3,012 research outputs found
Electron scattering states at solid surfaces calculated with realistic potentials
Scattering states with LEED asymptotics are calculated for a general
non-muffin tin potential, as e.g. for a pseudopotential with a suitable barrier
and image potential part. The latter applies especially to the case of low
lying conduction bands. The wave function is described with a reciprocal
lattice representation parallel to the surface and a discretization of the real
space perpendicular to the surface. The Schroedinger equation leads to a system
of linear one-dimensional equations. The asymptotic boundary value problem is
confined via the quantum transmitting boundary method to a finite interval. The
solutions are obtained basing on a multigrid technique which yields a fast and
reliable algorithm. The influence of the boundary conditions, the accuracy and
the rate of convergence with several solvers are discussed. The resulting
charge densities are investigated.Comment: 5 pages, 4 figures, copyright and acknowledgment added, typos etc.
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Chromosome mapping: radiation hybrid data and stochastic spin models
This work approaches human chromosome mapping by developing algorithms for
ordering markers associated with radiation hybrid data. Motivated by recent
work of Boehnke et al. [1], we formulate the ordering problem by developing
stochastic spin models to search for minimum-break marker configurations. As a
particular application, the methods developed are applied to 14 human
chromosome-21 markers tested by Cox et al. [2]. The methods generate
configurations consistent with the best found by others. Additionally, we find
that the set of low-lying configurations is described by a Markov-like ordering
probability distribution. The distribution displays cluster correlations
reflecting closely linked loci.Comment: 26 Pages, uuencoded LaTex, Submitted to Phys. Rev. E,
[email protected], [email protected]
Billiard Systems in Three Dimensions: The Boundary Integral Equation and the Trace Formula
We derive semiclassical contributions of periodic orbits from a boundary
integral equation for three-dimensional billiard systems. We use an iterative
method that keeps track of the composition of the stability matrix and the
Maslov index as an orbit is traversed. Results are given for isolated periodic
orbits and rotationally invariant families of periodic orbits in axially
symmetric billiard systems. A practical method for determining the stability
matrix and the Maslov index is described.Comment: LaTeX, 19 page
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Protocol-directed sedation versus non-protocol-directed sedation to reduce duration of mechanical ventilation in mechanically ventilated intensive care patients
Background
The sedation needs of critically ill patients have been recognized as a core component of critical care and meeting these is vital to assist recovery and ensure humane treatment. There is growing evidence to suggest that sedation requirements are not always optimally managed. Sub-optimal sedation incorporates both under- and over-sedation and has been linked to both short-term (e.g. length of stay) and long-term (e.g. psychological recovery) outcomes. Various strategies have been proposed to improve sedation management and address aspects of assessment as well as delivery of sedation.
Objectives
To assess the effects of protocol-directed sedation management on the duration of mechanical ventilation and other relevant patient outcomes in mechanically ventilated intensive care unit (ICU) patients. We looked at various outcomes and examined the role of bias in order to examine the level of evidence for this intervention.
Search methods
We searched the Cochrane Central Register of Controlled trials (CENTRAL) (2013; Issue 11), MEDLINE (OvidSP) (1990 to November 2013), EMBASE (OvidSP) (1990 to November 2013), CINAHL (BIREME host) (1990 to November 2013), Database of Abstracts of Reviews of Effects (DARE) (1990 to November 2013), LILACS (1990 to November 2013), Current Controlled Trials and US National Institutes of Health Clinical Research Studies (1990 to November 2013), and reference lists of articles. We re-ran the search in October 2014. We will deal with any studies of interest when we update the review.
Selection criteria
We included randomized controlled trials (RCTs) conducted in adult ICUs comparing management with and without protocol-directed sedation.
Data collection and analysis
Two authors screened the titles and abstracts and then the full-text reports identified from our electronic search. We assessed seven domains of potential risk of bias for the included studies. We examined the clinical, methodological and statistical heterogeneity and used the random-effects model for meta-analysis where we considered it appropriate. We calculated the mean difference (MD) for duration of mechanical ventilation and risk ratio (RR) for mortality across studies, with 95% confidence intervals (CI).
