Fat contamination of pericardial suction blood and its influence on in vitro capillary-pore flow properties in patients undergoing routine coronary artery bypass grafting

AbstractObjective: Neurologic dysfunction after cardiopulmonary bypass might be due to arterial microembolization. Pericardial suction blood is a possible source of embolic material. Our aim was to determine the capillary-pore flow ability of pericardial suction blood. Methods: Pericardial suction blood from patients undergoing coronary bypass was collected, and pericardial suction blood and venous blood were sampled at the end of cardiopulmonary bypass and before reinfusion of pericardial suction blood. Pericardial suction blood was (n = 10) or was not (n = 10) prefiltered through a 30-μm cardiotomy screen filter before capillary in vitro analysis. Additionally, in 8 patients the plasma viscosity was measured, and in 5 of these patients, pericardial suction blood capillary deposits were evaluated by using a microscopy-imprint method and fat staining. Capillary flow was tested through 5-μm pore membranes. Tested components were plasma, plasma-eliminated whole-blood resuspension, and leukocyte/plasma-eliminated erythrocyte resuspension. Initial filtration rate and clogging slope expressed the blood-to-capillary interaction. Results: The plasma-flow profile of pericardial suction blood was highly impaired, with a 47% reduction in initial filtration rate (P <.001) and a 142% steeper clogging slope flow deceleration (P <.01). This difference was not due to a change in pericardial suction blood viscosity, such as by free hemoglobin, which corresponded to 5.7% of the erythrocytes. There were no differences in resuspended whole blood or erythrocytes. The cardiotomy filter had no effect. Microscopy suggested the presence of capillary fat deposits in pericardial suction blood that were not seen with venous plasma (P <.05). The pericardial suction blood volume was 458 ± 42 mL and contained 95.6 ± 9.3 g/L hemoglobin. Conclusions: The pericardial suction blood plasma capillary flow function was highly impaired by liquid fat. Pericardial suction blood hemoglobin appears worth recovering after fat removal, despite profound hemolysis.J Thorac Cardiovasc Surg 2002;124:377-8

PULSE-the park for people of all kinds : a design proposal for "Selma's park-the park of the future"

Göteborgs stad utlyste den 1 december 2015 en allmän tävling för gestaltningen av ”Selmas park - Framtidens park” i stadsdelen Backa. Tävlingsuppgiften bestod av att arbeta fram en grundidé för hela Selmas park och ett mer detaljerat förslag för den södra delen av parken. Syftet med tävlingen var att generera förslag som var nytänkande, väl gestaltade och har en utvecklingspotential. I tävlingsprogrammet för tävlingen fanns också ett flertal programönskemål som förslagen förväntades uppfylla. Syftet med den här kandidatuppsatsen är att utarbeta ett gestaltningsförslag för “Selmas park- Framtidens park” och möta de önskemål som presenteras i tävlingsprogrammet. Backa är ett av Göteborgs prioriterade utbyggnadsområden där Selmas park är en del av den förtätning som stadsdelen står inför. Den nya kvartersstrukturen med små bostadsgårdar innebär ett ökat tryck på den befintliga grönstrukturen vilket ställer höga krav på gestaltningen av den nya parken. Bebyggelsen kommer att inhysa bostäder, idrottshus och verksamheter i bottenplan som ansluter till ett nytt torgstråk. En av utmaningarna var att sammankoppla torgstråket med tävlingsområdet. Förarbetet fram till färdig gestaltning har till stor del bestått av att studera det tävlingsprogram och medföljande bilagor som tillhandahölls tävlingsdeltagarna. Sammanställning av informationen som hämtas från dokumenten kompletterades med ett platsbesök. Resultatet av sammanställningen blev underlag för inventeringen och analyserna. Under gestaltningsprocessen utfördes en idégenererande övning, flera skisser och en litteraturundersökning vilket slutligen landade i ett förslag. Uppsatsen presenterar det förslag som lämnades in till tävlingen för ”Selmas park - Framtidens park”. Förslaget blev Puls - parken för folk av alla slag. Parken är öppen för alla att uttrycka sig i och delta i olika aktiviteter. Aktiviteterna varierar i intensitet längs med hela parkstråket. Från lugna aktiviteter i naturlik miljö till ytor för sport och lek. gestaltningsförslaget speglar det gamla Backa samtidigt som den möter det nya Backa. En park med liv och rörelse, en park med puls.The city of Gothenburg, announced the 1st of December 2015 a public architectural competition for ”Selma's park-The park of the Future” in the district Backa. The assignment was to develop a basic idea for the entire Selma's park and a more detailed proposal for the southern part of the park. The objective of the competition was to generate proposals that was innovative, well designed and that had a development potential. In the program for the competition there was also a number of requests that the proposals was expected to fulfill. The objective of this bachelor thesis has been to develop a design proposal for ”Selma's park-The park of the Future” and to meet the requests that are presented in the program for the competition. Backa is one of Gothenburg’s prioritized development areas where Selma's park is a part of the densification that the district is facing. The new grid with small yards implies that the pressure will increase on the existing green structure which means that the design of the park needs to be of high standard. The buildings will contain accommodations, an athletic center and businesses in the ground level that will connect to a market street. One of the challenges has been to connect the market street to the competition area. A big part of the preparatory work leading up to this proposal has consisted of examining the program of the competition with its following attachments that was provided to the contestants. A site visit was conducted as a supplement to the gathered information that was retrieved from the documents. The result of the combined information became the foundation to the inventory and analyses. During the design process an exercise to generate ideas was conducted, multiple sketches and a literature research which eventually resulted in a design proposal. The paper presents a design proposal that we handed in to the competition for ”Selma's park-The park of the Future”. The design proposal was PULSE-the park for people of all kinds. The park is open for all to express themselves in and to participate in a variety of activities. The intensity of the activites varies through out the park. From calm actvities in nature like environments to areas for sports and playing. We have attempted to design a park that reflects the old Backa and faces the new Backa. A park with life and movement, a park with a pulse

