395 research outputs found
The Efficacy of Renal Replacement Therapy for Rewarming of Patients in Severe Accidental Hypothermia-Systematic Review of the Literature.
Renal replacement therapy (RRT) can be used to rewarm patients in deep hypothermia. However, there is still no clear evidence for the effectiveness of RRT in this group of patients. This systematic review aims to summarize the rewarming rates during RRT in patients in severe hypothermia, below or equal to 32 °C.
This systematic review was registered in the PROSPERO International Prospective Register of Systematic Reviews (identifier CRD42021232821). We searched Embase, Medline, and Cochrane databases using the keywords hypothermia, renal replacement therapy, hemodialysis, hemofiltration, hemodiafiltration, and their abbreviations. The search included only articles in English with no time limit, up until 30 June 2021.
From the 795 revised articles, 18 studies including 21 patients, were selected for the final assessment and data extraction. The mean rate of rewarming calculated for all studies combined was 1.9 °C/h (95% CI 1.5-2.3) and did not differ between continuous (2.0 °C/h; 95% CI 0.9-3.0) and intermittent (1.9 °C/h; 95% CI 1.5-2.3) methods (p > 0.9).
Based on the reviewed literature, it is currently not possible to provide high-quality recommendations for RRT use in specific groups of patients in accidental hypothermia. While RRT appears to be a viable rewarming strategy, the choice of rewarming method should always be determined by the specific clinical circumstances, the available resources, and the current resuscitation guidelines
Does the autecology of core species reflect the synecology of functional groups during the assembly of vegetation in abandoned extracted peatlands?
The combined autecology of individual species is expected to reflect the synecology of their respective functional groups and vice versa, but this assumption has been rarely assessed. We estimated this similarity in limiting ecological filters using vegetation survey data from 64 abandoned extracted peatlands in Estonia, which form a 50-year chronosequence of secondary succession. Partial overlap was found between filters predicting the occurrence of individual core species and richness in their respective functional groups. These overlapping filters were microtopographical form (flats, margins, ditches), time since abandonment, and various properties of peat. At the functional group level, time since abandonment and habitat properties showed clear interactions with microform type. Bog species and acidophilous bilocals successfully established on flats and ditch margins when residual peat was acidic and poorly decayed, while species of fens and mineral soils preferentially established in ditches of large extraction fields, where residual peat had higher pH and higher mineral content. We also detected some effects of landscape-level (patch area and forest neighbourhood) and regional filters (continentality); however, their limiting role was inconsistent. Many ecological filters also were shared between functional groups at the species level, but the optimal levels of these filters differed between groups. We conclude that even in species-poor habitats, both the autecology of individual species and the synecology of functional groups should be considered during habitat restoration. In peatland restoration, the following management strategies are advised to direct a faster and more successful trajectory: controlling the depth of peat extraction, partial filling of ditches, introducing plant propagules and managing mineral dust pollution
Data and methods to calculate cut-off values for serum potassium and core temperature at hospital admission for extracorporeal rewarming of avalanche victims in cardiac arrest.
The data and estimation methods presented in this article are associated with the research article, "Cut-off values of serum potassium and core temperature at hospital admission for extracorporeal rewarming of avalanche victims in cardiac arrest: a retrospective multi-centre study" [1]. In this article we estimate recommended cut-off values for in-hospital triage with respect to extracorporeal rewarming. With only 6 survivors of 103 patients collected over a period of 20 years the ability to estimate reliable threshold values is limited. In addition, because the number of avalanche victims is also limited, a significantly larger dataset is unlikely to be obtained. We have therefore adapted two non-parametric estimation methods (bootstrapping and exact binomial distribution) to our specific needs and performed a simulations to confirm validity and reliability
A broad range quorum sensing inhibitor working through sRNA inhibition
Abstract For the last decade, chemical control of bacterial virulence has received considerable attention. Ajoene, a sulfur-rich molecule from garlic has been shown to reduce expression of key quorum sensing regulated virulence factors in the opportunistic pathogen Pseudomonas aeruginosa. Here we show that the repressing effect of ajoene on quorum sensing occurs by inhibition of small regulatory RNAs (sRNA) in P. aeruginosa as well as in Staphylococcus aureus, another important human pathogen that employs quorum sensing to control virulence gene expression. Using various reporter constructs, we found that ajoene lowered expression of the sRNAs RsmY and RsmZ in P. aeruginosa and the small dual-function regulatory RNA, RNAIII in S. aureus, that controls expression of key virulence factors. We confirmed the modulation of RNAIII by RNA sequencing and found that the expression of many QS regulated genes encoding virulence factors such as hemolysins and proteases were lowered in the presence of ajoene in S. aureus. Importantly, our findings show that sRNAs across bacterial species potentially may qualify as targets of anti-virulence therapy and that ajoene could be a lead structure in search of broad-spectrum compounds transcending the Gram negative-positive borderline