Main results
We identified two eligible studies with 633 participants. Both included studies compared the use of protocol-directed sedation, specifically protocols delivered by nurses, with usual care. We rated the risk of selection bias due to random sequence generation low for one study and unclear for one study. The risk of selection bias related to allocation concealment was low for both studies. We also assessed detection and attrition bias as low for both studies while we considered performance bias high due to the inability to blind participants and clinicians in both studies. Risk due to other sources of bias, such as potential for contamination between groups and reporting bias, was considered unclear. There was no clear evidence of differences in duration of mechanical ventilation (MD -5.74 hours, 95% CI -62.01 to 50.53, low quality evidence), ICU length of stay (MD -0.62 days, 95% CI -2.97 to 1.73) and hospital length of stay (MD -3.78 days, 95% CI -8.54 to 0.97) between people being managed with protocol-directed sedation versus usual care. Similarly, there was no clear evidence of difference in hospital mortality between the two groups (RR 0.96, 95% CI 0.71 to 1.31, low quality evidence). ICU mortality was only reported in one study preventing pooling of data. There was no clear evidence of difference in the incidence of tracheostomy (RR 0.77, 95% CI 0.31 to 1.89). The studies reported few adverse event outcomes; one study reported self extubation while the other study reported re-intubation; given this difference in outcomes, pooling of data was not possible. There was significant heterogeneity between studies for duration of mechanical ventilation (I2 = 86%, P value = 0.008), ICU length of stay (I2 = 82%, P value = 0.02) and incidence of tracheostomy (I2 = 76%, P value = 0.04), with one study finding a reduction in duration of mechanical ventilation and incidence of tracheostomy and the other study finding no difference.
Authors' conclusions
There is currently insufficient evidence to evaluate the effectiveness of protocol-directed sedation. Results from the two RCTs were conflicting, resulting in the quality of the body of evidence as a whole being assessed as low. Further studies, taking into account contextual and clinician characteristics in different ICU environments, are necessary to inform future practice. Methodological strategies to reduce the risk of bias need to be considered in future studies
The ethics of inherent trust in care robots for the elderly
The way elderly care is delivered is changing. Attempts are being made to accommodate the increasing number of elderly, and the decline in the number of people available to care for them, with care robots. This change introduces ethical issues into robotics and healthcare. The two-part study (heuristic evaluation and survey) reported here examines a phenomenon which is a result of that
change. The phenomenon rises out of a contradiction. All but 2 (who were undecided) of the 12 elderly survey respondents, out of the total of 102 respondents, wanted to be able to change how the presented care robot made decisions and 7 of those 12 elderly wanted to be able to examine its decision making process so
as to ensure the care provided is personalized. However, at the same time, 34% of the elderly participants said they were willing to trust the care robot inherently, compared to only 16% of the participants who were under fifty. Additionally, 66% of the elderly respondents said they were very likely or likely to accept and
use such a care robot in their everyday lives. The contradiction of inherent trust and simultaneous wariness about control gives rise to the phenomenon: elderly in need want control over their care to ensure it is personalized, but many may desperately take any help they can get. The possible causes, and ethical implications,
of this phenomenon are the focus of this paper
Testing QCD with Hypothetical Tau Leptons
We construct new tests of perturbative QCD by considering a hypothetical tau
lepton of arbitrary mass, which decays hadronically through the electromagnetic
current. We can explicitly compute its hadronic width ratio directly as an
integral over the e^+ e^- annihilation cross section ratio, R_{e^+e^-}.
