Comment on ``Two Time Scales and Violation of the Fluctuation-Dissipation Theorem in a Finite Dimensional Model for Structural Glasses''

In cond-mat/0002074 Ricci-Tersenghi et al. find two linear regimes in the fluctuation-dissipation relation between density-density correlations and associated responses of the Frustrated Ising Lattice Gas. Here we show that this result does not seem to correspond to the equilibrium quantities of the model, by measuring the overlap distribution P(q) of the density and comparing the FDR expected on the ground of the P(q) with the one measured in the off-equilibrium experiments.Comment: RevTeX, 1 page, 2 eps figures, Comment on F. Ricci-Tersenghi et al., Phys. Rev. Lett. 84, 4473 (2000

The Effects of Environment on the Interlaminar Shear Performance of an Oxide/Oxide Ceramic Matrix Composite at Elevated Temperature

This research investigated the interlaminar shear performance of an oxide/oxide ceramic matrix composite consisting of Nextel™ 720 fibers in a high purity, porous alumina (Al2O3) matrix. The interlaminar shear performance was observed in both tension and compression of double notched specimens (DNS) at 1200 °C. Interlaminar shear creep behavior was examined in both laboratory air and in steam environment at 1200 °C. In air, the creep stress was -6.5 MPa. In steam creep stresses included -4.0, -5.0, and -6.5 MPa. Primary and secondary creep regimes were observed in all air creep tests and the creep test in steam at -4.0 MPa. Tertiary creep was also observed in the creep tests in steam at -5.0 and -6.5 MPa. The specimens tested in creep at -6.5 MPa in air achieved run-out, defined as 100 hours at creep stress. The residual strength increased after 100 h of creep in air at 1200 °C. In the presence of steam, creep performance deteriorated rapidly and run-out was achieved only at ~50% the interlaminar shear strength. The fracture surfaces and the matrix of all samples were examined in order to determine the failure and environmental degradation mechanisms behind the reduced creep performance of the matrix in steam

Hydroxymethylglutaryl-CoA reductase inhibition with simvastatin in acute lung injury to reduce pulmonary dysfunction (HARP-2) trial : study protocol for a randomized controlled trial

Acute lung injury (ALI) is a common devastating clinical syndrome characterized by life-threatening respiratory failure requiring mechanical ventilation and multiple organ failure. There are in vitro, animal studies and pre-clinical data suggesting that statins may be beneficial in ALI. The Hydroxymethylglutaryl-CoA reductase inhibition with simvastatin in Acute lung injury to Reduce Pulmonary dysfunction (HARP-2) trial is a multicenter, prospective, randomized, allocation concealed, double-blind, placebo-controlled clinical trial which aims to test the hypothesis that treatment with simvastatin will improve clinical outcomes in patients with ALI

A qualitative synthesis of gastro-oesophageal reflux in bronchiectasis:Current understanding and future risk

Gastro-oesophageal reflux disease (GORD) is a common comorbidity in bronchiectasis, and is often associated with poorer outcomes. The cause and effect relationship between GORD and bronchiectasis has not yet been fully elucidated and a greater understanding of the pathophysiology of the interaction and potential therapies is required. This review explores the underlying pathophysiology of GORD, its clinical presentation, risk factors, commonly applied diagnostic tools, and a detailed synthesis of original articles evaluating the prevalence of GORD, its influence on disease severity and current management strategies within the context of bronchiectasis. The prevalence of GORD in bronchiectasis ranges from 26% to 75%. Patients with co-existing bronchiectasis and GORD were found to have an increased mortality and increased bronchiectasis severity, manifest by increased symptoms, exacerbations, hospitalisations, radiological extent and chronic infection, with reduced pulmonary function and quality of life. The pathogenic role of Helicobacter pylori infection in bronchiectasis, perhaps via aspiration of gastric contents, also warrants further investigation. Our index of suspicion for GORD should remain high across the spectrum of disease severity in bronchiectasis. Identifying GORD in bronchiectasis patients may have important therapeutic and prognostic implications, although clinical trial evidence that treatment targeted at GORD can improve outcomes in bronchiectasis is currently lacking.</p

