Comparison of lung ultrasound with transpulmonary thermodilution in assessing extra-vascular lung water

Background: Increased extra-vascular lung water (EVLW) is common in critical care and correlates with the severity of acute lung injury, length of intensive care unit stay and mortality. Lung ultrasound (LUS) can assess EVLW by determining the amount of ‘B-lines’: artefacts signifying alveolar-interstitial oedema. This study’s aim was to determine whether EVLW estimation with the help of LUS correlates with the more accurate PiCCO2® cardiac output system utilising transpulmonary thermodilution.Methods: This prospective observational study was undertaken at Universitas Academic Hospital, Bloemfontein. Patients were scanned according to a fixed protocol, followed by transpulmonary thermodilution. The cumulative B-line count was compared with the EVLW index generated by the PiCCO2® system.Results: Four males and six females were enrolled. The mean EVLW index was 9.1 ml/kg/m2 (standard deviation 1.45), and the median cumulative B-line count was 14 (interquartile range 6–25). A positive, but not statistically significant, correlation was found (r = 0.40, p = 0.25) between the B-line count and EVLW index.Conclusion: This study investigated a possible correlation between LUS interpretation and transpulmonary thermodilution in assessing EVLW. Results seem promising, but the small sample could indicate only that LUS might be of use for the assessment of EVLW. Further studies are needed.Keywords: B-lines,critical care, extra-vascular lung water, lung ultrasound, thermodilutio

Isolation and identification of Acinetobacter spp. from healthy canine skin

Acinetobacter species can exhibit widespread resistance to antimicrobial agents. They are already recognized as important nosocomial pathogens of humans, but are becoming increasingly recognized in opportunistic infections of animals. This study aimed to determine whether Acinetobacter spp. are carried on skin of healthy dogs and, if present, to identify the species

Concise Adoption of Generic Business Strategies, Virtues for Accomplishing:Corporate Mission in Multinational Firms in Nigeria

This study considered the concise adoption of generic business strategies in the accomplishment of corporate mission in multinational firms in Nigeria. Several attributes based on the resource and competencebased theories and models informed the nature of the study. Quantitative explanatory cross-sectional design was adopted using primarily the structured instrument designed on a 5-point Likert scale. Probability and non-probability sampling techniques were engaged in sampling 275 respondents from the multinational firms. The data obtained were analyzed using both descriptive statistics and regression analysis. The findings revealed that the generic business strategies have signify cant predictors of corporate mission accomplishment. Findings also revealed that there was positive significant influence between concise generic business strategies and firms’ productivity.This paper recommended a mandatory and thorough environmental scanning in order to select the appropriate business stratagem to be implemented in achieving the precise aspects of the corporate mission

The Role of Business Strategy in Accomplishing Organization Mission in Nigerian Manufacturing Companies

The imperativeness of strategic alignment in attaining organizational objectives have become critical in this contemporary business age. The study examined the role of Business Strategy on Mission Accomplishment of Manufacturing companies with a major focus on mission statements of two multi-national companies in Nigeria. Probability and non probability sampling techniques were adopted. In the first stage, the two multinational companies were purposively selected among the list of registered manufacturing companies while in the second stage, a simple random sampling procedure was employed to draw participants from the organizations. A total sample of 384 participants was planned by the sampling procedure, however, only 291 participants were successfully interviewed. From the analysis, it was asserted that the employment of business strategy enhances organizational mission irrespective of the type, ownership, management and size of the organization. In addition, there is need for a thorough environmental scanning in order to select the appropriate business strategy to be adopted in accomplishing the specific aspect of the organization`s mission

Terahertz underdamped vibrational motion governs protein-ligand binding in solution

Low-frequency collective vibrational modes in proteins have been proposed as being responsible for efficiently directing biochemical reactions and biological energy transport. However, evidence of the existence of delocalized vibrational modes is scarce and proof of their involvement in biological function absent. Here we apply extremely sensitive femtosecond optical Kerr-effect spectroscopy to study the depolarized Raman spectra of lysozyme and its complex with the inhibitor triacetylchitotriose in solution. Underdamped delocalized vibrational modes in the terahertz frequency domain are identified and shown to blue-shift and strengthen upon inhibitor binding. This demonstrates that the ligand-binding coordinate in proteins is underdamped and not simply solvent-controlled as previously assumed. The presence of such underdamped delocalized modes in proteins may have significant implications for the understanding of the efficiency of ligand binding and protein–molecule interactions, and has wider implications for biochemical reactivity and biological function

Oxygen exchange and C-reactive protein predict safe discharge in patients with H1N1 influenza

Background: Pandemic influenza has potential to overwhelm healthcare resources. There is uncertainty over performance of existing triage tools for hospital admission and discharge decisions. Aim: Our aim was to identify clinical criteria that predict safe discharge from hospital and develop a pragmatic triage tool to guide physician decision-making. Design: We retrospectively examined an existing database of patients who presented to the Royal Liverpool University Hospital during the 2010-2011 influenza pandemic. Methods: Inclusion criteria: patients ≥18 years, with PCR confirmed H1N1 influenza. Exclusion criteria: died in the emergency department or case notes unavailable. Successful discharge was defined as discharge within 24 hours of presentation and no readmission within seven days. Results: Eighty-six patients were included and 16 were successfully discharged. Estimated P/F ratio and C-reactive protein predicted safe discharge in a multivariable logistic regression model (AUC 0.883). A composite univariate predictor (estimated P/F minus C-reactive protein, AUC 0.877) was created to calculate specific cut off points for sensitivity and specificity. A pragmatic decision tool was created to incorporate these thresholds and relevant guidelines. Discharge: SpO2 (in air) ≥ 94% and CRP 50 or SpO2 ≤ 93% and CRP 50. Conclusions: We identified that oxygen exchange and CRP, a marker of acute inflammation, were the most important predictors of safe discharge. Our proposed simple triage model requires validation but has the potential to aid clinical decisions in the event of a future pandemic, and potentially for seasonal influenza