Productivity in relation to organization of a surgical department : a retrospective observational study

Background Responsible and efficient resource utilization are important factors in healthcare. The aim of this study was to investigate how total case time differs between two differently organized surgical departments. Methods This is a retrospective observational study of a cohort of patients undergoing elective surgery for breast cancer or malignant melanoma in a university hospital setting in Sweden. All patients were operated on by the same set of surgeons but in two different surgical departments: a general surgery (GS) and a cardiothoracic (CT) surgery department. Patients were selected to the two departments from a waiting list in the order of referral for surgery. The effect of being operated on at the CT department compared to the GS department was estimated by linear regression. Results The final study cohort comprised 349 patients in the GS department and 177 patients in the CT department. Both groups were similar regarding surgical procedures, American Society of Anesthesiologists' score, body mass index, age, sex, and the skill level of the operating surgeon. These covariates were included in the linear regression model. The total case time, defined by the Procedural Time Glossary as room set-up start to room clean-up finish, was significantly shorter for the patients who underwent a surgical procedure at the CT department compared to the GS department, even after adjusting for the background characteristics of the patients and surgeon. After adjusting for the selected covariates, the average difference in total case time between the two departments was - 30.67 min (p = 0.001). Conclusions A significantly shorter total case time was measured for operations in the CT department. Plausible explanations may be more beneficial organizational factors, such as staffing ratio, skill mix in the operating room team, and working behavioral aspects regarding resource utilization.Peer reviewe