On regularity and the word problem for free idempotent generated semigroups

The category of all idempotent generated semigroups with a prescribed structure E of their idempotents E (called the biordered set) has an initial object called the free idempotent generated semigroup over E, defined by a presentation over alphabet E, and denoted by IG(E). Recently, much effort has been put into investigating the structure of semigroups of the form IG(E), especially regarding their maximal subgroups. In this paper we take these investigations in a new direction by considering the word problem for IG(E). We prove two principal results, one positive and one negative. We show that, for a finite biordered set E, it is decidable whether a given word w ∈ E∗represents a regular element; if in addition one assumes that all maximal subgroups of IG(E) have decidable word problems, then the word problem in IG(E) restricted to regular words is decidable. On the other hand, we exhibit a biorder E arising from a finite idempotent semigroup S, such that the word problem for IG(E) is undecidable, even though all the maximal subgroups have decidable word problems. This is achieved by relating the word problem of IG(E) to the subgroup membership problem in finitely presented groups

Epidemiology, patterns of care, and mortality for patients with acute respiratory distress syndrome in intensive care units in 50 countries

IMPORTANCE: Limited information exists about the epidemiology, recognition, management, and outcomes of patients with the acute respiratory distress syndrome (ARDS). OBJECTIVES: To evaluate intensive care unit (ICU) incidence and outcome of ARDS and to assess clinician recognition, ventilation management, and use of adjuncts-for example prone positioning-in routine clinical practice for patients fulfilling the ARDS Berlin Definition. DESIGN, SETTING, AND PARTICIPANTS:The Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG SAFE) was an international, multicenter, prospective cohort study of patients undergoing invasive or noninvasive ventilation, conducted during 4 consecutive weeks in the winter of 2014 in a convenience sample of 459 ICUs from 50 countries across 5 continents. EXPOSURES:Acute respiratory distress syndrome. MAIN OUTCOMES AND MEASURES: The primary outcome was ICU incidence of ARDS. Secondary outcomes included assessment of clinician recognition of ARDS, the application of ventilatory management, the use of adjunctive interventions in routine clinical practice, and clinical outcomes from ARDS. RESULTS: Of 29,144 patients admitted to participating ICUs, 3022 (10.4%) fulfilled ARDS criteria. Of these, 2377 patients developed ARDS in the first 48 hours and whose respiratory failure was managed with invasive mechanical ventilation. The period prevalence of mild ARDS was 30.0% (95% CI, 28.2%-31.9%); of moderate ARDS, 46.6% (95% CI, 44.5%-48.6%); and of severe ARDS, 23.4% (95% CI, 21.7%-25.2%). ARDS represented 0.42 cases per ICU bed over 4 weeks and represented 10.4% (95% CI, 10.0%-10.7%) of ICU admissions and 23.4% of patients requiring mechanical ventilation. Clinical recognition of ARDS ranged from 51.3% (95% CI, 47.5%-55.0%) in mild to 78.5% (95% CI, 74.8%-81.8%) in severe ARDS. Less than two-thirds of patients with ARDS received a tidal volume 8 of mL/kg or less of predicted body weight. Plateau pressure was measured in 40.1% (95% CI, 38.2-42.1), whereas 82.6% (95% CI, 81.0%-84.1%) received a positive end-expository pressure (PEEP) of less than 12 cm H2O. Prone positioning was used in 16.3% (95% CI, 13.7%-19.2%) of patients with severe ARDS. Clinician recognition of ARDS was associated with higher PEEP, greater use of neuromuscular blockade, and prone positioning. Hospital mortality was 34.9% (95% CI, 31.4%-38.5%) for those with mild, 40.3% (95% CI, 37.4%-43.3%) for those with moderate, and 46.1% (95% CI, 41.9%-50.4%) for those with severe ARDS. CONCLUSIONS AND RELEVANCE: Among ICUs in 50 countries, the period prevalence of ARDS was 10.4% of ICU admissions. This syndrome appeared to be underrecognized and undertreated and associated with a high mortality rate. These findings indicate the potential for improvement in the management of patients with ARDS

The Current State and Future Trajectory of the Sharing Economy: A Multi-Stakeholder Perspective

