Anatomical Injury Clusters in Polytrauma Patients

Polytrauma is a major cause of death in young adults. The trial was to identify clusters of interlinked anatomical regions to improve strategical operational planning in the acute situation. A total of 2219 polytrauma patients with an ISS (Injury Severity Score) ≥ 16 and an age ≥ 16 years was included into this retrospective cohort study. Pearson’s correlation was performed amongst the AIS (Abbreviated Injury Scale) groups. The predictive quality was tested by ROC (Receiver Operating Curve) and their area under the curve. Independency was tested by the binary logistic regression , AIS ≥3 was taken as a significant injury. The analysis was conducted using IBM SPSS® 24.0. The highest predictive value was reached in the combination of thorax, abdomen, pelvis and spine injuries (ROC: abdomen for thorax 0.647, thorax for abdomen 0.621, pelvis for thorax 0.608, pelvis for abdomen 0.651, spine for thorax 0.617). The binary logistic regression revealed the anatomical regions thorax, abdomen pelvis and spine as per-mutative independent predictors for each other when a particular injury exceeded the AIS ≥3. The documented clusters of injuries in truncal trauma are crucial to define priorities in the polytrauma management

The Role of Lactate for Sepsis in Polytrauma Patients, a Time related Analysis using the IBM Watson Trauma Pathway Explorer®

The Watson Trauma Pathway Explorer® is an outcome prediction tool invented by the University Hospital of Zurich in collaboration with IBM®, representing an artificial intelligence application to predict the most adverse outcome scenarios in polytrauma patients: Systemic Inflammatory Respiratory Syndrome (SIRS), sepsis within 21 days and death within 72 h. The hypothesis was how lactate values woud be associated with the incidence of sepsis. Data from 3653 patients in an internal database, with ongoing implementation, served for analysis. Patients were split in two groups according to sepsis presence, and lactate values were measured at formerly defined time points from admission until 21 days after admission for both groups. Differences between groups were analyzed; time points with lactate as independent predictor for sepsis were identified. The predictive quality of lactate at 2 and 12 h after admission was evaluated. Threshold values between groups at all timepoints were calculated. Lactate levels differed from less than 2 h after admission until the end of the observation period (21 d). Lactate represented an independent predictor for sepsis from 12 to 48 h and 14 d to 21 d after admission relative to ISS levels. AUROC was poor at 2 and 12 h after admission with a slight improvement at the 12 h mark. Lactate levels decreased over time at a range of 2 [mmol/L] for 6-8 h after admission. These insights may allow for time-dependent referencing of lactate levels and anticipation of subsequent sepsis, although further parameters must be considered for a higher predictability

ЛЕВ ПАДАЛКА ЯК ДОСЛІДНИК ЗАПОРОЖЖЯ

Нові публікації останнього часу про формування ідейних та теоретичних засад української історичної науки дають підстави для переконливих висновків про тяглість і цілеспрямованість історіографічного процесу в Україні, а також про роль у ньому як окремих, справді видатних особистостей, так і істориків „другого плану”. Важливе значення для їх становлення мало навчання і залучення до наукової діяльності під егідою і за уважним сприянням фундаторів вітчизняної історичної науки. Переважну більшість серед них склали регіональні школи наукових досліджень, які ввели до наукового обігу величезний комплекс архівних джерел, даних топографії, археології, статистики, етнографії

IBM WATSON Trauma Pathway Explorer© as a Predictor for Sepsis after Polytrauma - Is Procalcitonin Useful for Identifying Septic Polytrauma Patients?

