Refractory Lactic Acidosis and an Approach to its Management - A Case Report.

BACKGROUND: Lactic acidosis (LA) is a complication of diseases commonly seen in intensive care patients which carries an increased risk of mortality. It is classified by its pathophysiology; Type A results from tissue hypo-perfusion and hypoxia, and Type B results from abnormal metabolic activity in the absence of hypoxia. Reports of the co-occurrence of both types have been rarely reported in the literature relating to intensive care patients. This case report describes the challenging management of a patient diagnosed with both Type A and Type B LA. CASE PRESENTATION: A 55-year-old female with newly diagnosed diffuse large B-cell lymphoma (DLBCL) developed hospital-acquired pneumonia, respiratory failure, shock and intra-abdominal septicaemia from a bowel perforation. Blood gases revealed a mixed picture lactic acidosis. Correction of septic shock, respiratory failure and surgical repair caused initial improvement to the lactic acidosis, but this gradually worsened in the intensive care unit. Only upon starting chemotherapy and renal replacement therapy was full resolution of the lactic acidosis achieved. The patient was discharged but succumbed to her DLBCL several months later. CONCLUSION: Type A and Type B LA can co-occur, making management difficult. A systematic approach can help diagnose any underlying pathology and aid in early management

On Civility

Commencement address given by John D. Ong, Chairman and Chief Executive Officer of B. F. Goodrich, to the Autumn 1996 graduating class of The Ohio State University, St. John Arena, Columbus, Ohio, December 13, 1996

Influence of soil chemical properties on relative abundance of arbuscular mycorrhiza in forested soils in Malaysia

Th eeff ect of soil chemical properties on the diversity and colonization of arbuscular mycorrhiza (AM) varies among ecosystems. This study was conducted to assess and compare the abundance of AM in a rehabilitated forest and a logged-over forest soil using the most probable number and spore number methods. Glomus (71.7%-82.1%) and Acaulospora (17.4%-19.5%) were found to be abundant in both sites, while Gigaspora was found only in the loggedover forest. Th e abundance of AM in the rehabilitated forest based on the spore count was signifi cantly higher than in the logged-over forest by a 6-fold diff erence. Furthermore, root colonization in the rehabilitated forest was found to be almost 9-fold higher than in the logged-over forest. Such diff erences are linked to the soil chemical properties. The addition of organic matter during forest rehabilitation activity had created favorable conditions for AM sporulation. Soil P in both forests was positively related to the spore count (r > 0.68, P < 0.001) while the most probable number (MPN)was negatively infl uenced by soil K (r = –0.632, P <0.01). In conclusion, this study showed that soil chemical properties have a direct eff ect on the abundance of AM

Sensitivity of High-Speed Lightwave System Receivers Using InAlAs Avalanche Photodiodes

Calculations based on a rigorous analytical model are carried out to compare the sensitivity of optical receivers that use InP and In0.52Al0.48As avalanche photodiodes (APDs). The model includes the effects of intersymbol interference, tunneling current, avalanche noise and its correlation with the stochastic avalanche duration, dead space, and transimpedance amplifier noise. For a 10-Gb/s system with a bit-error rate of 10-12, the optimum receiver sensitivity predicted for In0.52Al0.48As and InP APDs is -28.6 and -28.1 dBm, respectively, corresponding to a reduction of 11% in optical signal power for receivers using In0.52Al0.48As APDs. Thus, considering overall receiver sensitivity, the improvement offered by In0.52Al0.48As APDs over InP is modest

Mentoring and Supervision in Academia: Establishing Distinctions to Manage Expectations.

Dear Editor, We read with interest the article entitled “Great Expectations: Principal Investigator and Trainee Perspectives on Hiring, Supervision, and Mentoring” by Kaps et al. We agree that a good mentor–mentee relationship can improve outcomes of academic training and contribute positively to research output; however, we would like to highlight the following

Chemical sensors based on swellable polymer microparticles and molecular imprinted polymers

