Accuracy of rapid ultrasound in shock (RUSH) exam for diagnosis of shock in critically Ill patients

Background: Rapid ultrasound in shock (RUSH) is the most recent emergency ultrasound protocol, designed to help clinicians better recognize distinctive shock etiologies in a shorter time frame. Objectives: In this study, we evaluated the accuracy of the RUSH protocol, performed by an emergency physician or radiologist, in predicting the type of shock in critical patients. Patients and Methods: An emergency physician or radiologist performed the RUSH protocol for all patients with shock status at the emergency department. All patients were closely followed to determine their final clinical diagnosis. The agreement between the initial impression provided by RUSH and the final diagnosis was investigated by calculating the Kappa index. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of RUSH for diagnosis of each case. Results: We performed RUSH on 77 patients. Kappa index was 0.71 (P Value = 0.000), reflecting acceptable general agreement between initial impression and final diagnosis. For hypovolemic, cardiogenic and obstructive shock, the protocol had an NPV above 97 yet it had a lower PPV. For shock with distributive or mixed etiology, RUSH showed a PPV of 100 but it had low sensitivity. Subgroup analysis showed a similar Kappa index for the emergency physician and radiologist (0.70 and 0.73, respectively) in performing rush. Conclusions: This study highlights the role of the RUSH exam performed by an emergency physician, to make a rapid and reliable diagnosis of shock etiology, especially in order to rule out obstructive, cardiogenic and hypovolemic shock types in initial exam of shock patients. Copyright © 2015, Trauma Monthly

Nanopore structures of isolated kerogen and bulk shale in Bakken Formation

Pores that exist within the organic matter can affect the total pore system of bulk shale samples and, as a result, need to be studied and analyzed carefully. In this study, samples from the Bakken Formation, in conjunction with the kerogen that was isolated from them, were studied and compared through a set of analytical techniques: X-ray diffraction (XRD), Rock-Eval pyrolysis, Fourier Transform infrared spectroscopy (FTIR), and gas adsorption (CO 2 and N 2 ). The results can be summarized as follows: 1) quartz and clays are two major minerals in the Bakken samples; 2) the samples have rich organic matter content with TOC greater than 10 wt%; 3) kerogen is marine type II; 4) gas adsorption showed that isolated kerogen compared to the bulk sample has larger micropore volume and surface area, meso- and macropore volume, and Brunauer–Emmett–Teller (BET) surface area; 5) deconvolution of pore size distribution (PSD) curves demonstrated that pores in the isolated kerogen could be separated into five distinct clusters, whereas bulk shale samples exhibited one additional pore cluster with an average pore size of 4 nm hosted in the minerals. The comparison of PSD curves obtained from isolated kerogen and bulk shale samples proved that most of the micropores in the shale are hosted within the organic matter while the mesopores with a size ranging between 2 and 10 nm are mainly hosted by minerals. The overall results demonstrated that organic matter-hosted pores make a significant contribution to the total porosity of the Bakken shale samples

Potential of sorghum polyphenols to prevent and treat Alzheimer\u27s disease: A review article

Alzheimer’s disease (AD) is characterized by the excessive deposition of extracellular amyloid-beta peptide (Aβ) and the build-up of intracellular neurofibrillary tangles containing hyperphosphorylated tau proteins. This leads to neuronal damage, cell death and consequently results in memory and learning impairments leading to dementia. Although the exact cause of AD is not yet clear, numerous studies indicate that oxidative stress, inflammation, and mitochondrial dysfunction significantly contribute to its onset and progression. There is no effective therapeutic approach to stop the progression of AD and its associated symptoms. Thus, early intervention, preferably, pre-clinically when the brain is not significantly affected, is a better option for effective treatment. Natural polyphenols (PP) target multiple AD-related pathways such as protecting the brain from Aβ and tau neurotoxicity, ameliorating oxidative damage and mitochondrial dysfunction. Among natural products, the cereal crop sorghum has some unique features. It is one of the major global grain crops but in the developed world, it is primarily used as feed for farm animals. A broad range of PP, including phenolic acids, flavonoids, and condensed tannins are present in sorghum grain including some classes such as proanthocyanidins that are rarely found in others plants. Pigmented varieties of sorghum have the highest polyphenolic content and antioxidant activity which potentially makes their consumption beneficial for human health through different pathways such as oxidative stress reduction and thus the prevention and treatment of neurodegenerative diseases. This review summarizes the potential of sorghum PP to beneficially affect the neuropathology of AD

An improved optimization technique for estimation of solar photovoltaic parameters

