.34) and SOFA score [OR of 1.07 (95% CI 1.05-1.09 per point)]. The frequency of LST limitation was higher in countries with high GDP and was lower in religious countries. The most important patient variables associated with the instigation of LST limitation were acute admission, frailty, age, admission SOFA score and country. ClinicalTrials.gov (ID: NTC03134807).

Escitalopram treatment for depressive disorder following acute coronary syndrome: a 24-week double-blind, placebo-controlled trial.

PubMed

Kim, Jae-Min; Bae, Kyung-Yeol; Stewart, Robert; Jung, Bo-Ok; Kang, Hee-Ju; Kim, Sung-Wan; Shin, Il-Seon; Hong, Young Joon; Kim, Ju Han; Shin, Hee-Young; Kang, Gaeun; Ahn, Youngkeun; Kim, Jong-Keun; Jeong, Myung Ho; Yoon, Jin-Sang

2015-01-01

Depression is common after acute coronary syndrome (ACS) and has adverse effects on prognosis. There are few evidence-based interventions for treating depression in ACS. This study investigated the efficacy and safety of escitalopram in treating depressive disorders identified 2-14 weeks after a confirmed ACS episode. A total of 217 patients with DSM-IV depressive disorders (121 major and 96 minor) and ACS were randomly assigned to receive escitalopram in flexible doses of 5-20 mg/d (n = 108) or placebo (n = 109) for 24 weeks. The study was conducted from 2007 to 2013. The primary outcome measure was the Hamilton Depression Rating Scale (HDRS). Secondary outcome measures included the Montgomery-Asberg Depression Rating Scale (MADRS), Beck Depression Inventory (BDI), Clinical Global Impressions-Severity of Illness scale (CGI-S), Social and Occupational Functioning Assessment Scale (SOFAS), and World Health Organization Disability Assessment Schedule-12. Cardiovascular safety outcomes included echocardiography, electrocardiography, laboratory test, body weight, and blood pressure results. Escitalopram was superior to placebo in reducing HDRS scores (mean difference = 2.3, P = .016, effect size = 0.38). Escitalopram was also superior to placebo in decreasing depressive symptoms evaluated by the MADRS, BDI, and CGI-S and in improving SOFAS functioning level. Escitalopram was not associated with any harmful changes in cardiovascular safety measures. Dizziness was significantly more frequently reported in the escitalopram group (P = .018), but there were no significant differences in any other adverse events. These results indicate that escitalopram has clinically meaningful antidepressant effects with no evidence of reduced cardiovascular safety in depressive disorder following ACS. ClinicalTrials.gov identifier: NCT00419471. © Copyright 2015 Physicians Postgraduate Press, Inc.

An analysis of the predictors of mortality and morbidity in patients admitted after suicidal hanging to an Indian multidisciplinary Intensive Care Unit

PubMed Central

Renuka, MK; Kalaiselvan, MS; Arunkumar, AS

2017-01-01

Background and Aims: Hanging is a frequently used method to attempt suicide in India. There is a lack of data in the Indian population regarding clinical features and outcomes of suicidal hanging. The purpose of this study was to evaluate the factors affecting mortality and morbidity in patients admitted with suicidal hanging to the Intensive Care Unit (ICU). Methods: A 6-year retrospective study of adult patients admitted to the ICU with suicidal hanging was analysed for demographics, mode of hanging, lead time to emergency room (ER) admission, clinical presentation, Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores, admission Glasgow coma scale (GCS) and neurological outcomes. The primary outcome was in-hospital mortality rate. Secondary outcomes were hospital length of stay (LOS), ICU-LOS, time for neurological recovery, organ support and duration of mechanical ventilation. Statistical analysis was performed using the Student's t-test for continuous variables and Chi-square test for categorical variables. Results: We analysed data of 106 patients. The median age was 27 years [Interquartile Range (IQR) (22–34)]. The median lead time to ER admission was 1 h [IQR (0.5–1.4)] with median ICU stay of 3 days [IQR (2–4)]. Vasopressors were administered to 27.4% patients. GCS was ≤7 in 65% patients, and 84.9% patients received mechanical ventilation. Mortality rate was 10.3%. Survivors recovered with normal organ function. Conclusion: Suicidal hanging is associated with significant mortality. Admission GCS, APACHE II and 48 h SOFA score were predictors of poor outcome. PMID:28794524

Variants in LTA, TNF, IL1B and IL10 genes associated with the clinical course of sepsis.

PubMed

Montoya-Ruiz, Carolina; Jaimes, Fabián A; Rugeles, Maria T; López, Juan Álvaro; Bedoya, Gabriel; Velilla, Paula A

2016-12-01

The aim of this study was to explore the association between some SNPs of the TNF, LTA, IL1B and IL10 genes with cytokine concentrations and clinical course in Colombian septic patients. We conducted a cross-sectional study to genotype 415 septic patients and 205 patients without sepsis for the SNPs -308(G/A) rs1800629 of TNF; +252 (G/A) rs909253 of LTA; -511(A/G) rs16944 and +3953(C/T) rs1143634 of IL1B; and -1082(A/G) rs1800896, -819(C/T) rs1800871 and -592(C/A) rs1800872 of IL10. The association of theses SNPs with the following parameters was evaluated: (1) the presence of sepsis; (2) severity and clinical outcomes; (3) APACHE II and SOFA scores; and (4) procalcitonin, C-reactive protein, tumor necrosis factor, lymphotoxin alpha, interleukin 1 beta and interleukin 10 plasma concentrations. We found an association between the SNP LTA +252 with the development of sepsis [OR 1.29 (1.00-1.68)]; the SNP IL10 -1082 with sepsis severity [OR 0.53 (0.29-0.97)]; the TNF -308 with mortality [OR 0.33 (0.12-0.95)]; and the IL10 -592 and IL10 -1082 with admission to the intensive care unit (ICU) [OR 3.36 (1.57-7.18)] and [OR 0.18 (0.04-0.86)], respectively. None of the SNPs were associated with cytokine levels, procalcitonin and C-reactive protein serum concentrations, nor with APACHE II and SOFA scores. Our results suggest that these genetic variants play an important role in the development of sepsis and its clinical course.

Proposed primary endpoints for use in clinical trials that compare treatment options for bloodstream infection in adults: a consensus definition.

PubMed

Harris, P N A; McNamara, J F; Lye, D C; Davis, J S; Bernard, L; Cheng, A C; Doi, Y; Fowler, V G; Kaye, K S; Leibovici, L; Lipman, J; Llewelyn, M J; Munoz-Price, S; Paul, M; Peleg, A Y; Rodríguez-Baño, J; Rogers, B A; Seifert, H; Thamlikitkul, V; Thwaites, G; Tong, S Y C; Turnidge, J; Utili, R; Webb, S A R; Paterson, D L

2017-08-01

To define standardized endpoints to aid the design of trials that compare antibiotic therapies for bloodstream infections (BSI). Prospective studies, randomized trials or registered protocols comparing antibiotic therapies for BSI, published from 2005 to 2016, were reviewed. Consensus endpoints for BSI studies were defined using a modified Delphi process. Different primary and secondary endpoints were defined for pilot (small-scale studies designed to evaluate protocol design, feasibility and implementation) and definitive trials (larger-scale studies designed to test hypotheses and influence clinical practice), as well as for Staphylococcus aureus and Gram-negative BSI. For pilot studies of S. aureus BSI, a primary outcome of success at day 7 was defined by: survival, resolution of fever, stable/improved Sequential Organ Failure Assessment (SOFA) score and clearance of blood cultures, with no microbiologically confirmed failure up to 90 days. For definitive S. aureus BSI studies, a primary outcome of success at 90 days was defined by survival and no microbiologically confirmed failure. For pilot studies of Gram-negative BSI, a primary outcome of success at day 7 was defined by: survival, resolution of fever and symptoms related to BSI source, stable or improved SOFA score and negative blood cultures. For definitive Gram-negative BSI studies, a primary outcome of survival at 90 days supported by a secondary outcome of success at day 7 (as previously defined) was agreed. These endpoints provide a framework to aid future trial design. Further work will be required to validate these endpoints with respect to patient-centred clinical outcomes. Copyright © 2016 European Society of Clinical Microbiology and Infectious Diseases. All rights reserved.

Intensive Care in India: The Indian Intensive Care Case Mix and Practice Patterns Study.

PubMed

Divatia, Jigeeshu V; Amin, Pravin R; Ramakrishnan, Nagarajan; Kapadia, Farhad N; Todi, Subhash; Sahu, Samir; Govil, Deepak; Chawla, Rajesh; Kulkarni, Atul P; Samavedam, Srinivas; Jani, Charu K; Rungta, Narendra; Samaddar, Devi Prasad; Mehta, Sujata; Venkataraman, Ramesh; Hegde, Ashit; Bande, B D; Dhanuka, Sanjay; Singh, Virendra; Tewari, Reshma; Zirpe, Kapil; Sathe, Prachee

2016-04-01

To obtain information on organizational aspects, case mix and practices in Indian Intensive Care Units (ICUs). An observational, 4-day point prevalence study was performed between 2010 and 2011 in 4209 patients from 124 ICUs. ICU and patient characteristics, and interventions were recorded for 24 h of the study day, and outcomes till 30 days after the study day. Data were analyzed for 4038 adult patients from 120 ICUs. On the study day, mean age, Acute Physiology and Chronic Health Evaluation (APACHE II) and sequential organ failure assessment (SOFA) scores were 54.1 ± 17.1 years, 17.4 ± 9.2 and 3.8 ± 3.6, respectively. About 46.4% patients had ≥1 organ failure. Nearly, 37% and 22.2% patients received mechanical ventilation (MV) and vasopressors or inotropes, respectively. Nearly, 12.2% patients developed an infection in the ICU. About 28.3% patients had severe sepsis or septic shock (SvSpSS) during their ICU stay. About 60.7% patients without infection received antibiotics. There were 546 deaths and 183 terminal discharges (TDs) from ICU (including left against medical advice or discharged on request), with ICU mortality 729/4038 (18.1%). In 1627 patients admitted within 24 h of the study day, the standardized mortality ratio was 0.67. The APACHE II and SOFA scores, public hospital ICUs, medical ICUs, inadequately equipped ICUs, medical admission, self-paying patient, presence of SvSpSS, acute respiratory failure or cancer, need for a fluid bolus, and MV were independent predictors of mortality. The high proportion of TDs and the association of public hospitals, self-paying patients, and inadequately equipped hospitals with mortality has important implications for critical care in India.

Strong inhibitory effect of furanoses and sugar lactones on beta-galactosidase Escherichia coli.

PubMed

Huber, R E; Brockbank, R L

1987-03-24

Various sugars and their lactones were tested for their inhibition of beta-galactosidase (Escherichia coli). L-Ribose, which in the furanose form has a hydroxyl configuration similar to that of D-galactose at positions equivalent to the 3- and 4-positions of D-galactose, was a very strong inhibitor, and D-lyxose, which in the furanose form also resembles D-galactose, was a much better inhibitor than expected. Structural comparisons prelude the pyranose forms of these sugars from being significant contributors to the inhibition, and inhibition at different temperatures (at which there are different furanose concentrations) strongly supported the conclusion that the furanose form is inhibitory. Studies with sugar derivatives that can only be in the furanose form also supported the conclusion. This is the first report of the inhibitory effect of furanose on beta-galactosidase. Lactones were also inhibitory. Every lactone tested was much more inhibitory than was its parent sugar. D-Galactonolactone was especially good. Experiments indicated that it was D-galactono-1,5-lactone rather than D-galactono-1,4-lactone which was inhibitory. Inhibition of beta-galactosidases from mammalian sources by lactones has been reported previously, but this is the first report of the effect of beta-galactosidase from E. coli. Since furanoses in the envelope form are analogous (in some ways) to half-chair or sofa conformations and since lactones with six-membered rings probably have half-chair or sofa conformations, the results indicate that beta-galactosidase probably destabilizes its substrate into a planar conformation of some type and that the galactose in the transition state may, therefore, also be quite planar.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of SeptimebTM as a new natural extract on severe sepsis: A randomized clinical trial.

PubMed

Pourdast, Alieh; Sanaei, Maryam; Jafari, Sirous; Mohammadi, Mostafa; Khalili, Hossein; Shafiee, Gita; Ahadi, Zeinab; Rostami, Mahsa; Alizad, Saba; Heshmat, Ramin; Mohraz, Minoo

2017-01-01

Septimeb as a herbal medicine has regulatory effects on inflammation. This study set to evaluate the effects of Septimeb among patients with sepsis on inflammatory biomarkers and survival rate. In this randomized clinical trial, 51 patients with sepsis from the ICU and medical ward of Imam Khomeini Hospital were divided into two groups: Septimeb (n=25) and control group (n=26). In the control group, the patients received a standard treatment only for 7 days, while Septimeb group received Septimeb (6cc vial with 500cc serum glucose infusion 5% daily for one to two hours) plus standard treatment of sepsis for 7 days. Then, blood samples were analyzed. APACHE (Acute Physiologic and Chronic Health Evaluation), SOFA (Sequential Organ Failure Assessment), and GCS (Glasgow Coma Score) values were calculated daily. Treatment with Septimeb showed a significant decrease in SOFA value (1.54±0.83) compared to the control group (2.39±0.88) (P<0.001) and a significant increase in GCS value (14.46±0.88) compared to the control group (12.86±1.78) (P<0.001). Improvements of these values can confirm the potential of Septimeb in the reduction of severity of sepsis (P<0.05). There were significant decreases in lactate and blood sugar and WBC levels. In addition, inflammatory factors such as ESR (Septimeb group: 52.07±34.80, control group: 51.75±42.10, P=0.98) and CRP (Septimeb group: 48.86±23.21, control group: 49.93±36.22, P=0.92) decreased, but did not show a significant reduction. Septimeb has positive effects on reduction of the severity of sepsis which leads to reduction of patients' mortality rates.

