Modification and Assessment of the Bedside Pediatric Early Warning Score in the Pediatric Allogeneic Hematopoietic Cell Transplant Population

OBJECTIVES: To determine the validity of the Bedside Pediatric Early Warning Score system in the hematopoietic cell transplant population, and to determine if the addition of weight gain further strengthens the association with need for PICU admission. DESIGN: Retrospective cohort study of pediatric allogeneic hematopoietic cell transplant patients from 2009 to 2016. Daily Pediatric Early Warning Score and weights were collected during hospitalization. Logistic regression was used to identify associations between maximum Pediatric Early Warning Score or Pediatric Early Warning Score plus weight gain and the need for PICU intervention. The primary outcome was need for PICU intervention; secondary outcomes included mortality and intubation. SETTING: A large quaternary free-standing children's hospital. PATIENTS: One-hundred two pediatric allogeneic hematopoietic cell transplant recipients. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Of the 102 hematopoietic cell transplant patients included in the study, 29 were admitted to the PICU. The median peak Pediatric Early Warning Score was 11 (interquartile range, 8-13) in the PICU admission cohort, compared with 4 (interquartile range, 3-5) in the cohort without a PICU admission (p < 0.0001). Pediatric Early Warning Score greater than or equal to 8 had a sensitivity of 76% and a specificity of 90%. The area under the receiver operating characteristics curve was 0.83. There was a high negative predictive value at this Pediatric Early Warning Score of 90%. When Pediatric Early Warning Score greater than or equal to 8 and weight gain greater than or equal to 7% were compared together, the area under the receiver operating characteristic curve increased to 0.88. CONCLUSIONS: In this study, a Pediatric Early Warning Score greater than or equal to 8 was associated with PICU admission, having a moderately high sensitivity and high specificity. This study adds to literature supporting Pediatric Early Warning Score monitoring for hematopoietic cell transplant patients. Combining weight gain with Pediatric Early Warning Score improved the discriminative ability of the model to predict the need for critical care, suggesting that incorporation of weight gain into Pediatric Early Warning Score may be beneficial for monitoring of hematopoietic cell transplant patients

Influence of Yttrium on the Thermal Stability of Ti-Al-N Thin Films

Ti(1-x)Al(x)N coated tools are commonly used in high-speed machining, where the cutting edge of an end-mill or insert is exposed to temperatures up to 1100 degrees C. Here, we investigate the effect of Yttrium addition on the thermal stability of Ti(1-x)Al(x)N coatings. Reactive DC magnetron sputtering of powder metallurgically prepared Ti(0.50)Al(0.50), Ti(0.49)Al(0.49)Y(0.02), and Ti(0.46)Al(0.46)Y(0.08) targets result in the formation of single-phase cubic (c) Ti(0.45)Al(0.55)N, binary cubic/wurtzite c/w-Ti(0.41)Al(0.57)Y(0.02)N and singe-phase w-Ti(0.38)Al(0.54)Y(0.08)N coatings. Using pulsed DC reactive magnetron sputtering for the Ti(0.49)Al(0.49)Y(0.02) target allows preparing single-phase c-Ti(0.46)Al(0.52)Y(0.02)N coatings. By employing thermal analyses in combination with X-ray diffraction and transmission electron microscopy investigations of as deposited and annealed (in He atmosphere) samples, we revealed that Y effectively retards the decomposition of the Ti(1-x-y)Al(x)Y(y)N solid-solution to higher temperatures and promotes the precipitation of c-TiN, c-YN, and w-AlN. Due to their different microstructure and morphology already in the as deposited state, the hardness of the coatings decreases from similar to 35 to 22 GPa with increasing Y-content and increasing wurtzite phase fraction. Highest peak hardness of similar to 38 GPa is obtained for the Y-free c-Ti(0.45)Al(0.55)N coating after annealing at T(a) = 950 degrees C, due to spinodal decomposition. After annealing above 1000 degrees C the highest hardness is obtained for the 2 mol % YN containing c-Ti(0.46)Al(0.52)Y(0.02)N coating with similar to 29 and 28 GPa for T(a) = 1150 and 1200 degrees C, respectively

