427 research outputs found
Resistance of superconducting nanowires connected to normal metal leads
We study experimentally the low temperature resistance of superconducting
nanowires connected to normal metal reservoirs. We find that a substantial
fraction of the nanowires is resistive, down to the lowest temperature
measured, indicative of an intrinsic boundary resistance due to the
Andreev-conversion of normal current to supercurrent. The results are
successfully analyzed in terms of the kinetic equations for diffusive
superconductors
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The Legitimacy and Effectiveness of Law & Governance in a World of Multilevel Jurisdiction
Proximity effects in the superconductor / heavy fermion bilayer system Nb / CeCu_6
We have investigated the proximity effect between a superconductor (Nb) and a
'Heavy Fermion' system (CeCu_6) by measuring critical temperatures and
parallel critical fields H_{c2}^{\parallel}(T) of Nb films with varying
thickness deposited on 75 nm thick films of CeCu_6, and comparing the results
with the behavior of similar films deposited on the normal metal Cu. For Nb on
CeCu_6 we find a strong decrease of T_c with decreasing Nb thickness and a
finite critical thickness of the order of 10 nm. Also, dimensional crossovers
in H_{c2}^{\parallel}(T) are completely absent, in strong contrast with Nb/Cu.
Analysis of the data by a proximity effect model based on the Takahashi-Tachiki
theory shows that the data can be explained by taking into account both the
high effective mass (or low electronic diffusion constant), {\it and} the large
density of states at the Fermi energy which characterize the Heavy Fermion
metal.Comment: 7 pages, 2 figure. Manuscript has been submitted to a refereed
journa
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Recalibration of the delirium prediction model for ICU patients (PRE-DELIRIC): a multinational observational study
Purpose
Recalibration and determining discriminative power, internationally, of the existing delirium prediction model (PRE-DELIRIC) for intensive care patients.
Methods
A prospective multicenter cohort study was performed in eight intensive care units (ICUs) in six countries. The ten predictors (age, APACHE-II, urgent and admission category, infection, coma, sedation, morphine use, urea level, metabolic acidosis) were collected within 24 h after ICU admission. The confusion assessment method for the intensive care unit (CAM-ICU) was used to identify ICU delirium. CAM-ICU screening compliance and inter-rater reliability measurements were used to secure the quality of the data.
Results
A total of 2,852 adult ICU patients were screened of which 1,824 (64 %) were eligible for the study. Main reasons for exclusion were length of stay <1 day (19.1 %) and sustained coma (4.1 %). CAM-ICU compliance was mean (SD) 82 ± 16 % and inter-rater reliability 0.87 ± 0.17. The median delirium incidence was 22.5 % (IQR 12.8–36.6 %). Although the incidence of all ten predictors differed significantly between centers, the area under the receiver operating characteristic (AUROC) curve of the eight participating centers remained good: 0.77 (95 % CI 0.74–0.79). The linear predictor and intercept of the prediction rule were adjusted and resulted in improved re-calibration of the PRE-DELIRIC model.
Conclusions
In this multinational study, we recalibrated the PRE-DELIRIC model. Despite differences in the incidence of predictors between the centers in the different countries, the performance of the PRE-DELIRIC-model remained good. Following validation of the PRE-DELIRIC model, it may facilitate implementation of strategies to prevent delirium and aid improvements in delirium management of ICU patients
Multinational development and validation of an early prediction model for delirium in ICU patients
Rationale
Delirium incidence in intensive care unit (ICU) patients is high and associated with poor outcome. Identification of high-risk patients may facilitate its prevention.
Purpose
To develop and validate a model based on data available at ICU admission to predict delirium development during a patient’s complete ICU stay and to determine the predictive value of this model in relation to the time of delirium development.
Methods
Prospective cohort study in 13 ICUs from seven countries. Multiple logistic regression analysis was used to develop the early prediction (E-PRE-DELIRIC) model on data of the first two-thirds and validated on data of the last one-third of the patients from every participating ICU.
Results
In total, 2914 patients were included. Delirium incidence was 23.6 %. The E-PRE-DELIRIC model consists of nine predictors assessed at ICU admission: age, history of cognitive impairment, history of alcohol abuse, blood urea nitrogen, admission category, urgent admission, mean arterial blood pressure, use of corticosteroids, and respiratory failure. The area under the receiver operating characteristic curve (AUROC) was 0.76 [95 % confidence interval (CI) 0.73–0.77] in the development dataset and 0.75 (95 % CI 0.71–0.79) in the validation dataset. The model was well calibrated. AUROC increased from 0.70 (95 % CI 0.67–0.74), for delirium that developed 6 days.
Conclusion
Patients’ delirium risk for the complete ICU length of stay can be predicted at admission using the E-PRE-DELIRIC model, allowing early preventive interventions aimed to reduce incidence and severity of ICU delirium
Development and validation of PRE-DELIRIC (PREdiction of DELIRium in ICu patients) delirium prediction model for intensive care patients: observational multicentre study
Objectives To develop and validate a delirium prediction model for adult intensive care patients and determine its additional value compared with prediction by caregivers
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