The association between hyperoxia and patient outcomes after cardiac arrest: Analysis of a high-resolution database

PubMed Central

Elmer, Jonathan; Scutella, Michael; Pullalarevu, Raghevesh; Wang, Bo; Vaghasia, Nishit; Trzeciak, Stephen; Rosario-Rivera, Bedda L.; Guyette, Francis X.; Rittenberger, Jon C.; Dezfulian, Cameron

2014-01-01

Purpose Previous observational studies have inconsistently associated early hyperoxia with worse outcomes after cardiac arrest and have methodological limitations. We tested this association using a high-resolution database controlling for multiple disease-specific markers of severity of illness and care processes. Methods This was a retrospective analysis of a single-center, prospective registry of consecutive cardiac arrest patients. We included patients who survived and were mechanically ventilated ≥24h after arrest. Our main exposure was arterial oxygen tension (PaO2), which we categorized hourly for 24 hours as severe hyperoxia (>300mmHg), moderate or probable hyperoxia (101-299mmHg), normoxia (60-100mmHg) or hypoxia (<60mmHg). We controlled for Utstein-style covariates, markers of disease severity and markers of care responsiveness. We performed unadjusted and multiple logistic regression to test the association between oxygen exposure and survival to discharge, and used ordered logistic regression to test the association of oxygen exposure with neurological outcome and Sequential Organ Failure Assessment (SOFA) score at 24h. Results Of 184 patients, 36% were exposed to severe hyperoxia and overall mortality was 54%. Severe hyperoxia, but not moderate or probable hyperoxia, was associated with decreased survival in both unadjusted and adjusted analysis (adjusted odds ratio (OR) for survival 0.83 per hour exposure, P=0.04). Moderate or probable hyperoxia was not associated with survival but was associated with improved SOFA score 24h (OR 0.92, P<0.01). Conclusion Severe hyperoxia was independently associated with decreased survival to hospital discharge. Moderate or probable hyperoxia was not associated with decreased survival and was associated with improved organ function at 24h. PMID:25472570

Effect of SeptimebTM as a new natural extract on severe sepsis: A randomized clinical trial

PubMed Central

Pourdast, Alieh; Sanaei, Maryam; Jafari, Sirous; Mohammadi, Mostafa; Khalili, Hossein; Shafiee, Gita; Ahadi, Zeinab; Rostami, Mahsa; Alizad, Saba; Heshmat, Ramin; Mohraz, Minoo

2017-01-01

Background: Septimeb as a herbal medicine has regulatory effects on inflammation. This study set to evaluate the effects of Septimeb among patients with sepsis on inflammatory biomarkers and survival rate. Methods: In this randomized clinical trial, 51 patients with sepsis from the ICU and medical ward of Imam Khomeini Hospital were divided into two groups: Septimeb (n=25) and control group (n=26). In the control group, the patients received a standard treatment only for 7 days, while Septimeb group received Septimeb (6cc vial with 500cc serum glucose infusion 5% daily for one to two hours) plus standard treatment of sepsis for 7 days. Then, blood samples were analyzed. APACHE (Acute Physiologic and Chronic Health Evaluation), SOFA (Sequential Organ Failure Assessment), and GCS (Glasgow Coma Score) values were calculated daily. Results: Treatment with Septimeb showed a significant decrease in SOFA value (1.54±0.83) compared to the control group (2.39±0.88) (P<0.001) and a significant increase in GCS value (14.46±0.88) compared to the control group (12.86±1.78) (P<0.001). Improvements of these values can confirm the potential of Septimeb in the reduction of severity of sepsis (P<0.05). There were significant decreases in lactate and blood sugar and WBC levels. In addition, inflammatory factors such as ESR (Septimeb group: 52.07±34.80, control group: 51.75±42.10, P=0.98) and CRP (Septimeb group: 48.86±23.21, control group: 49.93±36.22, P=0.92) decreased, but did not show a significant reduction. Conclusion: Septimeb has positive effects on reduction of the severity of sepsis which leads to reduction of patients’ mortality rates. PMID:28503281

Pitfalls in gastrointestinal permeability measurement in ICU patients with multiple organ failure using differential sugar absorption.

PubMed

Oudemans-van Straaten, Heleen M; van der Voort, Peter J; Hoek, Frans J; Bosman, Rob J; van der Spoel, Johan I; Zandstra, Durk F

2002-02-01

To assess whether gastrointestinal permeability (GIP) at intensive care unit (ICU) admission, measured by differential sugar absorption, is related to severity of disease and multiple organ failure (MOF). Post hoc, to analyse the relation between the urinary sugar recovery and renal function. Prospective observational cohort study. Eighteen-bed general ICU of a teaching hospital. Sixty-four ventilated patients admitted with MOF. GIP was assessed within 24 h using cellobiose (C), sucrose (S) and mannitol (M) absorption. Severity of disease: APACHE II and III, SAPS II and MPM II systems. Organ failure: SOFA, MODS and Goris score. The median urinary recovery of C was 0.147% (range 0.004-2.145%), of S 0.249% (0.001-3.656%) and of M 10.7% (0.6-270%). In 16 patients, M recovery was over 100% of the oral dose. They received red blood cell transfusion (RBC). In the non-transfused, the median cellobiose/mannitol (CM) ratio was 0.015 (0.0004-0.550). CM ratio was not related to severity of disease and inversely related to the SOFA score ( r=-0.30, p=0.04). Post hoc regression analysis showed that recoveries of C, S and M were positively related to urinary volume. Recoveries of C and S, but not of M, were positively related to creatinine clearance. The CM ratio corrected for diuresis, but was inversely related to creatinine clearance. Differential C, S and M absorption testing is unreliable after RBC transfusion, since bank blood contains mannitol. The excretion of C and S, but not of M, is limited by renal dysfunction. Differential sugar absorption is not reliable to test GIP in MOF patients, since non-permeability related factors act as confounders.

Endotoxin Elimination in Patients with Septic Shock: An Observation Study.

PubMed

Adamik, Barbara; Zielinski, Stanislaw; Smiechowicz, Jakub; Kübler, Andrzej

2015-12-01

To evaluate the effectiveness of endotoxin elimination with an adsorption column in patients with septic shock and endotoxemia. The elimination therapy was guided by a new bedside method of measuring endotoxin activity (EA). Intensive care unit (ICU) patients with septic shock and suspected Gram-negative infection were consecutively added to the study group within the first 24 h. Endotoxin elimination was performed using hemoperfusion with the Alteco LPS Adsorber. The primary endpoint was improvement in organ function within the first 24 h of treatment. A secondary objective was to assess the usefulness of a new method of measuring EA to help guide endotoxin elimination therapy. Out of 64 patients 18 had a high baseline EA [0.70 EA units (0.66-0.77)]. Those patients had endotoxin elimination treatment in addition to conventional medical therapy. At 24 h after endotoxin elimination, the EA had decreased to 0.56 EA units (0.43-0.77), (p = 0.005); MAP increased from 69 (62-80) to 80 mm Hg (68-88), (p = 0.002), and noradrenaline use decreased from 0.28 (0.15-0.80) to 0.1 μg/kg/min (0.00-0.70) at the same time (p = 0.04). The SOFA score had decreased from 11 (9-15) to 9 (7-14) points 24 h after endotoxin elimination (p = 0.01) with a median delta SOFA -2 points. Endotoxin elimination did not have a significant effect on the ICU length of stay or ICU mortality. Effective endotoxin elimination resulted in a significant improvement in hemodynamic parameters and of organ function. The application of the EA assay was useful for the bedside monitoring of endotoxemia in critically ill ICU patients.

Clinical Significance of Tissue Factor and CD13 Double-Positive Microparticles in Sirs Patients with Trauma and Severe Sepsis.

PubMed

Matsumoto, Hisatake; Yamakawa, Kazuma; Ogura, Hiroshi; Koh, Taichin; Matsumoto, Naoya; Shimazu, Takeshi

2017-04-01

Activated immune cells such as monocytes are key factors in systemic inflammatory response syndrome (SIRS) following trauma and sepsis. Activated monocytes induce almost all tissue factor (TF) expression contributing to inflammation and coagulation. TF and CD13 double-positive microparticles (TF/CD13MPs) are predominantly released from these activated monocytes. This study aimed to evaluate TF/CD13MPs and assess their usefulness as a biomarker of pathogenesis in early SIRS following trauma and sepsis. This prospective study comprising 24 trauma patients, 25 severe sepsis patients, and 23 healthy controls was conducted from November 2012 to February 2015. Blood samples were collected from patients within 24 h after injury and diagnosis of severe sepsis and from healthy controls. Numbers of TF/CD13MPs were measured by flow cytometry immediately thereafter. Injury Severity Score (ISS) and Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores were calculated at patient enrollment. APACHE II and SOFA scores and International Society of Thrombosis and Haemostasis (ISTH) overt disseminated intravascular coagulation (DIC) diagnostic criteria algorithm were calculated at the time of enrollment of severe sepsis patients. Numbers of TF/CD13MPs were significantly increased in both trauma and severe sepsis patients versus controls and correlated significantly with ISS and APACHE II score in trauma patients and with APACHE II and ISTH DIC scores in severe sepsis patients. Increased numbers of TF/CD13MPs correlated significantly with severities in the acute phase in trauma and severe sepsis patients, suggesting that TF/CD13MPs are important in the pathogenesis of early SIRS following trauma and sepsis.

Plasma suPAR as a prognostic biological marker for ICU mortality in ARDS patients.

PubMed

Geboers, Diederik G P J; de Beer, Friso M; Tuip-de Boer, Anita M; van der Poll, Tom; Horn, Janneke; Cremer, Olaf L; Bonten, Marc J M; Ong, David S Y; Schultz, Marcus J; Bos, Lieuwe D J

2015-07-01

We investigated the prognostic value of plasma soluble urokinase plasminogen activator receptor (suPAR) on day 1 in patients with the acute respiratory distress syndrome (ARDS) for intensive care unit (ICU) mortality and compared it with established disease severity scores on day 1. suPAR was determined batchwise in plasma obtained within 24 h after admission. 632 ARDS patients were included. Significantly (P = 0.02) higher median levels of suPAR were found with increasing severity of ARDS: 5.9 ng/ml [IQR 3.1-12.8] in mild ARDS (n = 82), 8.4 ng/ml [IQR 4.1-15.0] in moderate ARDS (n = 333), and 9.0 ng/ml [IQR 4.5-16.0] in severe ARDS (n = 217). Non-survivors had higher median levels of suPAR [12.5 ng/ml (IQR 5.1-19.5) vs. 7.4 ng/ml (3.9-13.6), P < 0.001]. The area under the receiver operator characteristic curve (ROC-AUC) for mortality of suPAR (0.62) was lower than the ROC-AUC of the APACHE IV score (0.72, P = 0.007), higher than that of the ARDS definition classification (0.53, P = 0.005), and did not differ from that of the SOFA score (0.68, P = 0.07) and the oxygenation index (OI) (0.58, P = 0.29). Plasma suPAR did not improve the discrimination of the established disease severity scores, but did improve net reclassification of the APACHE score (29%), SOFA score (23%), OI (38%), and Berlin definition classification (39%). As a single biological marker, the prognostic value for death of plasma suPAR in ARDS patients is low. Plasma suPAR, however, improves the net reclassification, suggesting a potential role for suPAR in ICU mortality prediction models.

Prospective evaluation of the prognostic scores for cirrhotic patients admitted to an intensive care unit.

PubMed

Levesque, Eric; Hoti, Emir; Azoulay, Daniel; Ichaï, Philippe; Habouchi, Houssam; Castaing, Denis; Samuel, Didier; Saliba, Faouzi

2012-01-01

Cirrhotic patients admitted to an Intensive Care Unit (ICU) have a poor prognosis. Identifying patients in whom ICU care will be useful can be challenging. The aim of this study was to assess the predictive value of prognostic scores with respect to mortality and to identify mortality risk factors. Three hundred and seventy-seven cirrhotic patients admitted to a Liver ICU between May 2005 and March 2009 were enrolled in this study. Their average age was 55.5±11.4 years. The etiology of cirrhosis was alcohol (68%), virus hepatitis (18%), or mixed (5.5%). The main causes of hospitalization were gastrointestinal hemorrhage (43%), sepsis (19%), and hepatic encephalopathy (12%). ICU and in-hospital mortality rates were 34.7% and 43.0%, respectively. Infection was the major cause of death (81.6%). ROC curve analysis demonstrated that SOFA (0.92) and SAPS II (0.89) scores calculated within 24h of admission predicted ICU mortality better than the Child-Pugh score (0.79) or MELD scores with (0.79-0.82) or without the incorporation of serum sodium levels (0.82). Statistical analysis showed that the prognostic severity scores, organ replacement therapy, and infection were accurate predictors of mortality. On multivariate analysis, mechanical ventilation, vasopressor therapy, bilirubin level at admission, and infection were independently associated with ICU mortality. For cirrhotic patients admitted to the ICU, SAPS II, and SOFA scores predicted ICU mortality better than liver-specific scores. Mechanical ventilation or vasopressor therapy, bilirubin levels at admission and infection in patients with advanced cirrhosis were associated with a poor outcome. Copyright © 2011 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Application of a modified sequential organ failure assessment score to critically ill patients

PubMed Central

Ñamendys-Silva, S.A.; Silva-Medina, M.A.; Vásquez-Barahona, G.M.; Baltazar-Torres, J.A.; Rivero-Sigarroa, E.; Fonseca-Lazcano, J.A.; Domínguez-Cherit, G.

2013-01-01

The purpose of the present study was to explore the usefulness of the Mexican sequential organ failure assessment (MEXSOFA) score for assessing the risk of mortality for critically ill patients in the ICU. A total of 232 consecutive patients admitted to an ICU were included in the study. The MEXSOFA was calculated using the original SOFA scoring system with two modifications: the PaO2/FiO2 ratio was replaced with the SpO2/FiO2 ratio, and the evaluation of neurologic dysfunction was excluded. The ICU mortality rate was 20.2%. Patients with an initial MEXSOFA score of 9 points or less calculated during the first 24 h after admission to the ICU had a mortality rate of 14.8%, while those with an initial MEXSOFA score of 10 points or more had a mortality rate of 40%. The MEXSOFA score at 48 h was also associated with mortality: patients with a score of 9 points or less had a mortality rate of 14.1%, while those with a score of 10 points or more had a mortality rate of 50%. In a multivariate analysis, only the MEXSOFA score at 48 h was an independent predictor for in-ICU death with an OR = 1.35 (95%CI = 1.14-1.59, P < 0.001). The SOFA and MEXSOFA scores calculated 24 h after admission to the ICU demonstrated a good level of discrimination for predicting the in-ICU mortality risk in critically ill patients. The MEXSOFA score at 48 h was an independent predictor of death; with each 1-point increase, the odds of death increased by 35%. PMID:23369978

X-ray and conformational investigations of a 4:1 mixture of 6-(N-benzyl-N-tert-butoxycarbonylamino)-2,3,6,7-tetradeoxy-alpha- DL-ery thro- and -beta-DL-threo-hept-2-enopyranos-4-uloses.

PubMed

Krajewski, J W; Urbańczyk-Lipkowska, Z; Gluziński, P; Jurczak, J; Raczko, J; Gołebiowski, A

1990-07-01

The crystals of a 4:1 mixture of 6-(N-benzyl-N-tert-butoxycarbonylamino)-2,3,6,7-tetradeoxy-a-DL-er ythro- and -beta-DL-threo-hept-2-enopyranos-4-ulose were monoclinic, space group P2(1)/c, with cell dimensions: a = 9.490(2), b = 21.516(5), c = 10.279(2) A, beta = 115.31(1) degrees, Z = 4. The ulose ring had a half-chair conformation deformed towards the sofa (envelope) form.

3-(4-Hy­droxy­phen­yl)-7-meth­oxy­chroman-4-one monohydrate

PubMed Central

Xiao, Zhu-Ping; Peng, Zhu-Yun; Luo, Qun; Wu, Ying; Yang, Ye-Ling

2011-01-01

In the title compound, C16H14O4·H2O, the dihedral angle betwen the benzene rings is 71.4 (6)°. The pyran ring is in a sofa conformation. In the crystal, O—H⋯O hydrogen bonds connect the components into a two-dimensional network parallel to (010), incorporating C 2 2(4) and C 2 2(11) chains. In addition, weak C—H⋯O, C—H⋯π and π–π stacking inter­actions [centroid–centroid distance = 3.768 (2) Å] are present. PMID:22199730

A virtual reconstruction and comparative analysis of the KNM-ER 42700 cranium.