Rarity types among plant species with high conservation priority in Switzerland

Abstract.: Broennimann O., Vittoz P., Moser D. and Guisan A. 2005. Rarity types among plant species with high conservation priority in Switzerland. Bot. Helv. 115: 95-108. We investigated the ecogeographic characteristics of 118 Swiss plant species listed as those deserving highest conservation priority in a national conservation guide and classified them into the seven Rabinowitz' rarity types, taking geographic distribution, habitat rarity and local population size into account. Our analysis revealed that species with high conservation priority in Switzerland mostly have a very restricted geographic distribution in Switzerland and generally occur in rare habitats, but do not necessarily constitute small populations and are generally not endemics on a global scale. Moreover, species that are geographically very restricted on a regional scale are not generally restricted on a global scale. By analysing relationships between rarity and IUCN extinction risks for Switzerland, we demonstrated that species with the highest risk of extinction are those with the most restricted geographic distribution; whereas species with lower risk of extinction (but still high conservation priority) include many regional endemics. Habitat rarity and local population size appeared to be of minor importance for the assessment of extinction risk in Switzerland, but the total number of fulfilled rarity criteria still correlated positively with the severity of extinction risk. Our classification is the first preliminary assessment of the relative importance of each rarity type among endangered plant species of the Swiss flora and our results underline the need to distinguish between a regional and a global responsibility for the conservation of rare and endangered specie

The adaptation challenges of foreign students in TPU from the perspective of cross-cultural communication

The goal of Russian universities is to join the international scientific community. This aim is closely connected with the attraction of foreign students to study in Russia. TPU is one of the greatest centres to attract foreign students in our region. There are different programs of the adaptation to life in Tomsk and university life for foreign students. For our research it was important to learn about the features of the adaptation of foreign students who are away from home. We held a survey with 22 foreign students. In our research we identified important problems faced by foreign students: problem with communication; the problem of isolation living in separate hostels and studying; climate component in the process of the adaptation. In conclusion, we can say that Tomsk can be considered prosperous and hospitable zone for foreign students. Задача российских вузов - выйти в международное пространство и прочно утвердиться в нем. Эта цель тесно связана с привлечением иностранных студентов для обучения в России. ТПУ представляет собой один из крупнейших центров по привлечению иностранных студентов в своем регионе. Для иностранных студентов университетом предусматриваются различные программы адаптации к жизни в городе и к университетской жизни. Для нашей работы представлялось важным узнать об особенностях адаптации иностранных студентов, находящихся вдали от дома. Мы провели анкетирование 22 иностранных студентов. В нашей работе по опросу были выявлены важные проблемы, с которыми сталкиваются иностранные студенты: проблема с коммуникацией; проблема социальной замкнутости: отдельное проживание и обучение; климатическая составляющая процесса адаптации. В заключение мы можем сказать, что Томск может считаться процветающей и гостеприимной зоны для иностранных студентов

Braucht Europa eine Koordinierung der nationalen Lohnpolitiken?