Furthermore, we can design a set of commensurate scale relations and
perturbative QCD tests by varying the weight function away from the form
associated with the V-A decay of the physical tau. This method allows the wide
range of the R_{e^+e^-} data to be used as a probe of perturbative QCD.Comment: 4 pages, 4 figure
Flow cytometric maturity score as a novel prognostic parameter in patients with acute myeloid leukemia
The European LeukemiaNet (ELN) classification is widely accepted for risk stratification of patients with acute myeloid leukemia (AML). In order to establish immunophenotypic features that predict prognosis, the expression of single AML blast cell antigens has been evaluated with partly conflicting results; however, the influence of immunophenotypic blast maturity is largely unknown. In our study, 300 AML patients diagnosed at our institution between January 2003 and April 2012 were analyzed. A flow cytometric maturity score was developed in order to distinguish "mature" AML (AML-ma) from "immature" AML (AML-im) by quantitative expression levels of early progenitor cell antigens (CD34, CD117, and TdT). AML-ma showed significantly longer relapse-free survival (RFS) and overall survival (OS) than AML-im (pâ<â0.001). Interestingly, statistically significant differences in RFS and OS were maintained within the "intermediate-risk" group according to ELN (RFS, 7.0Â years (AML-ma) vs. 3.3Â years (AML-im); pâ=â0.002; OS, 5.1Â years (AML-ma) vs. 3.0Â years (AML-im); pâ=â0.022). Our novel flow cytometric score easily determines AML blast maturity and can predict clinical outcome. It remains to be clarified whether these results simply reflect an accumulation of favorable molecular phenotypes in the AML-ma subgroup or whether they rely on biological differences such as a higher proportion of leukemia stem cells and/or a higher degree of genetic instability within the AML-im subgroup
Quantum transport and momentum conserving dephasing
We study numerically the influence of momentum-conserving dephasing on the
transport in a disordered chain of scatterers. Loss of phase memory is caused
by coupling the transport channels to dephasing reservoirs. In contrast to
previously used models, the dephasing reservoirs are linked to the transport
channels between the scatterers, and momentum conserving dephasing can be
investigated. Our setup provides a model for nanosystems exhibiting conductance
quantization at higher temperatures in spite of the presence of phononic
interaction. We are able to confirm numerically some theoretical predictions.Comment: 7 pages, 4 figure
Ultrasound-evoked immediate early gene expression in the brainstem of the Chinese torrent frog, Odorrana tormota
The concave-eared torrent frog, Odorrana tormota, has evolved the extraordinary ability to communicate ultrasonically (i.e., using frequencies > 20 kHz), and electrophysiological experiments have demonstrated that neurons in the frogâs midbrain (torus semicircularis) respond to frequencies up to 34 kHz. However, at this time, it is unclear which region(s) of the torus and what other brainstem nuclei are involved in the detection of ultrasound. To gain insight into the anatomical substrate of ultrasound detection, we mapped expression of the activity-dependent gene, egr-1, in the brain in response to a full-spectrum mating call, a filtered, ultrasound-only call, and no sound. We found that the ultrasound-only call elicited egr-1 expression in the superior olivary and principal nucleus of the torus semicircularis. In sampled areas of the principal nucleus, the ultrasound-only call tended to evoke higher egr-1 expression than the full-spectrum call and, in the center of the nucleus, induced significantly higher egr-1 levels than the no-sound control. In the superior olivary nucleus, the full-spectrum and ultrasound-only calls evoked similar levels of expression that were significantly greater than the control, and egr-1 induction in the laminar nucleus showed no evidence of acoustic modulation. These data suggest that the sampled areas of the principal nucleus are among the regions sensitive to ultrasound in this species
A Missense Variant in the Bardet-Biedl Syndrome 2 Gene (BBS2) Leads to a Novel Syndromic Retinal Degeneration in the Shetland Sheepdog
Canine progressive retinal atrophy (PRA) describes a group of hereditary diseases characterized by photoreceptor cell death in the retina, leading to visual impairment. Despite the identification of multiple PRA-causing variants, extensive heterogeneity of PRA is observed across and within dog breeds, with many still genetically unsolved. This study sought to elucidate the causal variant for a distinct form of PRA in the Shetland sheepdog, using a whole-genome sequencing approach. Filtering variants from a single PRA-affected Shetland sheepdog genome compared to 176 genomes of other breeds identified a single nucleotide variant in exon 11 of the BardetâBiedl syndrome-2 gene (BBS2) (c.1222G>C; p.Ala408Pro). Genotyping 1386 canids of 155 dog breeds, 15 cross breeds and 8 wolves indicated the c.1222G>C variant was only segregated within Shetland sheepdogs. Out of 505 Shetland sheepdogs, seven were homozygous for the variant. Clinical history and photographs for three homozygotes indicated the presence of a novel phenotype. In addition to PRA, additional clinical features in homozygous dogs support the discovery of a novel syndromic PRA in the breed. The development and utilization of a diagnostic DNA test aim to prevent the mutation from becoming more prevalent in the breed
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