PubMed

Bauer, Catherine C; Harvati, Katerina

2015-01-01

The taxonomic attribution of the 1.55 million year old young adult fossil calvaria KNM-ER 42700   from Ileret, Kenya, is subject to ongoing controversy. It has been attributed to H. erectus based on comparative description and linear measurements. However, 3-D geometric morphometric analysis found that this specimen fell outside the range of variation of H. erectus in its cranial shape, which was intermediate between H. erectus and modern humans. One problem is that analyses so far were conducted on the original specimen, which shows slight post-mortem distortion. Here we use a surface scan of a high resolution cast of KNM-ER 42700 to virtually reconstruct the calvaria and conduct a new 3D geometric morphometric analysis of both its original and its reconstructed shape. Our comparative sample included several specimens of H. erectus (s.l., including the subadult KNM-WT 15000), H. habilis, H. heidelbergenis (s.l.) and H. neanderthalensis, as well as early and Upper Paleolithic H. sapiens. Our principal component analysis results showed that, like the original specimen, our virtual reconstruction of KNM-ER 42700 is also intermediate in shape between fossil Homo and modern humans. Taphonomic distortion, therefore, appears to not have been a major factor affecting previous 3-D geometric morphometric analyses. The intermediate shape of KNM-ER 42700 might instead be related to the young developmental age of the specimen. Further work on reconstructing the original specimen or based on computed tomorgraphic scans is needed to confirm these results.

Crystal structure of tris­(trans-1,2-cyclo­hexa­ne­diamine-κ2 N,N′)chromium(III) tetra­chlorido­zincate chloride trihydrate from synchrotron data

PubMed Central

Moon, Dohyun; Choi, Jong-Ha

2016-01-01

The structure of the title double salt, [Cr(rac-chxn)3][ZnCl4]Cl·3H2O (chxn is trans-1,2-cyclo­hexa­nedi­amine; C6H14N2), has been determined from synchrotron data. The CrIII ion is coordinated by six N atoms of three chelating chxn ligands, displaying a slightly distorted octa­hedral coordination environment. The distorted tetra­hedral [ZnCl4]2− anion, the isolated Cl− anion and three lattice water mol­ecules remain outside the coordination sphere. The Cr—N(chxn) bond lengths are in a narrow range between 2.0737 (12) and 2.0928 (12) Å; the mean N—Cr—N bite angle is 82.1 (4)°. The crystal packing is stabilized by hydrogen-bonding inter­actions between the amino groups of the chxn ligands and the water mol­ecules as donor groups, and O atoms of the water mol­ecules, chloride anions and Cl atoms of the [ZnCl4]2− anions as acceptor groups, leading to the formation of a three-dimensional network. The [ZnCl4]2− anion is disordered over two sets of sites with an occupancy ratio of 0.94:0.06. PMID:27308016

Crystal structure of bis­[trans-(1,4,8,11-tetra­aza­cyclo­tetra­decane-κ4 N)bis­(thio­cyanato-κN)chromium(III)] tetra­chlorido­zincate from synchrotron data

PubMed Central

Moon, Dohyun; Ryoo, Keon Sang; Choi, Jong-Ha

2015-01-01

The structure of the title compound, [Cr(NCS)2(cyclam)]2[ZnCl4] (cyclam = 1,4,8,11-tetra­aza­cyclo­tetra­decane, C10H24N4), has been determined from synchrotron data. The asymmetric unit contains two independent halves of the CrIII complex cations and half of a tetra­chlorido­zincate anion. In each complex cation, the CrIII atom is coordinated by the four N atoms of the cyclam ligand in the equatorial plane and by two N-bound NCS− anions in a trans axial arrangement, displaying a distorted octa­hedral geometry with crystallographic inversion symmetry. The mean Cr—N(cyclam) and Cr—N(NCS) bond lengths are 2.065 (4) and 1.995 (6) Å, respectively. The macrocyclic cyclam moieties adopt centrosymmetric trans-III configurations with six- and five-membered chelate rings in chair and gauche configurations, respectively. The [ZnCl4]2− anion, which lies about a twofold rotation axis, has a slightly distorted tetra­hedral geometry. The crystal packing is stabilized by hydrogen-bonding inter­actions between the N—H groups of the cyclam ligands, the S atoms of the NCS− groups and the Cl− ligands of the anion. PMID:25995875

The influence of incommensurability on the long-range periodicity of the Pd(100)-(√{ 5 } ×√{ 5 })R27°-PdO(101)

NASA Astrophysics Data System (ADS)

Shipilin, Mikhail; Stierle, Andreas; Merte, Lindsay R.; Gustafson, Johan; Hejral, Uta; Martin, Natalia M.; Zhang, Chu; Franz, Dirk; Kilic, Volkan; Lundgren, Edvin

2017-06-01

The structural model of the (√{ 5 } ×√{ 5 })R27°-PdO(101) surface oxide grown on Pd(100) has been proposed and refined by a number of authors over more than a decade. In the current contribution we discuss the long-range periodicity of this structure arising along one of the crystallographic directions due to its incommensurability with the substrate. Analyzing the results of surface sensitive diffraction studies, we determined a slight distortion of the previously reported perfect (√{ 5 } ×√{ 5 })R27° surface oxide unit cell. Considering it, we were able to achieve both qualitatively and quantitatively better fit to the experimental diffraction data than it was possible for the perfect structure. Further, taking into account the experimentally obtained scanning tunneling microscopy data and closely examining high-resolution patterns recorded by means of high-energy surface X-ray diffraction, we developed a qualitative structural model based on a larger non-orthogonal surface unit cell to shed more light on the long-range order of the PdO(101) surface oxide. The model comprises a shift of the atoms of the PdO perpendicularly to the direction of the incommensurability to correct for it. This structural model reproduces the fine details of the high-resolution diffraction patterns and qualitatively explains the periodic stripes of structural distortion observed in the images recorded by a scanning tunneling microscope.

Low-order auditory Zernike moment: a novel approach for robust music identification in the compressed domain

NASA Astrophysics Data System (ADS)

Li, Wei; Xiao, Chuan; Liu, Yaduo

2013-12-01

Audio identification via fingerprint has been an active research field for years. However, most previously reported methods work on the raw audio format in spite of the fact that nowadays compressed format audio, especially MP3 music, has grown into the dominant way to store music on personal computers and/or transmit it over the Internet. It will be interesting if a compressed unknown audio fragment could be directly recognized from the database without decompressing it into the wave format at first. So far, very few algorithms run directly on the compressed domain for music information retrieval, and most of them take advantage of the modified discrete cosine transform coefficients or derived cepstrum and energy type of features. As a first attempt, we propose in this paper utilizing compressed domain auditory Zernike moment adapted from image processing techniques as the key feature to devise a novel robust audio identification algorithm. Such fingerprint exhibits strong robustness, due to its statistically stable nature, against various audio signal distortions such as recompression, noise contamination, echo adding, equalization, band-pass filtering, pitch shifting, and slight time scale modification. Experimental results show that in a music database which is composed of 21,185 MP3 songs, a 10-s long music segment is able to identify its original near-duplicate recording, with average top-5 hit rate up to 90% or above even under severe audio signal distortions.

Can a proton be encapsulated in tetraamido/diamino quaternized macrocycles in aqueous solution and electric field?

PubMed

Jiang, Nan; Ma, Jing

2011-09-12

The proton-binding behavior of solvated tetraamido/diamino quaternized macrocyclic compounds with rigid phenyl and flexible phenyl bridges in the absence or presence of an external electric field is investigated by molecular dynamics simulation. The proton can be held through H-bonding interactions with the two carbonyl oxygen atoms in macrocycles containing rigid (phenyl) and flexible (propyl) bridges. The solute-solvent H-bonding interactions cause the macrocyclic backbones to twist to different extents, depending on the different bridges. The macrocycle with the rigid phenyl linkages folds into a cuplike shape due to π-π interaction, while the propyl analogue still maintains the ellipsoidal ringlike shape with just a slight distortion. The potential energy required for proton transfer is larger in the phenyl-containing macrocycle than in the compound with propyl units. When an external electric field with a strength of 2.5 V nm(-1) is exerted along the carbonyl oxygen atoms, a difference in proton encircling is exhibited for macrocycles with rigid and flexible bridges. In contrast to encapsulation of a proton in the propyl analogue, the intermolecular solute-solvent H-bonding and intramolecular π-π stacking between the two rigid phenyl spacers leads to loss of the proton from the highly distorted cuplike macrocycle with phenyl bridges. The competition between intra- and intermolecular interactions governs the behavior of proton encircling in macrocycles. Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

A new texture descriptor based on local micro-pattern for detection of architectural distortion in mammographic images

NASA Astrophysics Data System (ADS)

de Oliveira, Helder C. R.; Moraes, Diego R.; Reche, Gustavo A.; Borges, Lucas R.; Catani, Juliana H.; de Barros, Nestor; Melo, Carlos F. E.; Gonzaga, Adilson; Vieira, Marcelo A. C.

2017-03-01

This paper presents a new local micro-pattern texture descriptor for the detection of Architectural Distortion (AD) in digital mammography images. AD is a subtle contraction of breast parenchyma that may represent an early sign of breast cancer. Due to its subtlety and variability, AD is more difficult to detect compared to microcalcifications and masses, and is commonly found in retrospective evaluations of false-negative mammograms. Several computer-based systems have been proposed for automatic detection of AD, but their performance are still unsatisfactory. The proposed descriptor, Local Mapped Pattern (LMP), is a generalization of the Local Binary Pattern (LBP), which is considered one of the most powerful feature descriptor for texture classification in digital images. Compared to LBP, the LMP descriptor captures more effectively the minor differences between the local image pixels. Moreover, LMP is a parametric model which can be optimized for the desired application. In our work, the LMP performance was compared to the LBP and four Haralick's texture descriptors for the classification of 400 regions of interest (ROIs) extracted from clinical mammograms. ROIs were selected and divided into four classes: AD, normal tissue, microcalcifications and masses. Feature vectors were used as input to a multilayer perceptron neural network, with a single hidden layer. Results showed that LMP is a good descriptor to distinguish AD from other anomalies in digital mammography. LMP performance was slightly better than the LBP and comparable to Haralick's descriptors (mean classification accuracy = 83%).

Distribution analysis for F100(3) engine

NASA Technical Reports Server (NTRS)

Walter, W. A.; Shaw, M.

1980-01-01

The F100(3) compression system response to inlet circumferential distortion was investigated using an analytical compressor flow model. Compression system response to several types of distortion, including pressure, temperature, and combined pressure/temperature distortions, was investigated. The predicted response trends were used in planning future F100(3) distortion tests. Results show that compression system response to combined temperature and pressure distortions depends upon the relative orientation, as well as the individual amplitudes and circumferential extents of the distortions. Also the usefulness of the analytical predictions in planning engine distortion tests is indicated.

Effects of inflow distortion profiles on fan tone noise calculated using a 3-D theory

NASA Technical Reports Server (NTRS)

Kobayashi, H.; Groeneweg, J. F.

1979-01-01

Calculations of the fan tone acoustic power and modal structure generated by complex distortions in axial inflow velocity are presented. The model used treats the motor as a rotating three-dimensional cascade and calculates the acoustic field from the distortion-produced dipole distribution on the blades including noncompact source effects. Radial and circumferential distortion shapes are synthesized from Fourier-Bessel components representing individual distortion modes. The relation between individual distortion modes and the generated acoustic modes is examined for particular distortion cases. Comparisons between theoretical and experimental results for distortions produced by wakes from upstream radial rods show that the analysis is a good predictor of acoustic power dependence on disturbance strength.

Spatial Precision in Magnetic Resonance Imaging–Guided Radiation Therapy: The Role of Geometric Distortion

DOE Office of Scientific and Technical Information (OSTI.GOV)

Weygand, Joseph, E-mail: jw2899@columbia.edu; The University of Texas Graduate School of Biomedical Sciences at Houston, Houston, Texas; Fuller, Clifton David

2016-07-15

Because magnetic resonance imaging–guided radiation therapy (MRIgRT) offers exquisite soft tissue contrast and the ability to image tissues in arbitrary planes, the interest in this technology has increased dramatically in recent years. However, intrinsic geometric distortion stemming from both the system hardware and the magnetic properties of the patient affects MR images and compromises the spatial integrity of MRI-based radiation treatment planning, given that for real-time MRIgRT, precision within 2 mm is desired. In this article, we discuss the causes of geometric distortion, describe some well-known distortion correction algorithms, and review geometric distortion measurements from 12 studies, while taking into accountmore » relevant imaging parameters. Eleven of the studies reported phantom measurements quantifying system-dependent geometric distortion, while 2 studies reported simulation data quantifying magnetic susceptibility–induced geometric distortion. Of the 11 studies investigating system-dependent geometric distortion, 5 reported maximum measurements less than 2 mm. The simulation studies demonstrated that magnetic susceptibility–induced distortion is typically smaller than system-dependent distortion but still nonnegligible, with maximum distortion ranging from 2.1 to 2.6 mm at a field strength of 1.5 T. As expected, anatomic landmarks containing interfaces between air and soft tissue had the largest distortions. The evidence indicates that geometric distortion reduces the spatial integrity of MRI-based radiation treatment planning and likely diminishes the efficacy of MRIgRT. Better phantom measurement techniques and more effective distortion correction algorithms are needed to achieve the desired spatial precision.« less

An experimental investigation of compressor stall using an on-line distortion indicator and signal conditioner

NASA Technical Reports Server (NTRS)

Costakis, W. G.; Wenzel, L. M.

1975-01-01

The relation of the steady-state and dynamic distortions and the stall margin of a J85-13 turbojet engine was investigated. A distortion indicator capable of computing two distortion indices was used. A special purpose signal conditioner was also used as an interface between transducer signals and distortion indicator. A good correlation of steady-state distortion and stall margin was established. The prediction of stall by using the indices as instantaneous distortion indicators was not successful. A sensitivity factor that related the loss of stall margin to the turbulence level was found.

Underwater laser weld bowing distortion behavior and mechanism of thin 304 stainless steel plates

NASA Astrophysics Data System (ADS)

Huang, ZunYue; Luo, Zhen; Ao, Sansan; Cai, YangChuan

2018-10-01

Underwater laser weld bowing distortion behavior and mechanism of thin 304 stainless steel plates are studied in the paper. The influence of underwater laser welding parameters (such as laser power, welding speed, defocusing distance and gas flow rate) on weld bowing distortion was investigated through central composite rotatable design and an orthogonal test. A quadratic response model was established to evaluate the underwater laser weld bowing distortion by central composite rotatable design and the order of the impacts of the welding parameters on weld bowing distortion was studied by an orthogonal test. The weld bowing distortion after welding was determined by the digital image correlation technique. The weld bowing distortion of in-air laser welding and underwater laser welding were compared and it revealed that the shape of the in-air and underwater laser welded specimens are the same, but the weld bowing distortion amount of in-air welding is larger than that of underwater welding. Weld bowing distortion mechanism was studied by the digital image correlation technique, and it was demonstrated that weld bowing distortion is associated with the welding plate temperature gradient during laser welding. The wider weld width also resulted in larger weld bowing distortion.

