The evaluation of base deficit as the predictive agent of mortality in geriatric trauma

زمینه و هدف: کمبود باز (Base deficit) به عنوان یک عامل مرتبط با کاهش پرفیوژن نسجی مخفی شناخته شده است، لیکن نقطه بحرانی مؤثر در ایجاد این حالت و مرگ و میر به دنبال تروما تعیین نشده است. در این مطالعه ارزش پیشگویی کننده کمبود باز در مرگ و میر و نقطه برش آن در افراد سالمند مورد بررسی قرار گرفت. روش بررسی: در یک مطالعه تحلیلی - آینده نگر 300 بیمار سالمند (سن بالاتر یا مساوی 65 سال) مبتلا به تروما در مرکز پزشکی الزهراء (س) دانشگاه علوم پزشکی اصفهان مورد بررسی قرار گرفتند. از هر بیمار گازهای خونی آنالیز شده و مقدار کمبود باز محاسبه گردید و عوامل مؤثر در تغییرات کمبود باز مورد ارزیابی قرار گرفت. وضعیت بیماران تا زمان ترخیص و یا مرگ پیگیری شد و عوامل مؤثر در مرگ بیماران نیز مورد بررسی قرار گرفت. جهت تجزیه و تحلیل داده ها از محاسبه رگرسیون استفاده شد. یافته ها: نتایج این مطالعه نشان داد که در افراد سالمند مبتلا به تروما و علائم حیاتی پایدار، کمبود باز تنها عامل پیشگویی کننده مرگ می باشد (01/0

Measurement of the photon and thermal neutron doses of contralateral breast surface in breast cancer radiotherapy

Introduction and purpose:During the radiation therapy of tumoral breast, the contralateral breast (CB) will receive scattered doses. In the present study, the photon and thermal neutron dose values received by CB surface during breast cancer radiation therapy were measured.Materials and methods:The right breast region of RANDO phantom was considered as CB, and the measurements of photon and thermal neutron dose values were carried out on this region surface. The phantom was irradiated with 18 MV photon beams, and the dose values were measured with thermoluminescent dosimeter (TLD-600 and TLD-700) chips for 11 � 13, 11 � 17 and 11 � 21 cm2 field sizes in the presence of physical and dynamic wedges.Results:The total dose values (photon + thermal neutron) received by the CB surface in the presence of physical wedge were 12·06, 15·75 and 33·40 of the prescribed dose, respectively, for 11 � 13, 11 � 17 and 11 � 21 cm2 field sizes. The corresponding dose values for dynamic wedge were 9·18, 12·92 and 29·26 of the prescribed dose, respectively. Moreover, the results showed that treatment field size and wedge type affect the received photon and thermal neutron doses at CB surface.Conclusion:According to our results, the total dose values received at CB surface during breast cancer radiotherapy with high-energy photon beams are remarkable. In addition, the dose values received at CB surface when using a physical wedge were greater than when using a dynamic wedge, especially for medial tangential fields. © Cambridge University Press 2019

Clinical application of ceramics in anterior cervical discectomy and fusion: A review and update

Study Design: Narrative review. Objectives: Anterior cervical discectomy and fusion (ACDF) is a reliable procedure, commonly used for cervical degenerative disc disease. For interbody fusions, autograft was the gold standard for decades; however, limited availability and donor site morbidities have led to a constant search for new materials. Clinically, it has been shown that calcium phosphate ceramics, including hydroxyapatite (HA) and tricalcium phosphate (TCP), are effective as osteoconductive materials and bone grafts. In this review, we present the current findings regarding the use of ceramics in ACDF. Methods: A review of the relevant literature examining the clinical use of ceramics in anterior cervical discectomy and fusion procedures was conducted using PubMed, OVID and Cochrane. Result: HA, coralline HA, sandwiched HA, TCP, and biphasic calcium phosphate ceramics were used in combination with osteoinductive materials such as bone marrow aspirate and various cages composed of poly-ether-ether-ketone (PEEK), fiber carbon, and titanium. Stand-alone ceramic spacers have been associated with fracture and cracks. Metallic cages such as titanium endure the risk of subsidence and migration. PEEK cages in combination with ceramics were shown to be a suitable substitute for autograft. Conclusion: None of the discussed options has demonstrated clear superiority over others, although direct comparisons are often difficult due to discrepancies in data collection and study methodologies. Future randomized clinical trials are warranted before definitive conclusions can be drawn. © The Author(s) 2017