In der aktuellen wirtschaftspolitischen Diskussion wird häufig auf stärkeren Koordinierungsbedarf in der Lohnpolitik hingewiesen. Nach Ansicht von Hartmut Egger und Daniel Etzel, Universität Bayreuth, sind eine stärkere Koordinierung arbeitsmarktpolitischer Maßnahmen und eine kritische Debatte über gemeinsame arbeitsmarktpolitische Ziele innerhalb der Europäischen Union grundsätzlich sinnvoll. Allerdings können Regelungen in diesem Bereich jeweils nur unter Berücksichtigung der vorherrschenden Tarifautonomie getroffen werden. Ob aber eine derartige Koordination auch die gesamtwirtschaftliche Wohlfahrt erhöhen könne, sei bisher nicht Gegenstand der wissenschaftlichen Untersuchung gewesen. Hagen Lesch, Institut der deutschen Wirtschaft, hält eine Korrektur der Lohnstückkosten der Defizitländer relativ zu denen der Überschussländer für sinnvoll, um die Leistungsbilanzungleichgewichte abzubauen. Eine Koordinierung der nationalen Lohnpolitiken könnte diesen Prozess beschleunigen. Es bestehe derzeit aber weder ein Koordinationsanreiz noch eine allgemein akzeptierte Koordinationsregel. Holger Zemanek, Universität Leipzig, lehnt eine direkte bzw. supranationale Koordinierung der Lohnpolitik ab. Ein europäischer Konsens, dass Lohnsteigerungen nicht das Produktivitätswachstum übersteigen sollten, sei aber zu begrüßen. Die europaweit restriktiven Fiskalpolitiken sowie die lohnpolitische Stabilität Deutschlands stellen, seiner Meinung nach, aber bereits eine marktwirtschaftliche, indirekte Koordinierung der Lohnpolitiken in Europa dar. Auch Christoph Moser, ETH Zürich, findet eine Koordinierung der nationalen Lohnpolitik in Europa nicht förderlich für den Abbau der innereuropäischen Ungleichgewichte

Hyperbolic outer billiards : a first example

We present the first example of a hyperbolic outer billiard. More precisely we construct a one parameter family of examples which in some sense correspond to the Bunimovich billiards.Comment: 11 pages, 8 figures, to appear in Nonlinearit

The transformer2 gene in Musca domestica is required for selecting and maintaining the female pathway of development

We present the isolation and functional analysis of a transformer2 homologue Mdtra2 in the housefly Musca domestica. Compromising the activity of this gene by injecting dsRNA into embryos causes complete sex reversal of genotypically female individuals into fertile males, revealing an essential function of Mdtra2 in female development of the housefly. Mdtra2 is required for female-specific splicing of Musca doublesex (Mddsx) which structurally and functionally corresponds to Drosophila dsx, the bottom-most regulator in the sex-determining pathway. Since Mdtra2 is expressed in males and females, we propose that Mdtra2 serves as an essential co-factor of F, the key sex-determining switch upstream of Mddsx. We also provide evidence that Mdtra2 acts upstream as a positive regulator of F supporting genetic data which suggest that F relies on an autocatalytic activity to select and maintain the female path of development. We further show that repression of male courtship behavior by F requires Mdtra2. This function of F and Mdtra2 appears not to be mediated by Mddsx, suggesting that bifurcation of the pathway at this level is a conserved feature in the genetic architecture of Musca and Drosophil

Design of dual ligands using excessive pharmacophore query alignment : from 7th German Conference on Chemoinformatics: 25 CIC-Workshop Goslar, Germany, 6 - 8 November 2011

Dual- or multi-target ligands have gained increased attention in the past years due to several advantages, including more simple pharmacokinetic and phamarcodynamic properties compared to a combined application of several drugs. Furthermore multi-target ligands often possess improved efficacy. We present a new approach for the discovery of dual-target ligands using aligned pharmacophore models combined with a shape-based scoring. Starting with two sets of known active compounds for each target, a number of different pharmacophore models is generated and subjected to pairwise graph-based alignment using the Kabsch-Algorithm. Since a compound may be able to bind to different targets in different conformations, the algorithm aligns pairs of pharmacophore models sharing the same features which are not necessarily at the exactly same spatial distance. Using the aligned models, a pharmacophore search on a multi-conformation-database is performed to find compounds matching both models. The potentially “dual” ligands are scored by a shape-based comparison with the known active molecules using ShaEP. Using this approach, we performed a prospective fragment-based virtual screening for dual 5-LO/sEH inhibitors. Both enzymes play an important role in the arachidonic acid cascade and are involved in inflammatory processes, pain, cardiovascular diseases and allergic reactions. Beside several new selective inhibitors we were able to find a compound inhibiting both enzymes in low micromolar concentrations. The results indicate that the idea of aligned pharmacophore models can be successfully employed for the discovery of dual-target ligands