Prediction of transmission distortion for wireless video communication: analysis.

PubMed

Chen, Zhifeng; Wu, Dapeng

2012-03-01

Transmitting video over wireless is a challenging problem since video may be seriously distorted due to packet errors caused by wireless channels. The capability of predicting transmission distortion (i.e., video distortion caused by packet errors) can assist in designing video encoding and transmission schemes that achieve maximum video quality or minimum end-to-end video distortion. This paper is aimed at deriving formulas for predicting transmission distortion. The contribution of this paper is twofold. First, we identify the governing law that describes how the transmission distortion process evolves over time and analytically derive the transmission distortion formula as a closed-form function of video frame statistics, channel error statistics, and system parameters. Second, we identify, for the first time, two important properties of transmission distortion. The first property is that the clipping noise, which is produced by nonlinear clipping, causes decay of propagated error. The second property is that the correlation between motion-vector concealment error and propagated error is negative and has dominant impact on transmission distortion, compared with other correlations. Due to these two properties and elegant error/distortion decomposition, our formula provides not only more accurate prediction but also lower complexity than the existing methods.

Could the Use of Acoustic Reflexes Prior to Administering Distortion Product Otoacoustic Emissions (DPOAEs) Affect the Results of DPOAEs?

PubMed

Garrette, Rachel; Jones, Alisha L; Wilson, Martha W

2018-05-15

The purpose of this study is to investigate whether acoustic reflex threshold testing before administration of distortion product otoacoustic emissions can affect the results of the distortion product otoacoustic emissions testing using an automated protocol. Fifteen young adults with normal hearing ranging in age from 19 to 25 years participated in the study. All participants had clear external ear canals and normal Jerger Type A tympanograms and had passed a hearing screening. Testing was performed using the Interacoustics Titan acoustic reflex threshold and distortion product otoacoustic emissions protocol. Participants underwent baseline distortion product otoacoustic emissions. A paired-samples t test was conducted for both the right and left ears to assess within-group differences between baseline distortion product otoacoustic emissions and repeated distortion product otoacoustic emissions measures. No significant differences were found in distortion product otoacoustic emission measures following administration of acoustic reflexes. The use of a protocol when using an automated system that includes both acoustic reflexes and distortion product otoacoustic emissions is important. Overall, presentation of acoustic reflexes prior to measuring distortion product otoacoustic emission did not affect distortion product otoacoustic emission results; therefore, test sequence can be modified as needed.

Feature maps driven no-reference image quality prediction of authentically distorted images

NASA Astrophysics Data System (ADS)

Ghadiyaram, Deepti; Bovik, Alan C.

2015-03-01

Current blind image quality prediction models rely on benchmark databases comprised of singly and synthetically distorted images, thereby learning image features that are only adequate to predict human perceived visual quality on such inauthentic distortions. However, real world images often contain complex mixtures of multiple distortions. Rather than a) discounting the effect of these mixtures of distortions on an image's perceptual quality and considering only the dominant distortion or b) using features that are only proven to be efficient for singly distorted images, we deeply study the natural scene statistics of authentically distorted images, in different color spaces and transform domains. We propose a feature-maps-driven statistical approach which avoids any latent assumptions about the type of distortion(s) contained in an image, and focuses instead on modeling the remarkable consistencies in the scene statistics of real world images in the absence of distortions. We design a deep belief network that takes model-based statistical image features derived from a very large database of authentically distorted images as input and discovers good feature representations by generalizing over different distortion types, mixtures, and severities, which are later used to learn a regressor for quality prediction. We demonstrate the remarkable competence of our features for improving automatic perceptual quality prediction on a benchmark database and on the newly designed LIVE Authentic Image Quality Challenge Database and show that our approach of combining robust statistical features and the deep belief network dramatically outperforms the state-of-the-art.

Detection of chromatic and luminance distortions in natural scenes.

PubMed

Jennings, Ben J; Wang, Karen; Menzies, Samantha; Kingdom, Frederick A A

2015-09-01

A number of studies have measured visual thresholds for detecting spatial distortions applied to images of natural scenes. In one study, Bex [J. Vis.10(2), 1 (2010)10.1167/10.2.231534-7362] measured sensitivity to sinusoidal spatial modulations of image scale. Here, we measure sensitivity to sinusoidal scale distortions applied to the chromatic, luminance, or both layers of natural scene images. We first established that sensitivity does not depend on whether the undistorted comparison image was of the same or of a different scene. Next, we found that, when the luminance but not chromatic layer was distorted, performance was the same regardless of whether the chromatic layer was present, absent, or phase-scrambled; in other words, the chromatic layer, in whatever form, did not affect sensitivity to the luminance layer distortion. However, when the chromatic layer was distorted, sensitivity was higher when the luminance layer was intact compared to when absent or phase-scrambled. These detection threshold results complement the appearance of periodic distortions of the image scale: when the luminance layer is distorted visibly, the scene appears distorted, but when the chromatic layer is distorted visibly, there is little apparent scene distortion. We conclude that (a) observers have a built-in sense of how a normal image of a natural scene should appear, and (b) the detection of distortion in, as well as the apparent distortion of, natural scene images is mediated predominantly by the luminance layer and not chromatic layer.

The DISPARITY-II study: delays to antibiotic administration in women with severe sepsis or septic shock.

PubMed

Madsen, Tracy E; Napoli, Anthony M

2014-12-01

Early antibiotics reduce mortality in patients with severe sepsis and septic shock. Recent work demonstrated that women experience greater delays to antibiotic administration, but it is unknown if this relationship remains after adjusting for factors such as source of infection. The objective was to investigate whether gender and/or source of infection are associated with delays to antibiotics in patients with severe sepsis or septic shock. This was a retrospective, observational study in an urban academic emergency department and national Surviving Sepsis Campaign (SSC) database study site. Consecutive patients age 18 years and older admitted to intensive care with severe sepsis or septic shock and entered into the SSC database from October 2005 to March 2012 were included. Two trained research assistants, blinded to the primary outcome, used a standardized abstraction form to obtain patient demographic and clinical data, including the Sequential Organ Failure Assessment (SOFA) scores and comorbidities. Time to first antibiotic and presumed source of infection were extracted from the SSC database. Univariate analyses were performed with Pearson chi-square tests and t-tests. Linear regression was performed with time to first antibiotic as the primary outcome. Covariates, chosen a priori by study authors, included age, race, ethnicity, source of infection, SOFA score, and lactate. A total of 771 patients were included. Women were 45.3% of the sample, the mean age was 66 years (95% confidence interval [CI] = 65.1 to 67.5 years), 19.4% were nonwhite, and 8% were Hispanic. Mean time to first antibiotic was 153 minutes (95% CI = 143 to 163 minutes) for men and 184 minutes (95% CI = 171 to 197 minutes) for women (p < 0.001). The urinary tract was source of infection for 35.2% of women (95% CI = 30.2% to 40.3%) versus 23.7% (95% CI = 19.6% to 27.8%) of men. Pneumonia was present in 46.9% of men (95% CI = 42.1% to 51.7%) versus 35.8% (95% CI = 30.8% to 40.8%) of women. The mean time to antibiotics in women was longer than in men (adjusted odds ratio [aOR] = 1.18, 95% CI = 1.07 to 1.30), even after adjusting for age, race, ethnicity, presumed source of infection, SOFA score, and lactate (p = 0.001). Those with pneumonia compared to other infections received antibiotics faster (aOR = 0.73, 95% CI = 0.66 to 0.81). There was no significant association between other sources of infection and time to antibiotics in either univariate or multivariate analysis. Women experience longer delays to initial antibiotics among patients with severe sepsis or septic shock, even after adjusting for infectious source. Pneumonia was associated with shorter times to antibiotic administration. Future research is necessary to investigate contributors to delayed antibiotic administration in women. © 2014 by the Society for Academic Emergency Medicine.

Novel approaches to address spectral distortions in photon counting x-ray CT using artificial neural networks

NASA Astrophysics Data System (ADS)

Touch, M.; Clark, D. P.; Barber, W.; Badea, C. T.

2016-04-01

Spectral CT using a photon-counting x-ray detector (PCXD) can potentially increase accuracy of measuring tissue composition. However, PCXD spectral measurements suffer from distortion due to charge sharing, pulse pileup, and Kescape energy loss. This study proposes two novel artificial neural network (ANN)-based algorithms: one to model and compensate for the distortion, and another one to directly correct for the distortion. The ANN-based distortion model was obtained by training to learn the distortion from a set of projections with a calibration scan. The ANN distortion was then applied in the forward statistical model to compensate for distortion in the projection decomposition. ANN was also used to learn to correct distortions directly in projections. The resulting corrected projections were used for reconstructing the image, denoising via joint bilateral filtration, and decomposition into three-material basis functions: Compton scattering, the photoelectric effect, and iodine. The ANN-based distortion model proved to be more robust to noise and worked better compared to using an imperfect parametric distortion model. In the presence of noise, the mean relative errors in iodine concentration estimation were 11.82% (ANN distortion model) and 16.72% (parametric model). With distortion correction, the mean relative error in iodine concentration estimation was improved by 50% over direct decomposition from distorted data. With our joint bilateral filtration, the resulting material image quality and iodine detectability as defined by the contrast-to-noise ratio were greatly enhanced allowing iodine concentrations as low as 2 mg/ml to be detected. Future work will be dedicated to experimental evaluation of our ANN-based methods using 3D-printed phantoms.

Synthesis and crystal structure of the iridium(I) carbene complex with a pair of hydrogen wing tips

DOE Office of Scientific and Technical Information (OSTI.GOV)

Huang, H.-Y.; Chen, Z.-M.; Wang, Y.

The iridium(I) cyclooctadiene complex with two (3-tert-butylimidazol-2-ylidene) ligands [(H-Im{sup t}Bu){sub 2}Ir(COD)]{sup +}PF{sub 6}{sup −} (C{sub 22}H{sub 32}PF{sub 6}IrN{sub 4}) has been prepared, and its crystal structure is determined by X-ray diffraction. Complex exhibits slightly distorted square planar configurations around the metal atom, which is coordinated by two H-Im{sup t}Bu ligands and one cyclooctadiene group. The new iridium carbene complex has a pair of hydrogen wing tips. The Ir−C{sub carbene} bond lengths are 2.066(5) and 2.052(5) Å, and the bond angle C−Ir−C between these bonds is 95.54(19)°. The dihedral angle between two imidazol-2-ylidene rings is 86.42°.

Crystal structure of tetra­aqua­bis­(pyrimidin-1-ium-4,6-diolato-κO 4)manganese(II)

PubMed Central

Shennara, Khaled A.

2017-01-01

The MnII ion in the structure of the mononuclear title compound, [Mn(C4H3N2O2)2(H2O)4], is situated on an inversion center and is coordinated by two O atoms from two deprotonated 4,6-di­hydroxy­pyrimidine ligands and by four O atoms from water mol­ecules giving rise to a slightly distorted octa­hedral coordination sphere. The complex includes an intra­molecular hydrogen bond between an aqua ligand and the non-protonated N ring atom. The extended structure is stabilized by inter­molecular hydrogen bonds between aqua ligands, by hydrogen bonds between N and O atoms of the ligands of adjacent mol­ecules, and by hydrogen bonds between aqua ligands and the non-coordinating O atom of an adjacent mol­ecule. PMID:28435734

Transverse diode-pumped neodymium-doped yttrium vanadate laser of simple design

NASA Astrophysics Data System (ADS)

Agüero, Mónica B.; Hnilo, Alejandro A.; Kovalsky, Marcelo G.

2010-03-01

The design and performance of an all-solid-state Nd:YVO4 laser, transversely pumped by a single 20-W (at 808 nm) diode with no coupling optics, are presented. The prototype, which is devised to be the source of a micro-LIDAR station, is very simple, easy to align, compact, and stable. The key element is a roof prism as the end mirror of the laser cavity, which is used to symmetrize the effects of the thermal distortion and the inhomogeneity of the population inversion distribution. Typical numbers are 4.2-W cw with a slightly astigmatic (3:2) homogeneous spot and a divergence of 0.5 mrad. The protoype is also tested in the active Q-switching mode, providing pulses 50-ns full width at half maximum (FWHM) at 14 KHz, 3.5 W average. Frequency doubling external to the cavity in a nonoptimized configuration provides 700 mW at 532 nm.

Modelling the growth of triglycine sulphate crystals in Spacelab 3

NASA Technical Reports Server (NTRS)

Yoo, Hak-Do; Wilcox, William R.; Lal, Ravindra; Trolinger, James D.

1988-01-01

Two triglycine sulphate crystals were grown from an aqueous solution in Spacelab 3 aboard a Space Shuttle. Using a diffusion coefficient of 0.00002 sq cm/s, a computerized simulation gave reasonable agreement between experimental and theoretical crystal sizes and interferometric lines in the solution near the growing crystal. This diffusion coefficient is larger than most measured values, possibly due to fluctuating accelerations on the order of .001 g (Earth's gravity). The average acceleration was estimated to be less than .000001 g. At this level, buoyancy driven convection is predicted to add approx. 20 percent to the steady state growth rate. Only very slight distortion of the interferometric lines was observed at the end of a 33 hr run. It is suggested that the time to reach steady state convective transport may be inversely proportional to g at low g, so that the full effect of convection was not realized in these experiments.

Pulsed electron nuclear double resonance studies of the photoexcited triplet state of pentacene in p-terphenyl crystals at room temperature.

PubMed

Yago, Tomoaki; Link, Gerhard; Kothe, Gerd; Lin, Tien-Sung

2007-09-21

Pulsed electron nuclear double resonance (ENDOR) using a modified Davies-type [Phys. Lett. 47A, 1 (1974)] sequence is employed to study the hyperfine (HF) structure of the photoexcited triplet state of pentacene dispersed in protonated and deuterated p-terphenyl single crystals. The strong electron spin polarization and long phase memory time of triplet pentacene enable us to perform the ENDOR measurements on the S=1 spin system at room temperature. Proton HF tensor elements and spin density values of triplet pentacene are extracted from a detailed angular-dependent study in which the orientation of the magnetic field is varied systematically in two different pentacene planes. Analysis reveals that the pentacene molecule is no longer planar in the p-terphenyl host lattice. The distortion is more pronounced in the deuterated crystal where the unit cell dimensions are slightly smaller than those of the protonated crystal.

Structural study of gold clusters.

PubMed

Xiao, Li; Tollberg, Bethany; Hu, Xiankui; Wang, Lichang

2006-03-21

Density functional theory (DFT) calculations were carried out to study gold clusters of up to 55 atoms. Between the linear and zigzag monoatomic Au nanowires, the zigzag nanowires were found to be more stable. Furthermore, the linear Au nanowires of up to 2 nm are formed by slightly stretched Au dimers. These suggest that a substantial Peierls distortion exists in those structures. Planar geometries of Au clusters were found to be the global minima till the cluster size of 13. A quantitative correlation is provided between various properties of Au clusters and the structure and size. The relative stability of selected clusters was also estimated by the Sutton-Chen potential, and the result disagrees with that obtained from the DFT calculations. This suggests that a modification of the Sutton-Chen potential has to be made, such as obtaining new parameters, in order to use it to search the global minima for bigger Au clusters.

