Point-of-care measurement of blood lactate in children admitted with febrile illness to an African District Hospital.

BACKGROUND: Lactic acidosis is a consistent predictor of mortality owing to severe infectious disease, but its detection in low-income settings is limited to the clinical sign of "deep breathing" because of the lack of accessible technology for its measurement. We evaluated the use of a point-of-care (POC) diagnostic device for blood lactate measurement to assess the severity of illness in children admitted to a district hospital in Tanzania. METHODS: Children between the ages of 2 months and 13 years with a history of fever were enrolled in the study during a period of 1 year. A full clinical history and examination were undertaken, and blood was collected for culture, microscopy, complete blood cell count, and POC measurement of blood lactate and glucose. RESULTS: The study included 3248 children, of whom 164 (5.0%) died; 45 (27.4%) of these had raised levels of blood lactate (>5 mmol/L) but no deep breathing. Compared with mortality in children with lactate levels of ≤ 3 mmol/L, the unadjusted odds of dying were 1.6 (95% confidence interval [CI].8-3.0), 3.4 (95% CI, 1.5-7.5), and 8.9 (95% CI, 4.7-16.8) in children with blood lactate levels of 3.1-5.0, 5.1-8.0, or >8.0 mmol/L, respectively. The prevalence of raised lactate levels (>5 mmol/L) was greater in children with malaria than in children with nonmalarial febrile illness (P < .001) although the associated mortality was greater in slide-negative children. CONCLUSIONS: POC lactate measurement can contribute to the assessment of children admitted to hospital with febrile illness and can also create an opportunity for more hospitals in resource-poor settings to participate in clinical trials of interventions to reduce mortality associated with hyperlactatemia

Polarization dependent photoionization cross-sections and radiative lifetimes of atomic states in Ba

The photoionization cross-sections of two even-parity excited states, $5d6d ^3D_1$ and $6s7d ^3D_{2}$, of atomic Ba at the ionization-laser wavelength of 556.6 nm were measured. We found that the total cross-section depends on the relative polarization of the atoms and the ionization-laser light. With density-matrix algebra, we show that, in general, there are at most three parameters in the photoionization cross-section. Some of these parameters are determined in this work. We also present the measurement of the radiative lifetime of five even-parity excited states of barium.Comment: 11 pages, 7 figure

Hyperfine-interaction- and magnetic-field-induced Bose-Einstein-statistics suppressed two-photon transitions

Two-photon transitions between atomic states of total electronic angular momentum $J_a=0$ and $J_b=1$ are forbidden when the photons are of the same energy. This selection rule is analogous to the Landau-Yang theorem in particle physics that forbids decays of vector particle into two photons. It arises because it is impossible to construct a total angular momentum $J_{2\gamma}=1$ quantum-mechanical state of two photons that is permutation symmetric, as required by Bose-Einstein statistics. In atoms with non-zero nuclear spin, the selection rule can be violated due to hyperfine interactions. Two distinct mechanisms responsible for the hyperfine-induced two-photon transitions are identified, and the hyperfine structure of the induced transitions is evaluated. The selection rule is also relaxed, even for zero-nuclear-spin atoms, by application of an external magnetic field. Once again, there are two similar mechanisms at play: Zeeman splitting of the intermediate-state sublevels, and off-diagonal mixing of states with different total electronic angular momentum in the final state. The present theoretical treatment is relevant to the ongoing experimental search for a possible Bose-Einstein-statistics violation using two-photon transitions in barium, where the hyperfine-induced transitions have been recently observed, and the magnetic-field-induced transitions are being considered both as a possible systematic effect, and as a way to calibrate the measurement

Multibreather and vortex breather stability in Klein--Gordon lattices: Equivalence between two different approaches

In this work, we revisit the question of stability of multibreather configurations, i.e., discrete breathers with multiple excited sites at the anti-continuum limit of uncoupled oscillators. We present two methods that yield quantitative predictions about the Floquet multipliers of the linear stability analysis around such exponentially localized in space, time-periodic orbits, based on the Aubry band method and the MacKay effective Hamiltonian method and prove that their conclusions are equivalent. Subsequently, we showcase the usefulness of the methods by a series of case examples including one-dimensional multi-breathers, and two-dimensional vortex breathers in the case of a lattice of linearly coupled oscillators with the Morse potential and in that of the discrete $\phi^4$ model

Unusually large polarizabilities and "new" atomic states in Ba

Electric polarizabilities of four low-J even-parity states and three low-J odd-parity states of atomic barium in the range $35,600$ to $36,000\ $cm$^{-1}$are investigated. The states of interest are excited (in an atomic beam) via an intermediate odd-parity state with a sequence of two laser pulses. The odd-parity states can be excited due to the Stark-induced mixing with even-parity states. The polarizabilities are measured via direct spectroscopy on the second-stage transition. Several states have tensor and scalar polarizabilities that exceed the values that might be expected from the known energy levels of barium by more than two orders of magnitude. Two of the Stark-induced transitions cannot be identified from the known energy spectrum of barium. The observations suggest the existence of as yet unidentified odd-parity energy states, whose energies and angular momenta are determined in the present experiment. A tentative identification of these states as [Xe]$6s8p ^3P_{0,2}$ is suggested.Comment: 29 pages, 12 figure

Business Communication Students Appraisal Of Selected Communication Competencies

The purpose of this study was to determine business communication students perception of selected business communication competencies. Students enrolled in business communication classes at Texas A&amp;M University-Commerce from the summer of 2006 until the spring 2007 were survey. Students were asked to evaluate each of the listed 44 competencies. The two competencies that ranked the highest were Spells Correctly, and Understands the Importance of Business Relationships