IBM and the University Hospital Zurich have developed an online tool for predicting outcomes of a patient with polytrauma, the IBM WATSON Trauma Pathway Explorer®. The three predicted outcomes are Systemic Inflammatory Response Syndrome (SIRS) and sepsis within 21 days as well as early death within 72 hours since the admission of the patient. The validated Trauma Pathway Explorer® offers insights into the most common laboratory parameters, such as procalcitonin (PCT). Sepsis is one of the most important complications after polytrauma, which is why it is crucial to detect it early. This study aimed to examine the time-dependent relationship between PCT values and sepsis, based on the WATSON technology. A total of 3653 patients were included, and ongoing admissions are incorporated continuously. Patients were split into two groups (sepsis and non-sepsis), and the PCT value was assessed for 21 days (1, 2, 3, 4, 6, 8, 12, 24, 48 hours, and 3, 4, 5, 7, 10, 14 and 21 days). The Mann-Whitney U-Test was used to evaluate the difference between the two groups. Binary logistic regression was utilized to examine the dependency of prediction. The Closest Top-left Threshold Method provided time-specific thresholds at which the PCT level is predictive for sepsis. At p <0.05, the data were declared significant. R was used to conduct all statistical analyses. The Mann-Whitney U-test showed a significant difference in PCT values in sepsis and non-sepsis patients between 12 and 24 hours, including post-hoc analysis (p <0.05). Likewise, the p-value started to be significant between 12 and 24 hours in the binary logistic regression (p <0.05). The threshold value of PCT to predict sepsis at 24 hours is 0.7μg/l, and at 48 hours 0.5μg/l. The presented time course of PCT levels in polytrauma patients shows the PCT as a separate predictor for sepsis relatively early. Even later, during the 21-day observation period, time-dependent PCT values may be utilized as a benchmark for the early and preemptive detection of sepsis, which may reduce death from septic shock and other deadly infectious episodes

Post-LEP CMSSM Benchmarks for Supersymmetry

We introduce a set of CMSSM benchmark scenarios that take into account the constraints from LEP, Tevatron, $b \to s \gamma$, $g_\mu - 2$ and cosmology. The benchmark points are chosen to span the range of different generic possibilities, including focus-point models, points where coannihilation effects on the relic density are important, and points with rapid relic annihilation via direct-channel Higgs poles, as well as points with smaller sparticle masses. We make initial estimates of the physics reaches of different accelerators, including the LHC, and $e^+ e^-$ colliders in the sub- and multi-TeV ranges. We stress the complementarity of hadron and lepton colliders, with the latter favoured for non-strongly-interacting particles and precision measurements

Finding Concealed Active Faults: Extending the Southern Whidbey Island Fault across the Puget Lowland, Washington

The southern Whidbey Island fault zone (SWIF), as previously mapped using borehole data, potential field anomalies, and marine seismic reflection surveys, consists of three subparallel, northwest trending strands extending ~100 km from near Vancouver Island to the northern Puget Lowland. East of Puget Sound, the SWIF makes landfall between the cities of Seattle and Everett but is concealed beneath a thick mantle of young glacial deposits and vegetation. A ~20-km-wide, northwest trending swath of subparallel, low-amplitude aeromagnetic anomalies crosses this region of the Puget Lowland and is on strike with the SWIF. The most prominent aeromagnetic anomaly, the Cottage Lake lineament, extends at least 18 km and lies approximately on strike with the SWIF on Whidbey Island. Subtle scarps and topographic lineaments on Pleistocene surfaces, visible on high-resolution lidar topography at a number of locations along the SWIF, lie on or near these magnetic anomalies. In the field, scarps exhibit northeast-side-up and vertical relief of 1 to 5 m. Excavations across several lidar scarps lying on or near magnetic anomalies show evidence for multiple folding and faulting events since deglaciation, most likely above buried reverse/oblique faults. Excavations in areas away from magnetic anomalies do not show evidence of tectonic deformation. In total, paleoseismological evidence suggests that the SWIF produced at least four earthquakes since deglaciation about 16,400 years ago, the most recent less than 2700 years ago

Proposed Post-LEP Benchmarks for Supersymmetry

We propose a new set of supersymmetric benchmark scenarios, taking into account the constraints from LEP, b to s gamma, g_mu - 2 and cosmology. We work in the context of the constrained MSSM (CMSSM) with universal soft supersymetry-breaking masses and assume that R parity is conserved. We propose benchmark points that exemplify the different generic possibilities, including focus-point models, points where coannihilation effects on the relic density are important, and points with rapid relic annihilation via direct-channel Higgs poles. We discuss the principal decays and signatures of the different classes of benchmark scenarios, and make initial estimates of the physics reaches of different accelerators, including the Tevatron collider, the LHC, and e+ e- colliders in the sub- and multi-TeV ranges. We stress the complementarity of hadron and lepton colliders, with the latter favoured for non-strongly-interacting particles and precision measurements. We mention features that could usefully be included in future versions of supersymmetric event generators