Swellable thermoresponsive and lightly cross-linked polymer microparticles were prepared for the development of chemical sensors for various target analytes. The swelling and shrinking of the polymer particles as a function of concentration of target analytes has been investigated using turbidity and fluorescence measurements at suitable pH values. Chemical sensors that respond to transition metal ions such as Cu 2+, Ni2+, Zn2+, and Pb2+ were prepared by copolymerizing N-Isopropylacrylamide (NIPAAm) with ligands such as; 2,2\u27-acylamidodiacetic acid (AIDA), dibutyl-2,2\u27-(3 vinylphenylazanediyl) diacetate (DVPAA), N-((4\u27-methyl-2,2\u27-bipyridin-4yl)methyl)-N-propylacrylamide (NMPPAAm), and N,N-bis(pyridine-2-ylmethyl)prop-2-en-1-amine (NBPMPA). The microparticles were either labeled with 9-vinylanthracene (9-VA)/2-Naphthylmethacrylate (2-NMA), or fluorescein o-acrylate/methacryloxethyl thiocarbonyl rhodamine B fluorophore pairs. The particles were cross-linked using between 5--8% N, N-methylenebisacrylamide (MBA) and stabilized in acetonitrile using poly (styrene-co-acrylonitrile). The microparticles were suspended in pH 6 MOP buffer with ionic strength adjusted to 0.1M. The shrinking and swelling properties of the polymer microparticles with change in analyte concentration were evaluated by fluorescence measurements. Fluorescence intensity ratios of the acceptor to the donor fluorophores in the microparticles were calculated at different analyte concentrations. Another method was developed for preparing sensors that respond to both beta-D-glucopyranose and theophylline molecules by imprinting them in to a lightly cross-linked polymer network prepared by dispersion polymerization in water and acetonitrile, respectively. The molecular imprinting of beta-D-glucopyranose and theophylline was achieved by using acrylamide and methacrylic acid (MAA), respectively, as functional monomers. The theophylline imprinted polymer particles were labeled with fluorescein o-acrylate and methacryloxethyl thiocarbonyl rhodamine B fluorophores. MBA and poly (styrene-co-acrylonitrile) were used as cross-linker and stabilizer respectively in the polymer synthesis. Fluorescence measurements were used to monitor the swelling and shrinking of the polymer particles. The particles responded to theophylline concentration as low as 10-7M in pH 7 buffer. In the preparation of beta-D-glucopyranose imprinted polymer particles, poly (vinyl pyrrolidone) (PVP) was used as the stabilizer. The particles were immobilized in 10% poly (vinyl alcohol) (PVA) membranes and suspended in MOP buffer pH 7 for turbidity measurement. It was shown that these particles respond to beta-D-glucopyranose concentration as low as 10-5M

BLADE: Filter Learning for General Purpose Computational Photography

The Rapid and Accurate Image Super Resolution (RAISR) method of Romano, Isidoro, and Milanfar is a computationally efficient image upscaling method using a trained set of filters. We describe a generalization of RAISR, which we name Best Linear Adaptive Enhancement (BLADE). This approach is a trainable edge-adaptive filtering framework that is general, simple, computationally efficient, and useful for a wide range of problems in computational photography. We show applications to operations which may appear in a camera pipeline including denoising, demosaicing, and stylization

Strategies for Improving the Performance of Project Managers in South Sudan

Business leaders persistently face the challenges of project failures. Lack of proper project alignment with business strategies is a major contributor to less successful project outcomes. One major concern of project managers in South Sudan is that misalignment of the project management processes with business strategies could result in project delays and cost overruns. The purpose of this multiple case study was to explore strategies 8 project managers from 2 telecommunication companies use to align project management processes with business strategies to improve project performance in Juba, South Sudan. Using hoshin kanri as the conceptual framework for this study, semistructured face-to-face interviews were conducted with purposely selected participants. Four themes that emerged from the thematic analysis of the interview data and archival documents are effective communication among project stakeholders, stakeholder engagement in project management processes, competence of project manager in leadership decisions, and executive commitment and support to project team. The findings of the study may lead to proper project alignment and successful project outcome. Business leaders should involve project managers during the development of business strategies. The results from this study may contribute to positive social change by enabling project managers and business leaders to execute sustainable projects that can offer employment opportunities for the local citizens and help the recovery of the South Sudan economy

Tree growth and management in Ugandan agroforestry systems: effects of root pruning on tree growth and crop yield

Tree root pruning is a potential tool for managing below-ground competition when trees and crops are grown together in agroforestry systems. This study investigates its effects on growth and root distribution of Alnus acuminata (HB & K), Casuarina equisetifolia (L), Grevillea robusta (A. Cunn. ex R. Br), Maesopsis eminii (Engl.), and Markhamia lutea (Benth.) K. Schum. and on yield of adjacent crops in sub-humid Uganda. The trees were 3 years old at the commencement of the study, and most species were competing strongly with crops. Tree roots were pruned 41 months after planting by cutting and back-filling a trench to a depth of 0.3 m, at a distance of 0.3 m from the trees, on one side of the tree row. The trench was re-opened and roots re-cut at 50 and 62 months after planting. Effects on tree growth and root distribution were assessed over a 3 year period, and crop yield after the third root pruning at 62 months is reported here. Overall, root pruning had only a slight effect on tree growth: height growth was unaffected and diameter growth was reduced by only 4 %. A substantial amount of root re-growth was observed by 11 months after pruning. Tree species varied in the number and distribution of their roots, and Casuarina and Markhamia had considerably more roots per unit of trunk volume than the other tree species, especially in the surface soil layers. Casuarina and Maesopsis were the most competitive tree species with crops and Grevillea and Markhamia the least. Crop yield data provides strong evidence of the redistribution of root activity following root pruning, so that competition increased on the unpruned side of tree rows. Thus, one-sided root pruning will only be of use to farmers in a few circumstances. Key words: Alnus acuminata, Casuarina equisetifolia, Grevillea robusta, Maesopsis eminii, Markhamia lutea, root distribution, root functio