Behavior of Braced Sheetpile Excavation in Detroit Clay

This paper presents the design criteria, finite element modeling and actual behavior of a braced sheetpile excavation in Detroit soft clay. Due to the close proximity of existing structures to the excavation, a detailed analysis was performed to design and construct an earth retention system to avoid damage to these structures. The excavation involved a 170 ft by 220 ft area. The maximum depth of excavation was 23.5 ft. The subsurface soil consists of soft to very soft Detroit clay from the excavation level to a depth of 80 ft and has an undrained shear strength as low as 360 psf

Effect of TiO2-ZnO/GAC on by-product distribution of CVOCs decomposition in a NTP-assisted catalysis system

In this study, the catalytic effect of TiO2-ZnO/GAC coupled with non-thermal plasma was investigated on the byproducts distribution of decomposition of chlorinated VOCs in gas streams. The effect of specific input energy, and initial gas composition was examined in a corona discharge reactor energized by a high frequency pulsed power supply. Detected by-products for catalytic NTP at 750 J L-1 included CO, CO2, Cl2, trichloroacetaldehyde, as well as trichlorobenzaldehyde with chloroform feeding, while they were dominated by CO, CO2, and lower abundance of trichlorobenzaldehyde and Cl2 with chlorobenzene introduction. Some of the by-products such as O3, NO, NO2, and COCl2 disappeared totally over TiO2-ZnO/GAC. Furthermore, the amount of heavy products such as trichlorobenzaldehyde decreased significantly in favor of small molecules such as CO, CO2, and Cl2 with the hybrid process. The selectivity towards COx soared up to 77 over the catalyst at 750 J L-1 and 100 ppm of chlorobenzene. © by Farshid Ghorbani-Shahna 2015

Performance of a Semi-Rigid Braced Excavation in Soft Clay

Construction of a 21-foot wide, 28-foot deep braced excavation in Detroit soft clays has been completed. In order to protect an existing 50-year old tunnel adjacent to the excavation, a semi-rigid, tangent wall earth retention system was constructed to minimize the soil movements. The tangent wall was formed by 118 drilled piers with 42-inch in diameter and 41-foot long. The maximum soil lateral and vertical movements adjacent to the excavation were controlled below a magnitude of 2.0 inches, while bottom of the excavation experienced about 3 inches of heave. This paper presents the design considerations and construction performance of the retention system based on geotechnical instrumentation data. Prediction of maximum soil lateral movement based on a finite element analysis and a semi-empirical method conformed well with field measurements. Experience learned from the design and construction will be valuable for future construction of braced excavation systems in similar soil conditions

Excited-State Solvation Structure of Transition Metal Complexes from Molecular Dynamics Simulations and Assessment of Partial Atomic Charge Methods

In this work, we investigate the excited-state solute and solvation structure of $\mathrm{[Ru(bpy)_3]^{2+}}$, $\mathrm{[Fe(bpy)_3]^{2+}}$, $\mathrm{[Fe(bmip)_2]^{2+}}$ and $\mathrm{[Cu(phen)_2]^{+}}$ (bpy=2,2'-pyridine; bmip=2,6-bis(3-methyl-imidazole-1-ylidine)-pyridine; phen=1,10-phenanthroline) transition metal complexes (TMCs) in terms of solute-solvent radial distribution functions (RDFs) and evaluate the performance of some of the most popular partial atomic charge (PAC) methods for obtaining these RDFs by molecular dynamics (MD) simulations. To this end, we compare classical MD of a frozen solute in water and acetonitrile (ACN) with quantum mechanics/molecular mechanics Born-Oppenheimer molecular dynamics (QM/MM BOMD) simulations. The calculated RDFs show that the choice of a suitable PAC method is dependent on the coordination number of the metal, denticity of the ligands, and type of solvent. It is found that this selection is less sensitive for water than ACN. Furthermore, a careful choice of the PAC method should be considered for TMCs that exhibit a free direct coordination site, such as $\mathrm{[Cu(phen)_2]^{+}}$. The results of this work show that fast classical MD simulations with ChelpG/RESP or CM5 PACs can produce RDFs close to those obtained by QM/MM MD and thus, provide reliable solvation structures of TMCs to be used, e.g. in the analysis of scattering data

