Timing of drotrecogin alfa (activated) treatment in severe sepsis

The effect of the timing of drotrecogin alfa (activated) (DrotAA) treatment on the outcome of severe sepsis was recently evaluated, using the integrated clinical trial database INDEPTH. The evaluation demonstrated an association between earlier treatment (i.e. treatment within 24 hours of the appearance of first organ dysfunction) and lower patient mortality [1]. We assessed the timing of DrotAA treatment in our own (mixed) intensive care unit over a 3-year period. We selected all patients treated with commercial DrotAA since its availability in The Netherlands. Patients were treated with DrotAA according to the national guidelines [2]. As the results presented in Table 1 show, patients treated within 24 hours were younger and more often had pneumosepsis (45 % versus 9%, P = 0.03), which was due t

AURKA mRNA expression is an independent predictor of poor prognosis in patients with non-small cell lung cancer

Deregulation of mitotic spindle genes has been reported to contribute to the development and progression of malignant tumours. The aim of the present study was to explore the association between the expression profiles of Aurora kinases (AURKA, AURKB and AURKC), cytoskeleton-associated protein 5 (CKAP5), discs large-associated protein 5 (DLGAP5), kinesin-like protein 11 (KIF11), microtubule nucleation factor (TPX2), monopolar spindle 1 kinase (TTK), and β-tubulins (TUBB) and (TUBB3) genes and clinicopathological characteristics in human non-small cell lung carcinoma (NSCLC). Reverse transcription-quantitative polymerase chain reaction-based RNA gene expression profiles of 132 NSCLC and 44 adjacent wild-type tissues were generated, and Cox's proportional hazard regression was used to examine associations. With the exception of AURKC, all genes exhibited increased expression in NSCLC tissues. Of the 10 genes examined, only AURKA was significantly associated with prognosis in NSCLC. Multivariate Cox's regression analysis demonstrated that AURKA mRNA expression [hazard ratio (HR), 1.81; 95% confidence interval (CI), 1.16-2.84; P=0.009], age (HR, 1.03; 95% CI, 1.00-1.06; P=0.020), pathological tumour stage 2 (HR, 2.43; 95% CI, 1.16-5.10; P=0.019) and involvement of distal nodes (pathological node stage 2) (HR, 3.14; 95% CI, 1.24-7.99; P=0.016) were independent predictors of poor prognosis in patients with NSCLC. Poor prognosis of patients with increased AURKA expression suggests that those patients may benefit from surrogate therapy with AURKA inhibitors

Structured squaring down and zero assignment

The problem of zero assignment by squaring down is considered for a system of p-inputs, n-outputs and n-states (m > p), where not all outputs are free variables for design. We consider the case where a k-subset of outputs is preserved in the new output set, and the rest are recombined to produce a total new set of p-outputs. New invariants for the problem are introduced which include a new class of fixed zeros and the methodology of the global linearization, developed originally for the output feedback pole assignment problem, is applied to this restricted form of the squaring down problem. It is shown that the problem can be solved generically if (p − k)(m − p) > δ*, where k (k < p) is the number of fixed outputs and δ* is a system and compensation scheme invariant, which is defined as the restricted Forney degree

The clinical associate curriculum . the learning theory underpinning the BCMP programme at the University of Pretoria

The Bachelor of Clinical Medical Practice (BCMP) is a new degree at the University of Pretoria (UP), designed to create a new category of mid-levelmedical workers, namely clinical associates. UP produced its first 44 graduates in 2011. The BCMP created the opportunity to innovate learning andteaching through designing, monitoring and evaluating the transformation of the curriculum as action research. Drawing on the theories and practices of authentic learning, self-directed learning, whole-brain learning and collaborative learning, the curriculum has been transformed. The potential of this curriculum extends beyond the formal education part of the programme . into clinical associate practice, healthcare practice and, potentially, general medical and healthcare education

Symbols of One-Loop Integrals From Mixed Tate Motives

We use a result on mixed Tate motives due to Goncharov (arXiv:alg-geom/9601021) to show that the symbol of an arbitrary one-loop 2m-gon integral in 2m dimensions may be read off directly from its Feynman parameterization. The algorithm proceeds via recursion in m seeded by the well-known box integrals in four dimensions. As a simple application of this method we write down the symbol of a three-mass hexagon integral in six dimensions.Comment: 13 pages, v2: minor typos correcte