Decarboxylation of furfural on Pd(111): Ab initio molecular dynamics simulations

NASA Astrophysics Data System (ADS)

Xue, Wenhua; Dang, Hongli; Shields, Darwin; Liu, Yingdi; Jentoft, Friederike; Resasco, Daniel; Wang, Sanwu

2013-03-01

Furfural conversion over metal catalysts plays an important role in the studies of biomass-derived feedstocks. We report ab initio molecular dynamics simulations for the decarboxylation process of furfural on the palladium surface at finite temperatures. We observed and analyzed the atomic-scale dynamics of furfural on the Pd(111) surface and the fluctuations of the bondlengths between the atoms in furfural. We found that the dominant bonding structure is the parallel structure in which the furfural plane, while slightly distorted, is parallel to the Pd surface. Analysis of the bondlength fluctuations indicates that the C-H bond is the aldehyde group of a furfural molecule is likely to be broken first, while the C =O bond has a tendency to be isolated as CO. Our results show that the reaction of decarbonylation dominates, consistent with the experimental measurements. Supported by DOE (DE-SC0004600). Simulations and calculations were performed on XSEDE's and NERSC's supercomputers.

A Method for Prevention of Screaming in Rocket Engines

NASA Technical Reports Server (NTRS)

Kerslake, W. R.; Male, T.

1954-01-01

Lateral and longitudinal combustion-pressure oscillations that occurred in screaming combustion of a 1000-pound-thrust rocket engine using white fuming nitric acid and JP-4 fuel as propellants were successfully prevented by means of longitudinal fins in the combustion chamber. Fin position was critical, and complete attenuation was achieved only when the fins were located in a zone approximately 8 to 16 inches from the injector. Fins located in other zones, that is, near the injector or far downstream from the injector, did not stop the oscillations. When oscillations occurred in finned chambers, the longitudinal mode seemed more dominant than the lateral mode; in chambers without fins, the lateral mode tended to be dominant. The lateral oscillation was distorted and its intensity diminished by the fins. Fins, however, did not affect the frequencies; the longitudinal frequency varied inversely with chamber length, and lateral frequencies varied only slightly from an average of 6000 cycles per second.

Ion blocking dip shape analysis around a LaAlO3/SrTiO3 interface

NASA Astrophysics Data System (ADS)

Jalabert, D.; Zaid, H.; Berger, M. H.; Fongkaew, I.; Lambrecht, W. R. L.; Sehirlioglu, A.

2018-05-01

We present an analysis of the widths of the blocking dips obtained in MEIS ion blocking experiments of two LaAlO3/SrTiO3 heterostructures differing in their LaAlO3 layer thicknesses. In the LaAlO3 layers, the observed blocking dips are larger than expected. This enlargement is the result of the superposition of individual dips at slightly different angular positions revealing a local disorder in the atomic alignment, i.e., layer buckling. By contrast, in the SrTiO3 substrate, just below the interface, the obtained blocking dips are thinner than expected. This thinning indicates that the blocking atoms stand at a larger distance from the scattering center than expected. This is attributed to an accumulation of Sr vacancies at the layer/substrate interface which induces lattice distortions shifting the atoms off the scattering plane.

A high-stability scanning tunneling microscope achieved by an isolated tiny scanner with low voltage imaging capability.

PubMed

Wang, Qi; Hou, Yubin; Wang, Junting; Lu, Qingyou

2013-11-01

We present a novel homebuilt scanning tunneling microscope (STM) with high quality atomic resolution. It is equipped with a small but powerful GeckoDrive piezoelectric motor which drives a miniature and detachable scanning part to implement coarse approach. The scanning part is a tiny piezoelectric tube scanner (industry type: PZT-8, whose d31 coefficient is one of the lowest) housed in a slightly bigger polished sapphire tube, which is riding on and spring clamped against the knife edges of a tungsten slot. The STM so constructed shows low back-lashing and drifting and high repeatability and immunity to external vibrations. These are confirmed by its low imaging voltages, low distortions in the spiral scanned images, and high atomic resolution quality even when the STM is placed on the ground of the fifth floor without any external or internal vibration isolation devices.

Bench-marking effects in the blaming of professionals for incidents of aggression and assault.

PubMed

Carifio, J; Lanza, M

1994-01-01

This study compared all possible orders of responding to three vignettes describing incidents between a male patient and a female nurse in which the nurse is mildly assaulted, severely assaulted, or verbally abused by the patient (the control condition). Subjects were 32 female senior-year nursing students and 28 practicing nurses. It was found that response levels to a given vignette could predict a respondent's response to the other vignettes. Also, a significant "bench-marking" effect was found: if a subject responded to the mild assault vignette first, the subject's overall response pattern best fit the general nonlinear assignment-of-blame pattern observed, but if the subject responded to the severe assault or control vignette first, this vignette set a bench mark for responding from which the subject's subsequent responses did not deviate greatly, which slightly distorted the subject's V-shaped nonlinear response pattern.

Crystal structure of 3-benzamido-1-(4-nitro-benz-yl)quinolinium tri-fluoro-methane-sulfonate.

PubMed

Nicolas-Gomez, Mariana; Bazany-Rodríguez, Iván J; Plata-Vargas, Eduardo; Hernández-Ortega, Simón; Dorazco-González, Alejandro

2016-05-01

In the title compound, C23H18N3O3 (+)·CF3SO3 (-), the asymmetric unit contains two crystallographically independent organic cations with similar conformations. Each cation shows a moderate distortion between the planes of the amide groups and the quinolinium rings with dihedral angles of 14.90 (2) and 31.66 (2)°. The quinolinium and phenyl rings are slightly twisted with respect to each other at dihedral angles of 6.99 (4) and 8.54 (4)°. The tri-fluoro-methane-sulfonate anions are linked to the organic cations via N-H⋯O hydrogen-bonding inter-actions involving the NH amide groups. In the crystal, the organic cations are linked by weak C-H⋯O(nitro group) inter-actions into supramol-ecular chains propagating along the b-axis direction.

Influence of the Ag concentration on the medium-range order in a CuZrAlAg bulk metallic glass

DOE PAGES

Gammer, C.; Escher, B.; Ebner, C.; ...

2017-03-21

Fluctuation electron microscopy of bulk metallic glasses of CuZrAl(Ag) demonstrates that medium-range order is sensitive to minor compositional changes. Furthermore, by analyzing nanodiffraction patterns medium-range order is detected with crystal-like motifs based on the B2 CuZr structure and its distorted structures resembling the martensitic ones. This result thus demonstrates some structural homology between the metallic glass and its high temperature crystalline phase. The amount of medium-range order seems slightly affected with increasing Ag concentration (0, 2, 5 at.%) but the structural motifs of the medium-range ordered clusters become more diverse at the highest Ag concentration. The decrease of dominant clustersmore » is consistent with the destabilization of the B2 structure measured by calorimetry and accounts for the increased glass-forming ability.« less

Influence of the Ag concentration on the medium-range order in a CuZrAlAg bulk metallic glass

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gammer, C.; Escher, B.; Ebner, C.

Fluctuation electron microscopy of bulk metallic glasses of CuZrAl(Ag) demonstrates that medium-range order is sensitive to minor compositional changes. Furthermore, by analyzing nanodiffraction patterns medium-range order is detected with crystal-like motifs based on the B2 CuZr structure and its distorted structures resembling the martensitic ones. This result thus demonstrates some structural homology between the metallic glass and its high temperature crystalline phase. The amount of medium-range order seems slightly affected with increasing Ag concentration (0, 2, 5 at.%) but the structural motifs of the medium-range ordered clusters become more diverse at the highest Ag concentration. The decrease of dominant clustersmore » is consistent with the destabilization of the B2 structure measured by calorimetry and accounts for the increased glass-forming ability.« less

The rotationally modulated Zeeman spectrum at nearly 10 to the 9th Gauss of the white dwarf PG 1031 + 234

NASA Technical Reports Server (NTRS)

Latter, William B.; Schmidt, Gary D.; Green, Richard F.

1987-01-01

Detailed analyses are performed of high-quality, phase-resolved CCD spectroscopy of the absorption-line spectrum throughout its rotation period of the new white dwarf PG 1031 + 234. The spectral variations are discussed and compared with new theoretical calculations of the behavior of hydrogen in strong magnetic fields. This analysis is then extended through a modeling procedure which produces a synthetic magnetically distorted spectrum for a star of arbitrary field strength and structure. The results confirm that PG 1031 + 234 possesses the strongest field yet detected on a white dwarf, with regions on the surface spanning the range of about 200 to nearly 1000 MG. The spectroscopic data reflect a field pattern containing a slightly offset global component of polar field strength of about 500 MG together with a localized magnetic 'spot' whose central field approaches 2000 MG.

Ordered microporous layered lanthanide 1,3,5-benzenetriphosphonates pillared with cationic organic molecules.

PubMed

Araki, Takahiro; Kondo, Atsushi; Maeda, Kazuyuki

2015-04-13

Novel isomorphous pillared-layer-type crystalline lanthanide 1,3,5-benzenetriphosphonates were prepared with bpy and dbo as organic pillars (LnBP-bpy and LnBP-dbo; Ln: Ce, Pr, and Nd). Ab initio crystal structure solution using synchrotron X-ray powder diffraction data revealed that the organic pillars do not exist as neutral coordinating ligands but as cationic molecules. Especially the LnBP-dbo phases have ordered interlayer space filled with water molecules between the dbo pillars, and the interlayer water is successfully removed by heating under vacuum with slightly distorted but basically retained pillared layer structures. Microporosity of the materials is confirmed by adsorption of nitrogen, carbon dioxide, and hydrogen gases. Such microporous layered metal phosphonates pillared with cationic molecules should be unprecedented and should offer new strategies to design ordered microporous materials. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Analysis of Brown camera distortion model

NASA Astrophysics Data System (ADS)

Nowakowski, Artur; Skarbek, Władysław

2013-10-01

Contemporary image acquisition devices introduce optical distortion into image. It results in pixel displacement and therefore needs to be compensated for many computer vision applications. The distortion is usually modeled by the Brown distortion model, which parameters can be included in camera calibration task. In this paper we describe original model, its dependencies and analyze orthogonality with regard to radius for its decentering distortion component. We also report experiments with camera calibration algorithm included in OpenCV library, especially a stability of distortion parameters estimation is evaluated.

Close-range photogrammetry with video cameras

NASA Technical Reports Server (NTRS)

Burner, A. W.; Snow, W. L.; Goad, W. K.

1985-01-01

Examples of photogrammetric measurements made with video cameras uncorrected for electronic and optical lens distortions are presented. The measurement and correction of electronic distortions of video cameras using both bilinear and polynomial interpolation are discussed. Examples showing the relative stability of electronic distortions over long periods of time are presented. Having corrected for electronic distortion, the data are further corrected for lens distortion using the plumb line method. Examples of close-range photogrammetric data taken with video cameras corrected for both electronic and optical lens distortion are presented.

Close-Range Photogrammetry with Video Cameras

NASA Technical Reports Server (NTRS)

Burner, A. W.; Snow, W. L.; Goad, W. K.

1983-01-01

Examples of photogrammetric measurements made with video cameras uncorrected for electronic and optical lens distortions are presented. The measurement and correction of electronic distortions of video cameras using both bilinear and polynomial interpolation are discussed. Examples showing the relative stability of electronic distortions over long periods of time are presented. Having corrected for electronic distortion, the data are further corrected for lens distortion using the plumb line method. Examples of close-range photogrammetric data taken with video cameras corrected for both electronic and optical lens distortion are presented.

Impacts of snow cover fraction data assimilation on modeled energy and moisture budgets

NASA Astrophysics Data System (ADS)

Arsenault, Kristi R.; Houser, Paul R.; De Lannoy, Gabriëlle J. M.; Dirmeyer, Paul A.

2013-07-01

Two data assimilation (DA) methods, a simple rule-based direct insertion (DI) approach and a one-dimensional ensemble Kalman filter (EnKF) method, are evaluated by assimilating snow cover fraction observations into the Community Land surface Model. The ensemble perturbation needed for the EnKF resulted in negative snowpack biases. Therefore, a correction is made to the ensemble bias using an approach that constrains the ensemble forecasts with a single unperturbed deterministic LSM run. This is shown to improve the final snow state analyses. The EnKF method produces slightly better results in higher elevation locations, whereas results indicate that the DI method has a performance advantage in lower elevation regions. In addition, the two DA methods are evaluated in terms of their overall impacts on the other land surface state variables (e.g., soil moisture) and fluxes (e.g., latent heat flux). The EnKF method is shown to have less impact overall than the DI method and causes less distortion of the hydrological budget. However, the land surface model adjusts more slowly to the smaller EnKF increments, which leads to smaller but slightly more persistent moisture budget errors than found with the DI updates. The DI method can remove almost instantly much of the modeled snowpack, but this also allows the model system to quickly revert to hydrological balance for nonsnowpack conditions.

Evaluation of DNA damage and mutagenicity induced by lead in tobacco plants.

PubMed

Gichner, Tomás; Znidar, Irena; Száková, Jirina

2008-04-30

Tobacco (Nicotiana tabacum L. var. xanthi) seedlings were treated with aqueous solutions of lead nitrate (Pb2+) at concentrations ranging from 0.4 mM to 2.4 mM for 24 h and from 25 microM to 200 microM for 7 days. The DNA damage measured by the comet assay was high in the root nuclei, but in the leaf nuclei a slight but significant increase in DNA damage could be demonstrated only after a 7-day treatment with 200 microM Pb2+. In tobacco plants growing for 6 weeks in soil polluted with Pb2+ severe toxic effects, expressed by the decrease in leaf area, and a slight but significant increase in DNA damage were observed. The tobacco plants with increased levels of DNA damage were severely injured and showed stunted growth, distorted leaves and brown root tips. The frequency of somatic mutations in tobacco plants growing in the Pb2+-polluted soil did not significantly increase. Analytical studies by inductively coupled plasma optical emission spectrometry demonstrate that after a 24-h treatment of tobacco with 2.4 mM Pb2+, the accumulation of the heavy metal is 40-fold higher in the roots than in the above-ground biomass. Low Pb2+ accumulation in the above-ground parts may explain the lower levels or the absence of Pb2+-induced DNA damage in leaves.

An experimental investigation of two large annular diffusers with swirling and distorted inflow

NASA Technical Reports Server (NTRS)

Eckert, W. T.; Johnston, J. P.; Simons, T. D.; Mort, K. W.; Page, V. R.

1980-01-01

Two annular diffusers downstream of a nacelle-mounted fan were tested for aerodynamic performance, measured in terms of two static pressure recovery parameters (one near the diffuser exit plane and one about three diameters downstream in the settling duct) in the presence of several inflow conditions. The two diffusers each had an inlet diameter of 1.84 m, an area ratio of 2.3, and an equivalent cone angle of 11.5, but were distinguished by centerbodies of different lengths. The dependence of diffuser performance on various combinations of swirling, radially distorted, and/or azimuthally distorted inflow was examined. Swirling flow and distortions in the axial velocity profile in the annulus upstream of the diffuser inlet were caused by the intrinsic flow patterns downstream of a fan in a duct and by artificial intensification of the distortions. Azimuthal distortions or defects were generated by the addition of four artificial devices (screens and fences). Pressure recovery data indicated beneficial effects of both radial distortion (for a limited range of distortion levels) and inflow swirl. Small amounts of azimuthal distortion created by the artificial devices produced only small effects on diffuser performance. A large artificial distortion device was required to produce enough azimuthal flow distortion to significantly degrade the diffuser static pressure recovery.