Anaplastic carcinoma of the pancreas producing granulocyte-colony stimulating factor: a case report
<p>Abstract</p> <p>Introduction</p> <p>The granulocyte-colony stimulating factor-producing tumor was first reported in 1977, however, anaplastic pleomorphic type carcinoma of the pancreas producing granulocyte-colony stimulating factor is still rare.</p> <p>Case presentation</p> <p>A 63-year-old man was admitted to our hospital with body weight loss (-10 kg during months) and upper abdominal pain from 3 weeks. Abdominal computed tomography demonstrated a pancreatic tumor 10 cm in size and multiple low-density areas in the liver. On admission, the peripheral leukocyte count was elevated to 91,500/mm<sup>3 </sup>and the serum concentration of granulocyte-colony stimulating factor was 134 pg/mL (normal, < 18.1 pg/mL). Based on liver biopsy findings, the tumor was classified as an anaplastic pleomorphic-type carcinoma. Immunohistochemical staining showed that pancreatic carcinoma cells were positive for granulocyte-colony stimulating factor. The patient developed interstitial pneumonia, probably caused by granulocyte-colony stimulating factor, and died 11 days after admission.</p> <p>Conclusion</p> <p>This is a rare case report of anaplastic pleomorphic-type carcinoma of the pancreas producing granulocyte-colony stimulating factor and confirmed by immunohistochemistry.</p
Racetrack Inflation
We develop a model of eternal topological inflation using a racetrack
potential within the context of type IIB string theory with KKLT volume
stabilization. The inflaton field is the imaginary part of the K\"ahler
structure modulus, which is an axion-like field in the 4D effective field
theory. This model does not require moving branes, and in this sense it is
simpler than other models of string theory inflation. Contrary to
single-exponential models, the structure of the potential in this example
allows for the existence of saddle points between two degenerate local minima
for which the slow-roll conditions can be satisfied in a particular range of
parameter space. We conjecture that this type of inflation should be present in
more general realizations of the modular landscape. We also consider
`irrational' models having a dense set of minima, and discuss their possible
relevance for the cosmological constant problem.Comment: 23 pages 7 figures. The final version with minor modifications, to
appear in JHE
Creation of a Compact Topologically Nontrivial Inflationary Universe
If inflation can occur only at the energy density V much smaller than the
Planck density, which is the case for many inflationary models based on string
theory, then the probability of quantum creation of a closed or an infinitely
large open inflationary universe is exponentially suppressed for all known
choices of the wave function of the universe. Meanwhile under certain
conditions there is no exponential suppression for creation of topologically
nontrivial compact flat or open inflationary universes. This suggests, contrary
to the standard textbook lore, that compact flat or open universes with
nontrivial topology should be considered a rule rather than an exception.Comment: 9 pages 2 figures, new materials and references adde
Cloud height measurement by a network of all-sky-imagers
Cloud base height (CBH) is an important parameter for many applications such as aviation, climatology or solarirradiance nowcasting (forecasting for the next seconds to hours ahead). The latter application is of increasing importance tooperate distribution grids as well as photovoltaic power plants, energy storage systems and flexible consumers.To nowcast solar irradiance, systems based on all-sky-imagers (ASIs), cameras monitoring the entire sky dome above theirpoint of installation, have been demonstrated. Accurate knowledge of CBH is required to nowcast the spatial distribution of5solar irradiance around the ASI’s location at a resolution down to5 m. Two ASIs located at a distance of usually less than6 kmcan be combined into an ASI-pair to measure CBH. However, the accuracy of such systems is limited. We present and validatea method to measure CBH using a network of ASIs to enhance accuracy. To the best of our knowledge, this is the first methodto measure CBH by a network of ASIs which is demonstrated experimentally.In this study, the deviations of 42 ASI-pairs are studied in comparison to a ceilometer and characterized by camera distance.10The ASI-pairs are formed from seven ASIs and feature camera distances of0.8...5.7 km. Each of the 21 ASI-tuples formedfrom seven ASIs yields two independent ASI-pairs as the ASI used as main and auxiliary camera respectively is swapped.Deviations found are compiled into conditional probabilities telling how probable it is to receive a certain reading of CBHfrom an ASI-pair given that true CBH takes on some specific value. Based on such statistical knowledge, in the inference thelikeliest actual CBH is estimated from the readings of all 42 ASI-pairs.15Based on the validation results, ASI-pairs with small camera distance (especially if<1.2 km) are accurate for low clouds(CBH<4 km). In contrast, ASI-pairs with camera distance of more than3 kmprovide smaller deviations for greater CBH.No ASI-pair provides most accurate measurements under all conditions. The presented network of ASIs at different distancesproves that, under all cloud conditions, the measurements of CBH are more accurate than using a single ASI-pair
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