Hamnen möter

Sverige har ett av de största ekologiska fotavtrycken i världen, per capita (WWF 2016a). En av de främsta faktorerna är expansionen av den globala marknaden (Naturvårdsverket 2016b) som har gjort det möjligt för städer att växa oberoende av dess omland (Granvik 2012, s. 114). Istället tas en stor andel utländska markarealer i anspråk för att producera det som vi konsumerar i Sverige. En stor del av det som importeras från omvärlden går dock att producera lokalt vilket skulle minska vår negativa miljöpåverkan (Naturvårdsverket 2010). Landskapsarkitekten har sedan yrket uppstod jobbat med hållbarhetsfrågor (Bergquist & Hedfors 2016, s.1) och har en viktig roll i arbetet mot en framtid där vi lever i ett resilient samhälle (SLU 2016). I praktiken tas dock endast ett fåtal aspekter kring hållbarhet i beaktning vilket resulterar i ett fragmenterat landskap med svaga kopplingar och isolerade funktioner. Genom att applicera ett systemtänk i dagens planering kan landskap kopplas samman och stärka varandra (Granvik & Hedfors 2015). I detta examensarbete valde vi att fördjupa oss kring ämnet hållbar utveckling genom att använda oss av designkriterier för regenerativa systemlandskap. Sju designkriterier har tagits fram med syftet att guida landskapsarkitekter i design av hållbara miljöer (Bergquist & Hedfors 2016). Hållbarhetsbegreppet kompletteras med regenerativitet som betonar vikten av design som återställer och förbättrar miljömässiga och mänskliga resurser och deras kapacitet att växa över tid. Systemlandskap syftar på en platsspecifik enhet och pekar på komplexiteten och sammankopplingar mellan landskap på flera skalor av samhället och miljön. Ett systemtänk kan leda till regenerativa lösningar som bidrar till hållbara systemlandskap där medveten design av interaktionen mellan människa och miljö bygger upp och förstärker ekosystemen (Bergquist & Hedfors 2016, s.1) Vi valde att tillämpa designkriterierna i en gestaltning av stadsbyggnadsprojektet Norrtälje hamn. Norrtälje hamn valdes utifrån författarnas lokalkännedom och projektets aktualitet. Uppsatsen visar en första tillämpning av designkriterierna i praktiken. Arbetet visar hur designkriterierna tillämpas i Norrtälje hamn genom de programpunkter som vi utgår från i gestaltningen. Programpunkterna togs fram med hjälp av en litteraturundersökning som gav en kunskapsbas kring designkriterierna, en inventering av Norrtälje hamn med omnejd samt analyser av Norrtälje hamn. Förslaget som togs fram för Norrtälje hamn fick namnet Hamnen möter, landet, havet, staden. Gestaltningen syftar till att ge plats åt och förstärka regenerativa processer i Norrtälje hamn genom en platsspecifik design som tillvaratar de resurser som finns och skapar förutsättningar för nya. I detta arbete har vi använt ett systemtänk som fått oss att utvidga vår uppfattning av landskapet. Vi kommer att ha användning av detta sätt att tänka där vi sätter människan som en del av ekosystemet med möjlighet att bidra till regenerativa processer.Sweden has one of the largest ecological footprints, per capita, in the world, (WWF 2016a). One of the main reasons why we are able to consume such a great amount of resources is the expansion of the global market (Naturvårdsverket 2016b). This has enabled cities to grow without correlation to the land that surrounds them (Granvik 2012, s. 114). Instead we claim a large proportion of foreign land to produce what we consume in Sweden. However, a large part of what is imported from around the world can be produced locally, which would reduce our negative environmental impact (Swedish Environmental Protection Agency 2010). Sustainability has been a recurring subject for landscape architects since the discipline emerged (Bergquist & Hedfors 2016). As landscape architects we have an important role in working towards a future where we live in a resilient society and the opportunity to shape our surroundings for the better (SLU 2016). But still most landscape architects practice only a few aspects of sustainability resulting in a fragmented landscape with weak links and isolated functions. By applying a systems thinking in today's planning, landscapes can be merged and strengthened (Granvik & Hedfors 2015). In this thesis, we chose to deepen our knowledge regarding sustainable development by using design criteria for regenerative systems landscape. Seven design criteria have been developed for the purpose of guiding landscape architects in the design of sustainable environments (Bergquist & Hedfors 2016). The concept of sustainability is complemented with regenerativity which emphasizes the importance of a design that restores and improves environmental and human resources and their capacity to regenerate over time. Systems landscape refers to a site-specific unit and points out the complexity and interactions between landscapes at multiple scales of society and the environment. A systems thinking can lead to regenerative solutions that contribute to sustainable systems landscape where conscious design of interaction between human and environment regenerates and strengthens ecosystems (Bergquist & Hedfors 2016, p.1) We chose to apply the design criteria for regenerative systems landscape in a design proposal for the urban development in Norrtälje harbor. Norrtälje harbor was chosen due to the local knowledge that the author's posses and because it is an ongoing project with the ambition to work towards sustainable development. The essay shows a first application of the design criteria. The thesis shows how the design criterias are applied in Norrtälje harbor by creating a program from which we based our design. The program was presented with a literature review that provided a knowledge base of the design criterias, an inventory of Norrtälje harbor with surrounding areas as well as analyzes of Norrtälje harbor. The proposal for Norrtälje harbor was named The harbor meets, country, sea, city. The aim is to enable space and reinforce regenerative processes in Norrtälje harbor through a site-specific design which utilizes the resources available and creates the conditions for new ones to generate

Molecular structures and vibrations of neutral and anionic CuOx (x = 1-3,6) clusters

We report equilibrium geometric structures of CuO2, CuO3, CuO6, and CuO clusters obtained by an all-electron linear combination of atomic orbitals scheme within the density-functional theory with generalized gradient approximation to describe the exchange-correlation effects. The vibrational stability of all clusters is examined on the basis of the vibrational frequencies. A structure with Cs symmetry is found to be the lowest-energy structure for CuO2, while a -shaped structure with C2v symmetry is the most stable structure for CuO3. For the larger CuO6 and CuO clusters, several competitive structures exist with structures containing ozonide units being higher in energy than those with O2 units. The infrared and Raman spectra are calculated for the stable optimal geometries. ~Comment: Uses Revtex4, (Better quality figures can be obtained from authors

Факторы риска развития синдрома вегетативных дисфункций и признаков дисплазии соединительной ткани

СОЕДИНИТЕЛЬНОЙ ТКАНИ БОЛЕЗНИФАКТОРЫ РИСКАНЕРВНОЙ СИСТЕМЫ ВЕГЕТАТИВНОЙ ДИСФУНКЦИЯ НАСЛЕДСТВЕННАЯНЕРВНОЙ СИСТЕМЫ ВЕГЕТАТИВНОЙ БОЛЕЗНИДЕТЕЙ ОХРАНЫ ЗДОРОВЬЯ СЛУЖБ