Spontaneous hypothermia on intensive care unit admission is a predictor of unfavorable neurological outcome in patients after resuscitation: an observational cohort study

Introduction: A large number of patients resuscitated for primary cardiac arrest arrive in the intensive care unit (ICU) with a body temperature = 35.0 degrees C). Neurological outcome after six months was assessed by means of the Glasgow Outcome Score (GOS), with GOS 1 to 3 defined as unfavorable and GOS 4 to 5 as favorable. A logistic regression model was used to analyze the influence of the different parameters on neurological outcome. Results: The data of 105 consecutive patients resuscitated for primary cardiac arrest and treated with induced mild hypothermia were analyzed. Median ICU admission temperature was 35.1 degrees C (interquartile range (IQR) 34.3 to 35.7). After six months, 61% of the patients had an unfavorable outcome (59% died and 2% were severely disabled), whereas 39% had a favorable outcome (moderate disability or good recovery). Among patients with spontaneous hypothermia on ICU admission, the percentage with unfavorable outcome was higher (69% versus 50%, P = 0.05). Logistic regression showed that age, acute physiology and chronic health evaluation (APACHE) II and sequential organ failure assessment (SOFA) scores and spontaneous hypothermia on ICU admission all had an increased odds ratio (OR) for an unfavorable outcome after six months. Spontaneous hypothermia had the strongest association with unfavorable outcome (OR 2.6, 95% CI (confidence interval) 1.1 to 5.9), which became even stronger after adjustment for age, presenting heart rhythm, APACHE II and SOFA scores (OR 3.8, CI 1.3 to 11.0). Conclusions: In this observational cohort study, spontaneous hypothermia on ICU admission was the strongest predictor of an unfavorable neurological outcome in patients resuscitated for primary cardiac arres

Distance Optimization and the Extremal Variety of the Grassmann Variety

The approximation of a multivector by a decomposable one is a distance-optimization problem between the multivector and the Grassmann variety of lines in a projective space. When the multivector diverges from the Grassmann variety, then the approximate solution sought is the worst possible. In this paper, it is shown that the worst solution of this problem is achieved, when the eigenvalues of the matrix representation of a related two-vector are all equal. Then, all these pathological points form a projective variety. We derive the equation describing this projective variety, as well as its maximum distance from the corresponding Grassmann variety. Several geometric and algebraic properties of this extremal variety are examined, providing a new aspect for the Grassmann varieties and the respective projective spaces

Collinear and Soft Limits of Multi-Loop Integrands in N=4 Yang-Mills

It has been argued in arXiv:1112.6432 that the planar four-point integrand in N=4 super Yang-Mills theory is uniquely determined by dual conformal invariance together with the absence of a double pole in the integrand of the logarithm in the limit as a loop integration variable becomes collinear with an external momentum. In this paper we reformulate this condition in a simple way in terms of the amplitude itself, rather than its logarithm, and verify that it holds for two- and three-loop MHV integrands for n>4. We investigate the extent to which this collinear constraint and a constraint on the soft behavior of integrands can be used to determine integrands. We find an interesting complementarity whereby the soft constraint becomes stronger while the collinear constraint becomes weaker at larger n. For certain reasonable choices of basis at two and three loops the two constraints in unison appear strong enough to determine MHV integrands uniquely for all n.Comment: 27 pages, 14 figures; v2: very minor change

Triplet-Singlet Spin Relaxation via Nuclei in a Double Quantum Dot

The spin of a confined electron, when oriented originally in some direction, will lose memory of that orientation after some time. Physical mechanisms leading to this relaxation of spin memory typically involve either coupling of the electron spin to its orbital motion or to nuclear spins. Relaxation of confined electron spin has been previously measured only for Zeeman or exchange split spin states, where spin-orbit effects dominate relaxation, while spin flips due to nuclei have been observed in optical spectroscopy studies. Using an isolated GaAs double quantum dot defined by electrostatic gates and direct time domain measurements, we investigate in detail spin relaxation for arbitrary splitting of spin states. Results demonstrate that electron spin flips are dominated by nuclear interactions and are slowed by several orders of magnitude when a magnetic field of a few millitesla is applied. These results have significant implications for spin-based information processing