Surviving sepsis: going beyond the guidelines

The Surviving Sepsis Campaign is a global effort to improve the care of patients with severe sepsis and septic shock. The first Surviving Sepsis Campaign Guidelines were published in 2004 with an updated version published in 2008. These guidelines have been endorsed by many professional organizations throughout the world and come regarded as the standard of care for the management of patients with severe sepsis. Unfortunately, most of the recommendations of these guidelines are not evidence-based. Furthermore, the major components of the 6-hour bundle are based on a single-center study whose validity has been recently under increasing scrutiny. This paper reviews the validity of the Surviving Sepsis Campaign 6-hour bundle and provides a more evidence-based approach to the initial resuscitation of patients with severe sepsis

Development plan or public space in the small historical town of Waxholm, Sweden

Thesis (M. Arch.)--Massachusetts Institute of Technology, Dept. of Architecture, 1994.Vita.Includes bibliographical references (p. 163-164).Small towns offer a type of community different than that of large metropolitan areas. The ideals of this community are deeply rooted in its history and culture. However, the current state of small towns in general, not only in America but also in Sweden, has been transformed dramatically during the last several decades. Advancements in technology, dependence upon the automobile and the introduction of the shopping mall, have resulted in the decay of the physical and social qualities which defined these places. The public spaces of small towns, characteristically the Town square and Main street, historically have been thriving places for social interaction and places which contributed to the sense of community pride and identity which every resident could understand. Unfortunately, these are the areas which have been affected the most. This thesis project is intended to study the past, current and future state of the small town and its major public spaces, and propose, through a series of interventions, to create good quality public spaces in the form of clearly defined destinations along and at the end of the historical paths. The revitalization of these spaces, through a method of continuation of traditions and history, are vital to the future success of these places and should promote a renewed sense of community, a sense of participation and contribution to a larger whole : the town.by Peter M. Brockman, Jr.M.Arch

24 segment high field permanent sextupole magnets

We report on the design, construction, and magnetic field measurements of a system of high field sextupole magnets made from NdFeB compounds. The magnets are utilized as a focusing system for neutral hydrogen (or deuterium) atoms in a polarized atomic beam source based on Stern-Gerlach spin separation. Each magnet consists of 24 segments of permanently magnetized material differing in remanence and coercivity to reduce demagnetization. According to quadratic extrapolation to the pole tip the magnetic flux density reaches values of up to B-0=1.69 T. Three-dimensional field calculations using the MAFIA code were carried out to optimize the magnet performance and to avoid demagnetization by selecting appropriate materials for the individual segments. Measurements of the radial, azimuthal, and longitudinal magnetic flux density distributions were carried out by means of a small Hall probe (100x200x15 mu m(3)). The measurements with the small probe permitted to extract experimentally higher order multipole components very close (similar to 100 mu m) to the inner surface. Experimental values obtained are compared to predictions based on MAFIA calculations and on the Halbach formalism. (C) 2000 American Institute of Physics. [S0034-6748(00)05309-0]

Service-oriented agents for collaborative industrial automation and production systems

Service-oriented Multi-Agent Systems (SoMAS) is an approach to combine the fundamental characteristics of service-oriented and multi-agent methods into a new platform for industrial automation. Several research works already targeted the connection of these technologies, presenting different perspectives in how and why to join them. This research focuses on available efforts and solutions in the area of SoMAS and explains the idea behind the service-oriented agents in industrial automation. A SoMAS system is mainly composed by shared resources in form of services and their providing/requesting agents. The paper also discusses the required engineering aspects of these systems, from the internal anatomy to the interaction patterns. Parameters of flexibility, reconfiguration, autonomy and reduced development efforts were considered and they should be the trademark of SoMAS. Aiming to illustrate the proposed approach, an example of service-oriented automation agents is given.The authors would like to thank the European Commission and the partners of the EU IST FP6 project “Service-Oriented Cross-layer infrastructure for Distributed smart Embedded devices” (SOCRADES), the EU FP6 "Network of Excellence for Innovative Production Machines and Systems” (I*PROMS), and the EC ICT FP7 project “Cooperating Objects Network of Excellence” (CONET) for their support

A Neuroanatomically Grounded Optimal Control Model of the Compensatory Eye Movement System in Mice

We present a working model of the compensatory eye movement system in mice. We challenge the model with a data set of eye movements in mice (n =34) recorded in 4 different sinusoidal stimulus conditions with 36 different combinations of frequency (0.1–3.2 Hz) and amplitude (0.5–8°) in each condition. The conditions included vestibular stimulation in the dark (vestibular-ocular reflex, VOR), optokinetic stimulation (optokinetic reflex, OKR), and two combined visual/vestibular conditions (the visual-vestibular ocular reflex, vVOR, and visual suppression of the VOR, sVOR). The model successfully reproduced the eye movements in all conditions, except for minor failures to predict phase when gain was very low. Most importantly, it could explain the interaction of VOR and OKR when the two reflexes are activated simultaneously during vVOR stimulation. In addition to our own data, we also reproduced the behavior of the compensatory eye movement system found in the existing literature. These include its response to sum-of-sines stimuli, its response after lesions of the nucleus prepositus hypoglossi or the flocculus, characteristics of VOR adaptation, and characteristics of drift in the dark. Our model is based on ideas of state prediction and forward modeling that have been widely used in the study of motor control. However, it represents one of the first quantitative efforts to simulate the full range of behaviors of a specific system. The model has two separate processing loops, one for vestibular stimulation and one for visual stimulation. Importantly, state prediction in the visual processing loop depends on a forward model of residual ret

Recent developments and future trends of industrial agents

The agent technology provides a new way to design and engineer control solutions based on the decentralization of control over distributed structures, addressing the current requirements for modern control systems in industrial domains. This paper presents the current situation of the development and deployment of agent technology, discussing the initiatives and the current trends faced for a wider dissemination and industrial adoption, based on the work that is being carried out by the IEEE IES Technical Committee on Industrial Agents

Effects of Fluids on the Macro- and Microcirculations.

This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2018. Other selected articles can be found online at https://www.biomedcentral.com/collections/annualupdate2018. Further information about the Annual Update in Intensive Care and Emergency Medicine is available from http://www.springer.com/series/8901