Effect of human chorionic gonadotropin on sexual maturation, sex steroids and thyroid hormone levels in Caspian lamprey (Caspiomyzon wagneri Kessler, 1870)

The objective of this study was to determine the effect of human chorionic gonadotropin (hCG) on sexual maturation, plasma sex steroids [17β-estradiol, (E2) and 17α-hydroxy progesterone (17α_OHP)] and thyroid hormones (triiodothyronine, T3 and thyroxin, T4) levels in upstream - migrating Caspian lamprey. During the experiment, 36 fish (24 females and 12 males) in spring 2013 and 36 fish (24 females and 12 males) in fall 2013 were collected from the Shirud River estuary in Mazandaran Province, the Southern Caspian Sea during their upstream migration to the freshwater. All fish were injected with hCG at the doses of 1000, 1500 and 2000 IU.kg BW-1. The injection was a two - step process (50% of hormone in each step) by 12 h interval. After the first injection, fish were retained in the cages in the river beds and 24 hours after the second injection, fish were checked for egg and sperm release after mild abdomen pressure. Blood samples were taken for determining sex steroid levels. Results showed that hCG hormone injections caused increase in migration of germinal vesicle in the oocyte of female and sperm release in males. Significant differences were found in the serum E2 and 17α-OHP levels in hCG - injected fish compared to the control. However, no significant differences were found in serum T3 and T4 levels in the hCG -injected fish. According to the results, the appropriate hCG dosage to induce the reproduction acceleration in Caspian lamprey is 1500-2000 IU.kg BW-1

Prognostic factors for esophageal squamous cell Carcinoma-A Population-Based study in Golestan province, Iran, a high incidence area

Golestan Province in northern Iran is an area with a high incidence of esophageal squamous cell carcinoma (ESCC). We aimed to investigate prognostic factors for ESCC and survival of cases in Golestan, on which little data were available. We followed-up 426 ESCC cases participating in a population-based case-control study. Data were analyzed using the Kaplan-Meier method and the Cox proportional hazard models. Median survival was 7 months. Age at diagnosis was inversely associated with survival, but the association was disappeared with adjustment for treatment. Residing in urban areas (hazard ratio, HR = 0.70; 95 CI 0.54-0.90) and being of non-Turkmen ethnic groups (HR = 0.76; 95 CI 0.61-0.96) were associated with better prognosis. In contrast to other types of tobacco use, nass (a smokeless tobacco product) chewing was associated with a slightly poorer prognosis even in models adjusted for other factors including stage of disease and treatment (HR = 1.38; 95 CI 0.99-1.92). Opium use was associated with poorer prognosis in crude analyses but not in adjusted models. Almost all of potentially curative treatments were associated with longer survival. Prognosis of ESCC in Golestan is very poor. Easier access to treatment facilities may improve the prognosis of ESCC in Golestan. The observed association between nass chewing and poorer prognosis needs further investigations; this association may suggest a possible role for ingestion of nass constituents in prognosis of ESCC. © 2011 Aghcheli et al

Spectroscopy for asymmetric binary black hole mergers

We study Bayesian inference of black hole ringdown modes for simulated binary black hole signals. We consider to what extent different fundamental ringdown modes can be identified in the context of black hole spectroscopy. Our simulated signals are inspired by the high mass event GW190521. We find strong correlation between mass ratio and Bayes factors of the subdominant ringdown modes. The Bayes factor values and time dependency, and the peak time of the (3,3,0) mode align with those found analysing the real event GW190521, particularly for high-mass ratio systems.Comment: 11 pages, 6 figures, 2 table