Appraisal distortions and intimate partner violence: gender, power, and interaction.

PubMed

Whiting, Jason B; Oka, Megan; Fife, Stephen T

2012-06-01

In relationships characterized by control, abuse, or violence, many appraisal distortions occur including denial and minimization. However, the nature of the distortion varies depending on the individual's role in the relationship (i.e., abuser or victim). Reducing these distortions is an important component in treatment success and involves accepting responsibility for actions and attributions. This study used constructivist grounded theory methods to explore the following questions: (1) What are the types of distortions that are used by individuals who have been in violent or abusive relationships? (2) What are the gender and power differences in the appraisal distortions used? (3) What are the functions and interactions of the distortions in the relationship dynamics? Qualitative analysis of interviews with 29 individuals who had been in abusive relationships found that there were several types of distortions used by participants, but there were differences in the function of the distortion, depending on the individual's role in the abuse. These generally corresponded to power and gender, where the male as perpetrator used different distortions (or used similar distortions for different reasons) than did the female as victim. Suggestions for research as well as treatment implications for both offenders and survivors of abuse are given. © 2012 American Association for Marriage and Family Therapy.

A methodology to investigate the impact of image distortions on the radiation dose when using magnetic resonance images for planning

NASA Astrophysics Data System (ADS)

Yan, Yue; Yang, Jinzhong; Beddar, Sam; Ibbott, Geoffrey; Wen, Zhifei; Court, Laurence E.; Hwang, Ken-Pin; Kadbi, Mo; Krishnan, Sunil; Fuller, Clifton D.; Frank, Steven J.; Yang, James; Balter, Peter; Kudchadker, Rajat J.; Wang, Jihong

2018-04-01

We developed a novel technique to study the impact of geometric distortion of magnetic resonance imaging (MRI) on intensity-modulated radiation therapy treatment planning. The measured 3D datasets of residual geometric distortion (a 1.5 T MRI component of an MRI linear accelerator system) was fitted with a second-order polynomial model to map the spatial dependence of geometric distortions. Then the geometric distortion model was applied to computed tomography (CT) image and structure data to simulate the distortion of MRI data and structures. Fourteen CT-based treatment plans were selected from patients treated for gastrointestinal, genitourinary, thoracic, head and neck, or spinal tumors. Plans based on the distorted CT and structure data were generated (as the distorted plans). Dose deviations of the distorted plans were calculated and compared with the original plans to study the dosimetric impact of MRI distortion. The MRI geometric distortion led to notable dose deviations in five of the 14 patients, causing loss of target coverage of up to 3.68% and dose deviations to organs at risk in three patients, increasing the mean dose to the chest wall by up to 6.19 Gy in a gastrointestinal patient, and increases the maximum dose to the lung by 5.17 Gy in a thoracic patient.

Evolution of CMB spectral distortion anisotropies and tests of primordial non-Gaussianity

NASA Astrophysics Data System (ADS)

Chluba, Jens; Dimastrogiovanni, Emanuela; Amin, Mustafa A.; Kamionkowski, Marc

2017-04-01

Anisotropies in distortions to the frequency spectrum of the cosmic microwave background (CMB) can be created through spatially varying heating processes in the early Universe. For instance, the dissipation of small-scale acoustic modes does create distortion anisotropies, in particular for non-Gaussian primordial perturbations. In this work, we derive approximations that allow describing the associated distortion field. We provide a systematic formulation of the problem using Fourier-space window functions, clarifying and generalizing previous approximations. Our expressions highlight the fact that the amplitudes of the spectral-distortion fluctuations induced by non-Gaussianity depend also on the homogeneous value of those distortions. Absolute measurements are thus required to obtain model-independent distortion constraints on primordial non-Gaussianity. We also include a simple description for the evolution of distortions through photon diffusion, showing that these corrections can usually be neglected. Our formulation provides a systematic framework for computing higher order correlation functions of distortions with CMB temperature anisotropies and can be extended to describe correlations with polarization anisotropies.

FSD: Frequency Space Differential measurement of CMB spectral distortions

NASA Astrophysics Data System (ADS)

Mukherjee, Suvodip; Silk, Joseph; Wandelt, Benjamin D.

2018-07-01

Although the cosmic microwave background (CMB) agrees with a perfect blackbody spectrum within the current experimental limits, it is expected to exhibit certain spectral distortions with known spectral properties. We propose a new method Frequency Space Differential (FSD) to measure the spectral distortions in the CMB spectrum by using the inter-frequency differences of the brightness temperature. The difference between the observed CMB temperature at different frequencies must agree with the frequency derivative of the blackbody spectrum in the absence of any distortion. However, in the presence of spectral distortions, the measured inter-frequency differences would also exhibit deviations from blackbody that can be modelled for known sources of spectral distortions like y and μ. Our technique uses FSD information for the CMB blackbody, y, μ, or any other sources of spectral distortions to model the observed signal. Successful application of this method in future CMB missions can provide an alternative method to extract spectral distortion signals and can potentially make it feasible to measure spectral distortions without an internal blackbody calibrator.

Paleoseismic Investigations of the Walnut Site on the San Jacinto Fault

USGS Publications Warehouse

Fumal, T.E.; Kendrick, K.J.

2008-01-01

The Walnut paleoseismic site is located along the northern San Jacinto fault about 3 km southeast of the San Bernardino, California city center (Figures 1, 2). More than 340 meters of trenches were excavated across the fault zone at this site as part of an Alquist-Priolo fault study (Figure 3). We photographed and logged the SE wall and most of the NE wall of trench 1, both walls of trenches 2 and 7, the NW walls of trenches 3 and 4 and the SE wall of trench 6. After carefully cleaning the trench walls we put up a 1m by 0.5m string and nail grid. For trenches 1, 2, 6, and 7, we photographed each 1m by 0.5m panel individually and photologged on these unrectified photos. These large-scale photos were later rectified to remove the distortion due to irregularities in the trench walls and slight distortion introduced by the camera lens. Field linework was then transferred to the rectified photomosaics. We also took a set of overview photographs for each trench taken from the top of the trench towards the opposite wall. We spliced together these overview photos to make photomosaics of all of the trenches. Because the photos were taken at a downward angle, there is significant distortion. Some of this distortion has been corrected: an attempt was made to keep horizontal grid lines horizontal and there has been some horizontal scaling to align vertical lines between benches. Although the string and nail grid spacing is 1 meter by 0.5 meter, because of the distortion in the photos and subsequent adjustments, the scale is variable along the benches, from bench to bench and from trench to trench for these overview mosaics. This report serves principally as a repository for the overview photomosaics. Sheet 1 shows the overview mosaics for both walls of trenches 1 and 2 along with some linework including most of the fault traces, a prominent unconformity within the fluvial deposits and the larger bodies of liquefied sand. Sheet 2 shows the overview mosaics for the SE wall of trench 3 and the NW wall of trench 4 along with photomosaics of both walls of trench 7 and the SE wall of trench 6 that were complied from the rectified, large scale photos. No linework has been portrayed on these photomosaics. Sheet 3 shows the overview mosaics of both walls of trench 1 with the locations of detrital charcoal samples that were collected. A later version of this report will contain photomosaics for trenches 1 and 2 compiled from the individual, fully rectified photos covering each 1m by 0.5m area with detailed linework superimposed. The trenches exposed a main, Holocene-active, fault zone about 5-12 m wide which juxtaposes Late Pleistocene (?) fluvial sand and gravel southwest of the fault against organic-rich, Holocene fine sand, silt and clay apparently deposited in a marsh. Most of the faults in the main zone appear to rupture to the ground surface making it impossible to resolve individual prehistoric earthquakes along this zone. However, the main fault zone is associated with a slight upwarp and growth strata associated with this folding has recorded evidence for at least 6 late-Holocene earthquakes. Deformation due to liquefaction is further evidence of large earthquakes at these horizons. The fine-grained Holocene deposits contain abundant detrital charcoal. We have so far dated 36 samples from 20 stratigraphic layers. We used 27 of these dates in an Oxcal chronological model in order to constrain the ages of the six earthquakes. Too few samples have so far been dated from the uppermost horizons so the ages of the two youngest earthquakes recorded at the site are poorly constrained. However, it appears that the youngest sediment at the site was deposited about 2000 years ago and the thick surface soil indicate that the two youngest earthquake recorded at the site may be about this old. The radiocarbon dates provide good constraints on the ages of the four older earthquakes (Table 1). The ages of these four earthquakes suggest an aver

Image distortion analysis using polynomial series expansion.

PubMed

Baggenstoss, Paul M

2004-11-01

In this paper, we derive a technique for analysis of local distortions which affect data in real-world applications. In the paper, we focus on image data, specifically handwritten characters. Given a reference image and a distorted copy of it, the method is able to efficiently determine the rotations, translations, scaling, and any other distortions that have been applied. Because the method is robust, it is also able to estimate distortions for two unrelated images, thus determining the distortions that would be required to cause the two images to resemble each other. The approach is based on a polynomial series expansion using matrix powers of linear transformation matrices. The technique has applications in pattern recognition in the presence of distortions.

Analysis of distortion data from TF30-P-3 mixed compression inlet test

NASA Technical Reports Server (NTRS)

King, R. W.; Schuerman, J. A.; Muller, R. G.

1976-01-01

A program was conducted to reduce and analyze inlet and engine data obtained during testing of a TF30-P-3 engine operating behind a mixed compression inlet. Previously developed distortion analysis techniques were applied to the data to assist in the development of a new distortion methodology. Instantaneous distortion techniques were refined as part of the distortion methodology development. A technique for estimating maximum levels of instantaneous distortion from steady state and average turbulence data was also developed as part of the program.

Assessment of dosimetric impact of system specific geometric distortion in an MRI only based radiotherapy workflow for prostate

NASA Astrophysics Data System (ADS)

Gustafsson, C.; Nordström, F.; Persson, E.; Brynolfsson, J.; Olsson, L. E.

2017-04-01

Dosimetric errors in a magnetic resonance imaging (MRI) only radiotherapy workflow may be caused by system specific geometric distortion from MRI. The aim of this study was to evaluate the impact on planned dose distribution and delineated structures for prostate patients, originating from this distortion. A method was developed, in which computer tomography (CT) images were distorted using the MRI distortion field. The displacement map for an optimized MRI treatment planning sequence was measured using a dedicated phantom in a 3 T MRI system. To simulate the distortion aspects of a synthetic CT (electron density derived from MR images), the displacement map was applied to CT images, referred to as distorted CT images. A volumetric modulated arc prostate treatment plan was applied to the original CT and the distorted CT, creating a reference and a distorted CT dose distribution. By applying the inverse of the displacement map to the distorted CT dose distribution, a dose distribution in the same geometry as the original CT images was created. For 10 prostate cancer patients, the dose difference between the reference dose distribution and inverse distorted CT dose distribution was analyzed in isodose level bins. The mean magnitude of the geometric distortion was 1.97 mm for the radial distance of 200-250 mm from isocenter. The mean percentage dose differences for all isodose level bins, were  ⩽0.02% and the radiotherapy structure mean volume deviations were  <0.2%. The method developed can quantify the dosimetric effects of MRI system specific distortion in a prostate MRI only radiotherapy workflow, separated from dosimetric effects originating from synthetic CT generation. No clinically relevant dose difference or structure deformation was found when 3D distortion correction and high acquisition bandwidth was used. The method could be used for any MRI sequence together with any anatomy of interest.

Assessment of dosimetric impact of system specific geometric distortion in an MRI only based radiotherapy workflow for prostate.

PubMed

Gustafsson, C; Nordström, F; Persson, E; Brynolfsson, J; Olsson, L E

2017-04-21

Dosimetric errors in a magnetic resonance imaging (MRI) only radiotherapy workflow may be caused by system specific geometric distortion from MRI. The aim of this study was to evaluate the impact on planned dose distribution and delineated structures for prostate patients, originating from this distortion. A method was developed, in which computer tomography (CT) images were distorted using the MRI distortion field. The displacement map for an optimized MRI treatment planning sequence was measured using a dedicated phantom in a 3 T MRI system. To simulate the distortion aspects of a synthetic CT (electron density derived from MR images), the displacement map was applied to CT images, referred to as distorted CT images. A volumetric modulated arc prostate treatment plan was applied to the original CT and the distorted CT, creating a reference and a distorted CT dose distribution. By applying the inverse of the displacement map to the distorted CT dose distribution, a dose distribution in the same geometry as the original CT images was created. For 10 prostate cancer patients, the dose difference between the reference dose distribution and inverse distorted CT dose distribution was analyzed in isodose level bins. The mean magnitude of the geometric distortion was 1.97 mm for the radial distance of 200-250 mm from isocenter. The mean percentage dose differences for all isodose level bins, were  ⩽0.02% and the radiotherapy structure mean volume deviations were  <0.2%. The method developed can quantify the dosimetric effects of MRI system specific distortion in a prostate MRI only radiotherapy workflow, separated from dosimetric effects originating from synthetic CT generation. No clinically relevant dose difference or structure deformation was found when 3D distortion correction and high acquisition bandwidth was used. The method could be used for any MRI sequence together with any anatomy of interest.

Structure and Stability of Carboxylate Complexes. 20. Diaqua Bis(methoxyacetato) Complexes of Nickel(II), Copper(II), and Zinc(II): A Structural Study of the Dynamic Pseudo-Jahn-Teller Effect.

PubMed

Prout, Keith; Edwards, Alison; Mtetwa, Victor; Murray, Jon; Saunders, John F.; Rossotti, Francis J. C.

1997-06-18

The crystal structure of trans-diaquabis(methoxyacetato)copper(II), C(6)H(14)O(8)Cu, has been determined by neutron diffraction at 4.2 K (monoclinic, P2(1)/n, a = 6.88(1), b = 7.19(1), c = 9.77(2) Å, gamma = 95.7(1) degrees, (Z = 2)) and by X-ray diffraction at 125, 165, 205, 240, 265, 295, and 325 K. These measurements show that there is no phase change in the temperature range 4.2-325 K. The copper(II) coordination at 4.2 K is a tetragonally distorted elongated rhombic octahedron (Cu-OOC 1.955(1), Cu-OMe 2.209(1), and Cu-OH(2) 2.031(2) Å). As the temperature increases to 325 K, the Cu-OOC bonds shorten slightly to 1.934(5) Å, the Cu-OMe bonds shorten more markedly to 2.137(4) Å, and Cu-OH(2) lengthens to 2.155(6) Å to give a tetragonally distorted compressed rhombic octahedron. For comparison the structure of the isomorphous nickel(II) complex (monoclinic, P2(1)/n, a = 6.633(1), b = 7.192(1), c = 10.016(2) Å, gamma = 98.30(2) degrees, (Z = 2)) has been redetermined at 295 K and the structure of the analogous zinc(II) complex (orthorhombic, F2dd, a = 7.530(1), b = 13.212(1), c = 21.876(2) Å (Z = 8)) has also been determined. The nickel(II) complex has an almost regular trans (centrosymmetric) octahedral coordination (Ni-OOC 2.022(1), Ni-OMe 2.043(1), and Ni-OH(2) 2.077(2) Å). However, zinc(II) has a very distorted octahedral coordination with the zinc atom on a 2-fold axis with the water molecules and the methoxy ligators cis and the carboxylate ligators trans (Zn-OOC 1.985(1), Zn-OMe 2.304(2), and Zn-OH(2) 2.038(2) Å). The variation in the dimensions of the copper(II) coordination sphere is discussed in terms of static (low temperature) and planar dynamic (high temperature) pseudo-Jahn-Teller effects.