The nonlinear current vs voltage (I-V) characteristics of solar PV make its modelling difficult. Optimization techniques are the best tool for identifying the parameters of nonlinear models. Even though, there are different optimization techniques used for parameter estimation of solar PV, still the best optimized results are not achieved to date. In this paper, Wind Driven Optimization (WDO) technique is proposed as the new method for identifying the parameters of solar PV. The accuracy and convergence time of the proposed method is compared with results of Pattern Search (PS), Genetic Algorithm (GA), and Simulated Annealing (SA) for single diode and double diode models of solar PV. Furthermore, for performance validation, the parameters obtained through WDO are compared with hybrid Bee Pollinator Flower Pollination Algorithm (BPFPA), Flower Pollination Algorithm (FPA), Generalized Oppositional Teaching Learning Based Optimization (GOTLBO), Artificial Bee Swarm Optimization (ABSO), and Harmony Search (HS). The obtained results clearly reveal that WDO algorithm can provide accurate optimized values with less number of iterations at different environmental conditions. Therefore, the WDO can be recommended as the best optimization algorithm for parameter estimation of solar PV

Radiosensitization of DNA in presence of Pt(II)-based compounds

X-ray irradiation of plasmid DNA in presence of platinum (II)-based compounds was carried out in order to assess the radiosensitization capabilities of these drugs. In present investigations pBR322 plasmid DNA was used to monitor effectiveness of chosen compounds in inducing strand breaks. Samples were incubated in presence of potential radiosensitisers: platinum (II) bromide and cis-diamminedibromoplatinum (II). The results were examined against a common cancer chemotherapy drug cis-diamminedichloroplatinum (II). It was found that platinum (II) bromide can greatly increase the levels of single- and double-strand break formation observed in the irradiated samples with respect to the samples containing platinum as a radiosensitizer only, possessing very little chemotherapeutic activity. The suggested drugs exhibit much higher level of radiosensitivity than widely used cisplatin and thus may be good candidates for cancer treatment

Finite quantum tomography via semidefinite programming

Using the the convex semidefinite programming method and superoperator formalism we obtain the finite quantum tomography of some mixed quantum states such as: qudit tomography, N-qubit tomography, phase tomography and coherent spin state tomography, where that obtained results are in agreement with those of References \cite{schack,Pegg,Barnett,Buzek,Weigert}.Comment: 25 page

Pediatric patient with systemic lupus erythematosus & congenital acquired immunodeficiency syndrome: An unusual case and a review of the literature

The coexistence of systemic lupus erythematosus (SLE) in patients with congenital human immunodeficiency virus (HIV) infection is rare. This is a case report of a child diagnosed with SLE at nine years of age. She initially did well on non-steroidal anti-inflammatory agents, hydroxychloroquine, and steroids. She then discontinued her anti-lupus medications and was lost to follow-up. At 13 years of age, her lupus symptoms had resolved and she presented with intermittent fevers, cachexia, myalgias, arthralgias, and respiratory symptoms. Through subsequent investigations, the patient was ultimately diagnosed with congenitally acquired immunodeficiency syndrome (AIDS)

Do we know how scabies outbreaks in residential and nursing care homes for the elderly should be managed? A systematic review of interventions using a novel approach to assess evidence quality.

Currently no national guidelines exist for the management of scabies outbreaks in residential or nursing care homes for the elderly in the United Kingdom. In this setting, diagnosis and treatment of scabies outbreaks is often delayed and optimal drug treatment, environmental control measures and even outcome measures are unclear. We undertook a systematic review to establish the efficacy of outbreak management interventions and determine evidence-based recommendations. Four electronic databases were searched for relevant studies, which were assessed using a quality assessment tool drawing on STROBE guidelines to describe the quality of observational data. Nineteen outbreak reports were identified, describing both drug treatment and environmental management measures. The quality of data was poor; none reported all outcome measures and only four described symptom relief measures. We were unable to make definitive evidence-based recommendations. We draw on the results to propose a framework for data collection in future observational studies of scabies outbreaks. While high-quality randomised controlled trials are needed to determine optimal drug treatment, evidence on environmental measures will need augmentation through other literature studies. The quality assessment tool designed is a useful resource for reporting of outcome measures including patient-reported measures in future outbreaks. Nineteen outbreak reports were identified, describing both drug treatment and environmental management measures. The quality of data was poor; none reported all outcome measures and only four described symptom relief measures. We were unable to make definitive evidence-based recommendations. We draw on the results to propose a framework for data collection in future observational studies of scabies outbreaks. While high quality randomized controlled trials are needed to determine optimal drug treatment, evidence on environmental measures will need augmentation through other literatures. The quality assessment tool designed is a useful resource for reporting of outcome measures including patient-reported measures in future outbreaks