The COVID-19 pandemic has had a transformative impact on social and economic value, as well as the role of mediating technology and regulation driving participation in the sharing economy. Considering the consequences that such transformations entail, in this paper, we provide a multi-stakeholder perspective of the pandemic\u27s impact on sharing economy enablers and drivers, and the resulting short and long-term implications for customers, providers, platform companies, and policymakers. Through the amalgamation and exploration of these multiple perspectives, we then present a roadmap of the key research themes, considerations, and policy gaps, supplemented with insights contributing toward the vision for a sustainable sharing economy. The comprehensive overview provided in this paper offers multiple avenues for future research across social, economic, technological, and regulatory domains

Noninvasive Ventilation of Patients with Acute Respiratory Distress Syndrome: Insights from the LUNG SAFE Study

Abstract RATIONALE: Noninvasive ventilation (NIV) is increasingly used in patients with acute respiratory distress syndrome (ARDS). The evidence supporting NIV use in patients with ARDS remains relatively sparse. OBJECTIVES: To determine whether, during NIV, the categorization of ARDS severity based on the PaO2/FiO2 Berlin criteria is useful. METHODS: The LUNG SAFE (Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure) study described the management of patients with ARDS. This substudy examines the current practice of NIV use in ARDS, the utility of the PaO2/FiO2 ratio in classifying patients receiving NIV, and the impact of NIV on outcome. MEASUREMENTS AND MAIN RESULTS: Of 2,813 patients with ARDS, 436 (15.5%) were managed with NIV on Days 1 and 2 following fulfillment of diagnostic criteria. Classification of ARDS severity based on PaO2/FiO2 ratio was associated with an increase in intensity of ventilatory support, NIV failure, and intensive care unit (ICU) mortality. NIV failure occurred in 22.2% of mild, 42.3% of moderate, and 47.1% of patients with severe ARDS. Hospital mortality in patients with NIV success and failure was 16.1% and 45.4%, respectively. NIV use was independently associated with increased ICU (hazard ratio, 1.446 [95% confidence interval, 1.159-1.805]), but not hospital, mortality. In a propensity matched analysis, ICU mortality was higher in NIV than invasively ventilated patients with a PaO2/FiO2 lower than 150 mm Hg. CONCLUSIONS: NIV was used in 15% of patients with ARDS, irrespective of severity category. NIV seems to be associated with higher ICU mortality in patients with a PaO2/FiO2 lower than 150 mm Hg. Clinical trial registered with www.clinicaltrials.gov (NCT 02010073)

Simvastatin for patients with Acute Respiratory Distress Syndrome: long term outcomes and cost-effectiveness from a randomised controlled trial

Background: Simvastatin therapy for patients with ARDS has been shown to be safe and associated with minimal adverse effects, but it does not improve clinical outcomes. The aim of this research was to report on mortality and cost-effectiveness of simvastatin in patients with ARDS at 12 months. Methods: A cost-utility analysis alongside a multicentre, double-blind, randomised controlled trial carried out in the UK and Ireland. Five hundred and forty intubated and mechanically ventilated patients with acute respiratory distress syndrome were randomly assigned (1:1) to receive once-daily simvastatin (at a dose of 80 mg) or identical placebo tablets enterally for up to 28 days. Results: Mortality was lower in the simvastatin group (31.8%; 95% CI 26.1, 37.5) compared to the placebo group (37.3%; 95% CI 31.6, 43.0) at 12 months although this was not significant. Simvastatin was associated with statistically significant QALY gain (incremental QALYs 0.064, 95% CI 0.002, 0.127) compared to placebo. Simvastatin was also less costly (incremental total costs –£3601, 95% CI –8061, 859). At a willingness-to-pay threshold of £20,000 per QALY the probability of simvastatin being cost-effective was 99%. Sensitivity analyses indicated that the results were robust to changes in methodological assumptions with the probability of cost-effectiveness never dropping below 90%. Conclusion: Simvastatin was found to be cost-effective for the treatment of ARDS, being associated with both a significant QALY gain and a cost saving. There was no significant reduction in mortality at 12 months