SU-F-E-02: A Feasibility Study for Application of Metal Artifact Reduction Techniques in MR-Guided Brachytherapy Gynecological Cancer with Titanium Applicators

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kadbi, M

Purpose: Utilization of Titanium Tandem and Ring (T&R) applicators in MR-guided brachytherapy has become widespread for gynecological cancer treatment. However, Titanium causes magnetic field disturbance and susceptibility artifact, which complicate image interpretation. In this study, metal artifact reduction techniques were employed to improve the image quality and reduce the metal related artifacts. Methods: Several techniques were employed to reduce the metal artifact caused by titanium T&R applicator. These techniques include Metal Artifact Reduction Sequence (MARS), View Angle Tilting (VAT) to correct in-plane distortion, and Slice Encoding for Metal Artifact Correction (SEMAC) for through-plane artifact correction. Moreover, MARS can be combinedmore » with VAT to further reduce the in-plane artifact by reapplying the selection gradients during the readout (MARS+VAT). SEMAC uses a slice selective excitation but acquires additional z-encodings in order to resolve off-resonant signal and to reduce through-plane distortions. Results: Comparison between the clinical sequences revealed that increasing the bandwidth reduces the error in measured diameter of T&R. However, the error is larger than 4mm for the best case with highest bandwidth and spatial resolution. MARS+VAT with isotropic resolution of 1mm reduced the error to 1.9mm which is the least among the examined 2D sequences. The measured diameter of tandem from SEMAC+VAT has the closest value to the actual diameter of tandem (3.2mm) and the error was reduced to less than 1mm. In addition, SEMAC+VAT significantly reduces the blooming artifact in the ring compared to clinical sequences. Conclusion: A higher bandwidth and spatial resolution sequence reduces the artifact and diameter of applicator with a slight compromise in SNR. Metal artifact reduction sequences decrease the distortion associated with titanium applicator. SEMAC+VAT sequence in combination with VAT revealed promising results for titanium imaging and can be utilized for MR-guided brachytherapy in gynecological cancer. The author is employee with Philips Healthcare.« less

Borderline features are associated with inaccurate trait self-estimations.

PubMed

Morey, Leslie C

2014-01-01

Many treatments for Borderline Personality Disorder (BPD) are based upon the hypothesis that gross distortion in perceptions and attributions related to self and others represent a core mechanism for the enduring difficulties displayed by such patients. However, available experimental evidence of such distortions provides equivocal results, with some studies suggesting that BPD is related to inaccuracy in such perceptions and others indicative of enhanced accuracy in some judgments. The current study uses a novel methodology to explore whether individuals with BPD features are less accurate in estimating their levels of universal personality characteristics as compared to community norms. One hundred and four students received course instruction on the Five Factor Model of personality, and then were asked to estimate their levels of these five traits relative to community norms. They then completed the NEO-Five Factor Inventory and the Personality Assessment Inventory-Borderline Features scale (PAI-BOR). Accuracy of estimates was calculated by computing squared differences between self-estimated trait levels and norm-referenced standardized scores in the NEO-FFI. There was a moderately strong relationship between PAI-BOR score and inaccuracy of trait level estimates. In particular, high BOR individuals dramatically overestimated their levels of Agreeableness and Conscientiousness, estimating themselves to be slightly above average on each of these characteristics but actually scoring well below average on both. The accuracy of estimates of levels of Neuroticism were unrelated to BOR scores, despite the fact that BOR scores were highly correlated with Neuroticism. These findings support the hypothesis that a key feature of BPD involves marked perceptual distortions of various aspects of self in relationship to others. However, the results also indicate that this is not a global perceptual deficit, as high BOR scorers accurately estimated that their emotional responsiveness was well above average. However, such individuals appear to have limited insight into their relative disadvantages in the capacity for cooperative relationships, or their limited ability to approach life in a planful and non-impulsive manner. Such results suggest important targets for treatments addressing problems in self-other representations.

Image Registration to Compensate for EPI Distortion in Patients with Brain Tumors: An Evaluation of Tract-Specific Effects.

PubMed

Albi, Angela; Meola, Antonio; Zhang, Fan; Kahali, Pegah; Rigolo, Laura; Tax, Chantal M W; Ciris, Pelin Aksit; Essayed, Walid I; Unadkat, Prashin; Norton, Isaiah; Rathi, Yogesh; Olubiyi, Olutayo; Golby, Alexandra J; O'Donnell, Lauren J

2018-03-01

Diffusion magnetic resonance imaging (dMRI) provides preoperative maps of neurosurgical patients' white matter tracts, but these maps suffer from echo-planar imaging (EPI) distortions caused by magnetic field inhomogeneities. In clinical neurosurgical planning, these distortions are generally not corrected and thus contribute to the uncertainty of fiber tracking. Multiple image processing pipelines have been proposed for image-registration-based EPI distortion correction in healthy subjects. In this article, we perform the first comparison of such pipelines in neurosurgical patient data. Five pipelines were tested in a retrospective clinical dMRI dataset of 9 patients with brain tumors. Pipelines differed in the choice of fixed and moving images and the similarity metric for image registration. Distortions were measured in two important tracts for neurosurgery, the arcuate fasciculus and corticospinal tracts. Significant differences in distortion estimates were found across processing pipelines. The most successful pipeline used dMRI baseline and T2-weighted images as inputs for distortion correction. This pipeline gave the most consistent distortion estimates across image resolutions and brain hemispheres. Quantitative results of mean tract distortions on the order of 1-2 mm are in line with other recent studies, supporting the potential need for distortion correction in neurosurgical planning. Novel results include significantly higher distortion estimates in the tumor hemisphere and greater effect of image resolution choice on results in the tumor hemisphere. Overall, this study demonstrates possible pitfalls and indicates that care should be taken when implementing EPI distortion correction in clinical settings. Copyright © 2018 by the American Society of Neuroimaging.

Correction of amplitude-phase distortion for polarimetric active radar calibrator

NASA Astrophysics Data System (ADS)

Lin, Jianzhi; Li, Weixing; Zhang, Yue; Chen, Zengping

2015-01-01

The polarimetric active radar calibrator (PARC) is extensively used as an external test target for system distortion compensation and polarimetric calibration for the high-resolution polarimetric radar. However, the signal undergoes distortion in the PARC, affecting the effectiveness of the compensation and the calibration. The system distortion compensation resulting from the distortion of the amplitude and phase in the PARC was analyzed based on the "method of paired echoes." Then the correction method was proposed, which separated the ideal signals from the distorted signals. Experiments were carried on real radar data, and the experimental results were in good agreement with the theoretical analysis. After the correction, the PARC can be better used as an external test target for the system distortion compensation.

Limited distortion in LSB steganography

NASA Astrophysics Data System (ADS)

Kim, Younhee; Duric, Zoran; Richards, Dana

2006-02-01

It is well known that all information hiding methods that modify the least significant bits introduce distortions into the cover objects. Those distortions have been utilized by steganalysis algorithms to detect that the objects had been modified. It has been proposed that only coefficients whose modification does not introduce large distortions should be used for embedding. In this paper we propose an effcient algorithm for information hiding in the LSBs of JPEG coefficients. Our algorithm uses parity coding to choose the coefficients whose modifications introduce minimal additional distortion. We derive the expected value of the additional distortion as a function of the message length and the probability distribution of the JPEG quantization errors of cover images. Our experiments show close agreement between the theoretical prediction and the actual additional distortion.

Experimental Study on 340GHz Wave Material Penetration Attenuation Properties

DTIC Science & Technology

2015-07-01

wave penetrate materials, detailed are foam with dimension 52.6cm×61.6cm×0.4cm, paper dimension 52.6cm×61.6cm×0.4cm, wood board 52.6cm×66.0cm×0.42cm...paper box 52.6cm×61.6cm×0.01cm, and 8cm thickness sofa chair, 14cm human body chest, 21cm cement wall, are shown in Fig. 5. As the 0.34THz wave...insertion) comparison shown in Tab. 2, we get the foam has minimum penetration attenuation about 0.3dB, due to its low dielectric constant and tangent

14-Meth­oxy-4,6-dimethyl-9-phenyl-8,12-dioxa-4,6-di­aza­tetra­cyclo­[8.8.0.02,7.013,18]octa­deca-2(7),13,15,17-tetra­ene-3,5,11-trione

PubMed Central

Jagadeesan, G; Jayashree, S.; Kannan, D.; Bakthadoss, M.; Aravindhan, S.

2013-01-01

The title compound, C23H20N2O6, crystallizes with two mol­ecules in the asymmetric unit in which the dihedral angles between the mean planes of the pyran and phenyl rings are 66.6 (1) and 61.9 (1) °. The fused pyrone and pyran rings each adopts a sofa conformation. In the crystal, C—H⋯O hydrogen bonds link the mol­ecules, forming a two-dimensional network parallel to [001]. PMID:24109298

14-Eth­oxy-4,6-dimethyl-9-phenyl-8,12-dioxa-4,6-diaza­tetra­cyclo­[8.8.0.02,7.013,18]octa­deca-2(7),13,15,17-tetra­ene-3,5,11-trione

PubMed Central

Jagadeesan, G.; Kannan, D.; Bakthadoss, M.; Aravindhan, S.

2013-01-01

In the title compound, C23H20N2O6, the fused pyrone and pyran rings each adopt a sofa conformation. The dihedral angle between the mean planes of the pyran and phenyl rings is 61.9 (1)°. In the crystal, mol­ecules are linked by two pairs of C—H⋯O hydrogen bonds, forming dimers. These dimers are linked via a third C—H⋯O hydrogen bond, forming a two-dimensional network parallel to (10-2). PMID:23476462

Cognitive distortions as a component and treatment focus of pathological gambling: a review.

PubMed

Fortune, Erica E; Goodie, Adam S

2012-06-01

The literature on the role of cognitive distortions in the understanding and treatment of pathological gambling (PG) is reviewed, with sections focusing on (a) conceptual underpinnings of cognitive distortions, (b) cognitive distortions related to PG, (c) PG therapies that target cognitive distortions, (d) methodological factors and outcome variations, and (e) conclusions and prescriptive recommendations. The conceptual background for distortions related to PG lies in the program of heuristics and biases (Kahneman & Tversky, 1974) as well as other errors identified in basic psychology. The literature has focused on distortions arising from the representativeness heuristic (gambler's fallacy, overconfidence, and trends in number picking), the availability heuristic (illusory correlation, other individuals' wins, and inherent memory bias), and other sources (the illusion of control and double switching). Some therapies have incorporated cognitive restructuring within broader cognitive-behavioral therapies, with success. Other therapies have focused more narrowly on correcting distorted beliefs, more often with limited success. It is concluded that the literature establishes the role of cognitive distortions in PG and suggests therapies with particularly good promise, but is in need of further enrichment.

System performance enhancement with pre-distorted OOFDM signal waveforms in DM/DD systems.

PubMed

Sánchez, C; Ortega, B; Capmany, J

2014-03-24

In this work we propose a pre-distortion technique for the mitigation of the nonlinear distortion present in directly modulated/detected OOFDM systems and explore the system performance achieved under varying system parameters. Simulation results show that the proposed pre-distortion technique efficiently mitigates the nonlinear distortion, achieving transmission information rates around 40 Gbits/s and 18.5 Gbits/s over 40 km and 100 km of single mode fiber links, respectively, under optimum operating conditions. Moreover, the proposed pre-distortion technique can potentially provide higher system performance to that obtained with nonlinear equalization at the receiver.

On relative distortion in fingerprint comparison.

PubMed

Kalka, Nathan D; Hicklin, R Austin

2014-11-01

When fingerprints are deposited, non-uniform pressure in conjunction with the inherent elasticity of friction ridge skin often causes linear and non-linear distortions in the ridge and valley structure. The effects of these distortions must be considered during analysis of fingerprint images. Even when individual prints are not notably distorted, relative distortion between two prints can have a serious impact on comparison. In this paper we discuss several metrics for quantifying and visualizing linear and non-linear fingerprint deformations, and software tools to assist examiners in accounting for distortion in fingerprint comparisons. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

ARTICULATION OF SPEECH SOUNDS OF SERBIAN LANGUAGE IN CHILDREN AGED SIX TO EIGHT.

PubMed

Mihajlović, Biljana; Cvjetićanin, Bojana; Veselinović, Mila; Škrbić, Renata; Mitrović, Slobodan M

2015-01-01

Phonetic and phonological system of the healthy members of one linguistic community is fully formed around 8 yedrs of age. The auditory and articulatory habits are established with age and tend to be more difficult to be upgraded and completed later. The research was done as a cross-sectional study, conducted at the preschool institution "Radosno detinjstvo" and primary school "Branko Radičević" in Novi Sad. It included 66 children of both genders, aged 6 to 8. The quality of articulation was determined according to the Global Articulation Test by working with each child individually. In each individual vowel, plosive, nasal, lateral and fricative, the quality of articulation was statistically significantly better in the first graders compared to the preschool children (p<0.01). In each affricate, except for the sound /ć/, the quality of articulation was statistically significantly better in the first graders than in the preschool children (p<0.01). The quality of articulation of all speech sounds was statistically significantly better in the first graders than in the preschool children (p<0.01). The most common disorder of articulation is distortion, while only substitution and substitution associated with distortion are less common. Omission does not occur in children from 6 to 8 years of age. Girls have slightly better quality of articulation. The articulatory disorders are more common in preschool children than in children who are in the first grade of primary school. The most commonly mispronounced sounds belong to the group of affricates and fricatives.

Determination of Fermi contour and spin polarization of ν = 3 2 composite fermions via ballistic commensurability measurements

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kamburov, D.; Mueed, M. A.; Jo, I.

