Physiological parameters for Prognosis in Abdominal Sepsis (PIPAS) Study : a WSES observational study

BackgroundTiming and adequacy of peritoneal source control are the most important pillars in the management of patients with acute peritonitis. Therefore, early prognostic evaluation of acute peritonitis is paramount to assess the severity and establish a prompt and appropriate treatment. The objectives of this study were to identify clinical and laboratory predictors for in-hospital mortality in patients with acute peritonitis and to develop a warning score system, based on easily recognizable and assessable variables, globally accepted.MethodsThis worldwide multicentre observational study included 153 surgical departments across 56 countries over a 4-month study period between February 1, 2018, and May 31, 2018.ResultsA total of 3137 patients were included, with 1815 (57.9%) men and 1322 (42.1%) women, with a median age of 47years (interquartile range [IQR] 28-66). The overall in-hospital mortality rate was 8.9%, with a median length of stay of 6days (IQR 4-10). Using multivariable logistic regression, independent variables associated with in-hospital mortality were identified: age > 80years, malignancy, severe cardiovascular disease, severe chronic kidney disease, respiratory rate >= 22 breaths/min, systolic blood pressure 4mmol/l. These variables were used to create the PIPAS Severity Score, a bedside early warning score for patients with acute peritonitis. The overall mortality was 2.9% for patients who had scores of 0-1, 22.7% for those who had scores of 2-3, 46.8% for those who had scores of 4-5, and 86.7% for those who have scores of 7-8.ConclusionsThe simple PIPAS Severity Score can be used on a global level and can help clinicians to identify patients at high risk for treatment failure and mortality.Peer reviewe

Easy to adapt electron beam proximity effect correction parameter calibration based on visual inspection of a “Best Dose Sensor”

The quality of e-beam proximity effect correction depends on the quality of the proximity effect model parameters, which are not accessible to direct measurement. Monte Carlo simulation is capable of determining the electron scattering coefficients, but does not include the process induced effects such as resist blur. Therefore, various experimental methods have been suggested (Stevensat et al. (1986) [1]; Rishton and Kern (1987) [2]; Hudek (2006) [3]). Most are either highly labor intensive due to a large required number of critical dimension measurements, or simple in the experimental evaluation, but limited in accuracy (Babin and Svintsov (1992) [4]), since resist effects interfere with the evaluation criterion.This paper presents an easy to adapt experimental calibration method based on visual inspection of a “Best Dose Sensor”, and its application to calibrate long- and mid-range effect

Describing a new syndrome in L5-S1 disc herniation: Sexual and sphincter dysfunction without pain and muscle weakness

Context: Little seems to be known about the sexual dysfunction (SD) in lumbar intervertebral disc herniation. Aims: Investigation of sexual and sphincter dysfunction in patient with lumbar disc hernitions. Settings and Design: A retrospective analysis. Materials and Methods: Sexual and sphincter dysfunction in patients admitted with lumbar disc herniations between September 2012-March 2014. Statistical Analysis Used: Statistical analysis was performed using the Predictive Analytics SoftWare (PASW) Statistics 18.0 for Windows (Statistical Package for the Social Sciences, SPSS Inc., Chicago, Illinois). The statistical significance was set at P < 0.05. The Wilcoxon signed ranks test was used to evaluate the difference between patients. Results: Four patients with sexual and sphincter dysfunction were found, including two women and two men, aged between 20 and 52 years. All of them admitted without low back pain. In addition, on neurological examination, reflex and motor deficit were not found. However, almost all patients had perianal sensory deficit and sexual and sphincter dysfunction. Magnetic resonance imaging (MRI) of three patients displayed a large extruded disc fragment at L5-S1 level on the left side. In fourth patient, there were not prominent disc herniations. There was not statistically significant difference between pre-operative and post-operative sexual function, anal-urethral sphincter function, and perianal sensation score. A syndrome in L5-S1 disc herniation with sexual and sphincter dysfunction without pain and muscle weakness was noted. We think that it is crucial for neurosurgeons to early realise that paralysis of the sphincter and sexual dysfunction are possible in patients with lumbar L5-S1 disc disease. Conclusion: A syndrome with perianal sensory deficit, paralysis of the sphincter, and sexual dysfunction may occur in patients with lumbar L5-S1 disc disease. The improvement of perianal sensory deficit after surgery was counteracted by a trend toward disturbed sexual function. Further researches are needed to explore the extent of this problem

Application of optical proximity correction for 193 nm deep UV enabled InP photonic integrated circuits

We present the first-time application of rule-based optical proximity correction for InP based photonic integrated circuits fabricated with 193 nm deep UV lithography. Simulations of the lithography process were used to systematically predict and preserve pattern fidelity of sidewall gratings to find optimal correction parameters. Optical proximity corrected designs were exposed in ArF resist, demonstrating high correlation with lithography simulation results and exhibiting up to 70% improved pattern fidelity

A patient-based study on the adherence of physicians to guidelines for the management of type 2 diabetes in Turkey.

Aims: To evaluate physicians' adherence to guidelines by Diabetes Study Group of The Society of Endocrinology and Metabolism of Turkey (SEMT)