2014-12-01

We report ballistic transport commensurability minima in the magnetoresistance of nu = 3/2 composite fermions (CFs). The CFs are formed in high-quality two-dimensional electron systems confined to wide GaAs quantum wells and subjected to an in-plane, unidirectional periodic potential modulation. We observe a slight asymmetry of the CF commensurability positions with respect to nu = 3/2, which we explain quantitatively by comparing three CF density models and concluding that the nu = 3/2 CFs are likely formed by the minority carriers in the upper energy spin state of the lowest Landau level. Our data also allow us to probe themore » shape and size of the CF Fermi contour. At a fixed electron density of similar or equal to 1.8x10(11) cm(-2), as the quantum well width increases from 30 to 60 nm, the CFs show increasing spin polarization. We attribute this to the enhancement of the Zeeman energy relative to the Coulomb energy in wider wells where the latter is softened because of the larger electron layer thickness. The application of an additional parallel magnetic field (B-parallel to) leads to a significant distortion of the CF Fermi contour as B-parallel to couples to the CFs' out-of-plane orbital motion. The distortion is much more severe compared to the nu = 1/2 CF case at comparable B-parallel to. Moreover, the applied B-parallel to further spin-polarizes the nu = 3/2 CFs as deduced from the positions of the commensurability minima.« less

Crystal structure of trans-di­fluoridotetra­kis(pyridine-κN)chromium(III) tri­chlorido­(pyridine-κN)zincate monohydrate from synchrotron data

PubMed Central

Moon, Dohyun; Choi, Jong-Ha

2014-01-01

In the asymmetric unit of the title compound, [CrF2(C5H5N)4][ZnCl3(C5H5N)]·H2O, there are two independent complex cations, one tri­chlorido­(pyridine-κN)zincate anion and one solvent water mol­ecule. The cations lie on inversion centers. The CrIII ions are coordinated by four pyridine (py) N atoms in the equatorial plane and two F atoms in a trans axial arrangement, displaying a slightly distorted octa­hedral geometry. The Cr—N(py) bond lengths are in the range 2.0873 (14) to 2.0926 (17) Å while the Cr—F bond lengths are 1.8609 (10) and 1.8645 (10) Å. The [ZnCl3(C5H5N)]− anion has a distorted tetra­hedral geometry. The Cl atoms of the anion were refined as disordered over two sets of sites in a 0.631 (9):0.369 (9) ratio. In the crystal, two anions and two water mol­ecules are linked via O—H⋯Cl hydrogen bonds, forming centrosymmetric aggregates. In addition, weak C—H⋯Cl, C—H⋯π and π–π stacking inter­actions [centroid–centroid distances = 3.712 (2) and 3.780 (2)Å] link the components of the structure into a three-dimensional network. PMID:25484725

The power spectrum of galaxies in the 2dF 100k redshift survey

NASA Astrophysics Data System (ADS)

Tegmark, Max; Hamilton, Andrew J. S.; Xu, Yongzhong

2002-10-01

We compute the real-space power spectrum and the redshift-space distortions of galaxies in the 2dF 100k galaxy redshift survey using pseudo-Karhunen-Loève eigenmodes and the stochastic bias formalism. Our results agree well with those published by the 2dFGRS team, and have the added advantage of producing easy-to-interpret uncorrelated minimum-variance measurements of the galaxy-galaxy, galaxy-velocity and velocity-velocity power spectra in 27 k-bands, with narrow and well-behaved window functions in the range 0.01 h Mpc-1 < k < 0.8 h Mpc-1. We find no significant detection of baryonic wiggles, although our results are consistent with a standard flat ΩΛ= 0.7`concordance' model and previous tantalizing hints of baryonic oscillations. We measure the galaxy-matter correlation coefficient r > 0.4 and the redshift-distortion parameter β= 0.49 +/- 0.16 for r= 1 (β= 0.47 +/- 0.16 without finger-of-god compression). Since this is an apparent-magnitude limited sample, luminosity-dependent bias may cause a slight red-tilt in the power spectrum. A battery of systematic error tests indicate that the survey is not only impressive in size, but also unusually clean, free of systematic errors at the level to which our tests are sensitive. Our measurements and window functions are available at http://www.hep.upenn.edu/~max/2df.html together with the survey mask, radial selection function and uniform subsample of the survey that we have constructed.

Tidal reorientation and the fracturing of Jupiter's moon Europa

USGS Publications Warehouse

McEwen, A.S.

1986-01-01

The most striking characteristic of Europa is the network of long linear albedo markings over the surface, suggestive of global-scale tectonic processes. Various explanations for the fractures have been proposed: Freezing and expansion of an early liquid water ocean1, planetary expansion due to dehydration of hydrated silicates2, localization by weak points in the crust generated by impacts3, and a combination of stresses due to planetary volume change and tidal distortions from orbital recession and orbital eccentricity4,5. Calculations by Yoder6 and Greenberg and Weidenschilling7 have shown that Europa may rotate slightly more rapidly than the synchronous rate, with a rotation period (reorientation through 360??) ranging from 20 to >103 yr if a liquid mantle is present, or up to 1010 yr if the satellite is essentially solid7. Helfen-stein and Parmentier8 modelled the stresses due to nonsynchronous rotation, and concluded that this could explain the long fractures in part of the anti-jovian hemisphere. In this note, I present a global map of lineaments with long arc lengths (>20?? or 550 km), and compare the lineament orientations to the tensile stress trajectories due to tidal distortions (changes in the lengths of three principal semiaxes) and to nonsynchronous rotation (longitudinal reorientation of two of the principal semiaxes). An excellent orthogonal fit to the lineaments is achieved by the stresses due to nonsynchronous rotation with the axis radial to Jupiter located 25?? east of its present position. This fit suggests that nonsynchronous rotation occurred at some time in Europa's history. ?? 1986 Nature Publishing Group.

Holographic measurement of distortion during laser melting: Additive distortion from overlapping pulses

NASA Astrophysics Data System (ADS)

Haglund, Peter; Frostevarg, Jan; Powell, John; Eriksson, Ingemar; Kaplan, Alexander F. H.

2018-03-01

Laser - material interactions such as welding, heat treatment and thermal bending generate thermal gradients which give rise to thermal stresses and strains which often result in a permanent distortion of the heated object. This paper investigates the thermal distortion response which results from pulsed laser surface melting of a stainless steel sheet. Pulsed holography has been used to accurately monitor, in real time, the out-of-plane distortion of stainless steel samples melted on one face by with both single and multiple laser pulses. It has been shown that surface melting by additional laser pulses increases the out of plane distortion of the sample without significantly increasing the melt depth. The distortion differences between the primary pulse and subsequent pulses has also been analysed for fully and partially overlapping laser pulses.

The prevalence of cognitive distortion in depressed adolescents.

PubMed

Marton, P; Kutcher, S

1995-01-01

This study examined the prevalence of cognitive distortion in depressed adolescents. Ninety-four consecutive depressed adolescent psychiatric outpatients were administered the Beck Depression Inventory, the Dysfunctional Attitude Scale, the Interpersonal Dependency Inventory and the Maudsley Personality Inventory. Depressed patients who scored above a threshold for cognitive distortion were compared to those who fell below the threshold. Of the depressed patients, 47.4% were found to meet the severity criteria for cognitive distortion, while the remaining 52.6% were found to be below the severity threshold. Cognitive distortion was associated with more severe symptoms of depression, lack of social self confidence and greater introversion. These results do not support the hypothesis that cognitive distortion is universal in clinical depression. However, they do suggest that cognitive distortion is associated with more severe depression.

The prevalence of cognitive distortion in depressed adolescents.

PubMed Central

Marton, P; Kutcher, S

1995-01-01

This study examined the prevalence of cognitive distortion in depressed adolescents. Ninety-four consecutive depressed adolescent psychiatric outpatients were administered the Beck Depression Inventory, the Dysfunctional Attitude Scale, the Interpersonal Dependency Inventory and the Maudsley Personality Inventory. Depressed patients who scored above a threshold for cognitive distortion were compared to those who fell below the threshold. Of the depressed patients, 47.4% were found to meet the severity criteria for cognitive distortion, while the remaining 52.6% were found to be below the severity threshold. Cognitive distortion was associated with more severe symptoms of depression, lack of social self confidence and greater introversion. These results do not support the hypothesis that cognitive distortion is universal in clinical depression. However, they do suggest that cognitive distortion is associated with more severe depression. PMID:7865499

Summary of investigations of engine response to distorted inlet conditions

NASA Technical Reports Server (NTRS)

Biesiadny, T. J.; Braithwaite, W. M.; Soeder, R. H.; Abdelwahab, M.

1986-01-01

A survey is presented of experimental and analytical experience of the NASA Lewis Research Center in engine response to inlet temperature and pressure distortions. This includes a description of the hardware and techniques employed, and a summary of the highlights of experimental investigations and analytical modeling. Distortion devices successfully simulated inlet distortion, and knowledge was gained about compression system response to different types of distortion. A list of NASA research references is included.

Monitoring carboplatin ototoxicity with distortion-product otoacoustic emissions in children with retinoblastoma

PubMed Central

Bhagat, Shaum P.; Bass, Johnnie K.; White, Stephanie T.; Qaddoumi, Ibrahim; Wilson, Matthew W.; Wu, Jianrong; Rodriguez-Galindo, Carlos

2016-01-01

Objective Carboplatin is a common chemotherapy agent with potential ototoxic side effects that is used to treat a variety of pediatric cancers, including retinoblastoma. Retinoblastoma is a malignant tumor of the retina that is usually diagnosed in young children. Distortion-product otoacoustic emission tests offer an effective method of monitoring for ototoxicity in young children. This study was designed to compare measurements of distortion-product otoacoustic emissions obtained before and after several courses of carboplatin chemotherapy in order to examine if (a) mean distortion-product otoacoustic emission levels were significantly different; and (b) if criterion reductions in distortion-product otoacoustic emission levels were observed in individual children. Methods A prospective repeated measures study. Ten children with a median age of 7.6 months (range, 3–72 months) diagnosed with unilateral or bilateral retinoblastoma were examined. Distortion-product otoacoustic emissions were acquired from both ears of the children with 65/55 dB SPL primary tones (f2= 793–7996 Hz) and a frequency resolution of 3 points/octave. Distortion-product otoacoustic emission levels in dB SPL were measured before chemotherapy treatment (baseline measurement) and after 3–4 courses of chemotherapy (interim measurement). Comparisons were made between baseline and interim distortion-product otoacoustic emission levels (collapsed across ears). Evidence of ototoxicity was based on criterion reductions (≥ 6 dB) in distortion-product otoacoustic emission levels. Results Significant differences between baseline and interim mean distortion-product otoacoustic emission levels were only observed at f2=7996 Hz. Four children exhibited criterion reductions in distortion-product otoacoustic emission levels. Conclusions Mean distortion-product otoacoustic emission levels at most frequencies were not changed following 3–4 courses of carboplatin chemotherapy in children with retinoblastoma. However, on an individual basis, children receiving higher doses of carboplatin exhibited criterion reductions in distortion-product otoacoustic emission level at several frequencies. These findings suggest that higher doses of carboplatin affect outer hair cell function, and distortion-product otoacoustic emission tests can provide useful information when monitoring children at risk of developing carboplatin ototoxicity. PMID:20667604

Effect of spatial inlet temperature and pressure distortion on turbofan engine stability

NASA Technical Reports Server (NTRS)

Mehalic, Charles M.

1988-01-01

The effects of circumferential and radial inlet temperature distortion, circumferential pressure distortion, and combined temperature and pressure distortion on the stability of an advanced turbofan engine were investigated experimentally at simulated altitude conditions. With circumferential and radial inlet temperature distortion, a flow instability generated by the fan operating near stall caused the high-pressure compressor to surge at, or near, the same time as the fan. The effect of combined distortion was dependent on the relative location of the high-temperature and low-pressure regions; high-pressure compressor stalls occurred when the regions coincided, and fan stalls occurred with the regions separated.

Circumferential distortion modeling of the TF30-P-3 compression system

NASA Technical Reports Server (NTRS)

Mazzawy, R. S.; Banks, G. A.

1977-01-01

Circumferential inlet pressure and temperature distortion testing of the TF30 P-3 turbofan engine was conducted. The compressor system at the test conditions run was modelled according to a multiple segment parallel compressor model. Aspects of engine operation and distortion configuration modelled include the effects of compressor bleeds, relative pressure-temperature distortion alignment and circumferential distortion extent. Model predictions for limiting distortion amplitudes and flow distributions within the compression system were compared with test results in order to evaluate predicted trends. Relatively good agreement was obtained. The model also identified the low pressure compressor as the stall-initiating component, which was in agreement with the data.

Spline function approximation techniques for image geometric distortion representation. [for registration of multitemporal remote sensor imagery

NASA Technical Reports Server (NTRS)

Anuta, P. E.

1975-01-01

Least squares approximation techniques were developed for use in computer aided correction of spatial image distortions for registration of multitemporal remote sensor imagery. Polynomials were first used to define image distortion over the entire two dimensional image space. Spline functions were then investigated to determine if the combination of lower order polynomials could approximate a higher order distortion with less computational difficulty. Algorithms for generating approximating functions were developed and applied to the description of image distortion in aircraft multispectral scanner imagery. Other applications of the techniques were suggested for earth resources data processing areas other than geometric distortion representation.

Application-Driven No-Reference Quality Assessment for Dermoscopy Images With Multiple Distortions.

PubMed

Xie, Fengying; Lu, Yanan; Bovik, Alan C; Jiang, Zhiguo; Meng, Rusong

2016-06-01

Dermoscopy images often suffer from blur and uneven illumination distortions that occur during acquisition, which can adversely influence consequent automatic image analysis results on potential lesion objects. The purpose of this paper is to deploy an algorithm that can automatically assess the quality of dermoscopy images. Such an algorithm could be used to direct image recapture or correction. We describe an application-driven no-reference image quality assessment (IQA) model for dermoscopy images affected by possibly multiple distortions. For this purpose, we created a multiple distortion dataset of dermoscopy images impaired by varying degrees of blur and uneven illumination. The basis of this model is two single distortion IQA metrics that are sensitive to blur and uneven illumination, respectively. The outputs of these two metrics are combined to predict the quality of multiply distorted dermoscopy images using a fuzzy neural network. Unlike traditional IQA algorithms, which use human subjective score as ground truth, here ground truth is driven by the application, and generated according to the degree of influence of the distortions on lesion analysis. The experimental results reveal that the proposed model delivers accurate and stable quality prediction results for dermoscopy images impaired by multiple distortions. The proposed model is effective for quality assessment of multiple distorted dermoscopy images. An application-driven concept for IQA is introduced, and at the same time, a solution framework for the IQA of multiple distortions is proposed.

Ubiquitous Log Odds: A Common Representation of Probability and Frequency Distortion in Perception, Action, and Cognition

PubMed Central

Zhang, Hang; Maloney, Laurence T.

2012-01-01

In decision from experience, the source of probability information affects how probability is distorted in the decision task. Understanding how and why probability is distorted is a key issue in understanding the peculiar character of experience-based decision. We consider how probability information is used not just in decision-making but also in a wide variety of cognitive, perceptual, and motor tasks. Very similar patterns of distortion of probability/frequency information have been found in visual frequency estimation, frequency estimation based on memory, signal detection theory, and in the use of probability information in decision-making under risk and uncertainty. We show that distortion of probability in all cases is well captured as linear transformations of the log odds of frequency and/or probability, a model with a slope parameter, and an intercept parameter. We then consider how task and experience influence these two parameters and the resulting distortion of probability. We review how the probability distortions change in systematic ways with task and report three experiments on frequency distortion where the distortions change systematically in the same task. We found that the slope of frequency distortions decreases with the sample size, which is echoed by findings in decision from experience. We review previous models of the representation of uncertainty and find that none can account for the empirical findings. PMID:22294978