Glasgow Coma Scale score at intensive care unit discharge predicts the 1-year outcome of patients with severe traumatic brain injury

OBJECTIVE: To analyse the association between the Glasgow Coma Scale (GCS) score at intensive care unit (ICU) discharge and the 1-year outcome of patients with severe traumatic brain injury (TBI). DESIGN: Retrospective analysis of prospectively collected observational data. PATIENTS: Between 01/2001 and 12/2005, 13 European centres enrolled 1,172 patients with severe TBI. Data on accident, treatment and outcomes were collected. According to the GCS score at ICU discharge, survivors were classified into four groups: GCS scores 3–6, 7–9, 10–12 and 13–15. Using the Glasgow Outcome Scale (GOS), 1-year outcomes were classified as “favourable” (scores 5, 4) or “unfavourable” (scores <4). Factors that may have contributed to outcomes were compared between groups and for favourable versus unfavourable outcomes within each group. MAIN RESULTS: Of the 538 patients analysed, 308 (57 %) had GCS scores 13–15, 101 (19 %) had scores 10–12, 46 (9 %) had scores 7–9 and 83 (15 %) had scores 3–6 at ICU discharge. Factors significantly associated with these GCS scores included age, severity of trauma, neurological status (GCS, pupils) at admission and patency of the basal cisterns on the first computed tomography (CT) scan. Favourable outcome was achieved in 74 % of all patients; the rates were significantly different between GCS groups (93, 83, 37 and 10 %, respectively). Within each of the GCS groups, significant differences regarding age and trauma severity were found between patients with favourable versus unfavourable outcomes; neurological status at admission and CT findings were not relevant. CONCLUSION: The GCS score at ICU discharge is a good predictor of 1-year outcome. Patients with a GCS score <10 at ICU discharge have a poor chance of favourable outcome

Performance of IMPACT, CRASH and Nijmegen models in predicting six month outcome of patients with severe or moderate TBI: An external validation study

Background: External validation on different TBI populations is important in order to assess the generalizability of prognostic models to different settings. We aimed to externally validate recently developed models for prediction of six month unfavourable outcome and six month mortality. Methods: The International Neurotrauma Research Organization - Prehospital dataset (INRO-PH) was collected within an observational study between 2009-2012 in Austria and includes 778 patients with TBI of GCS < = 12. Three sets of prognostic models were externally validated: the IMPACT core and extended models, CRASH basic models and the Nijmegen models developed by Jacobs et al - all for prediction of six month unfavourable outcome and six month mortality. The external validity of the models was assessed by discrimination (Area Under the receiver operating characteristic Curve, AUC) and calibration (calibration statistics and plots). Results: Median age in the validation cohort was 50 years and 44% had an admission GSC motor score of 1-3. Six-month mortality was 27%. Mortality could better be predicted (AUCs around 0.85) than unfavourable outcome (AUCs around 0.80). Calibration plots showed that the o

Local Optical Spectroscopy in Quantum Confined Systems: A Theoretical Description

A theoretical description of local absorption is proposed in order to investigate spectral variations on a length scale comparable with the extension of the relevant quantum states. A general formulation is derived within the density-matrix formalism including Coulomb correlation, and applied to the prototypical case of coupled quantum wires. The results show that excitonic effects may have a crucial impact on the local absorption with implications for the spatial resolution and the interpretation of near-field optical spectra.Comment: To appear in Phys. Rev. Lett. - 11 pages, 3 PostScript figures (1 figure in colors) embedded. Uses RevTex, and psfig style

Multi Mode Interferometer for Guided Matter Waves

We describe the fundamental features of an interferometer for guided matter waves based on Y-beam splitters and show that, in a quasi two-dimensional regime, such a device exhibits high contrast fringes even in a multi mode regime and fed from a thermal source.Comment: Final version (accepted to PRL

High Temperature Proton Exchange Membranes With Enhanced Proton Conductivities At Low Humidity and High Temperature Based On Polymer Blends and Block Copolymers of Poly(1,3-Cyclohexadiene) and Poly(ethylene Glycol)

Hot (at 120 °C) and dry (20% relative humidity) operating conditions benefit fuel cell designs based on proton exchange membranes (PEMs) and hydrogen due to simplified system design and increasing tolerance to fuel impurities. Presented are preparation, partial characterization, and multi-scale modeling of such PEMs based on cross-linked, sulfonated poly(1,3-cyclohexadiene) (xsPCHD) blends and block copolymers with poly(ethylene glycol) (PEG). These low cost materials have proton conductivities 18 times that of current industry standard Nafion at hot, dry operating conditions. Among the membranes studied, the blend xsPCHD-PEG PEM displayed the highest proton conductivity, which exhibits a morphology with higher connectivity of the hydrophilic domain throughout the membrane. Simulation and modeling provide a molecular level understanding of distribution of PEG within this hydrophilic domain and its relation to proton conductivities. This study demonstrates enhancement of proton conductivity at high temperature and low relative humidity by incorporation of PEG and optimized sulfonation conditions

Open system effects on slow light and electromagnetically induced transparency

The coherence properties of a three-level $\Lambda$-system influenced by a Markovian environment are analyzed. A coherence vector formalism is used and a vector form of the Lindblad equation is derived. Together with decay channels from the upper state, open system channels acting on the subspace of the two lower states are investigated, i.e., depolarization, dephasing, and amplitude damping channels. We derive an analytic expression for the coherence vector and the concomitant optical susceptibility, and analyze how the different channels influence the optical response. This response depends non-trivially on the type of open system interaction present, and even gain can be obtained. We also present a geometrical visualization of the coherence vector as an aid to understand the system response.Comment: Several changes; journal reference adde

Electron and Hole Spin Splitting and Photogalvanic Effect in Quantum Wells

A theory of the circular photogalvanic effect caused by spin splitting in quantum wells is developed. Direct interband transitions between the hole and electron size-quantized subbands are considered. It is shown that the photocurrent value and direction depend strongly on the form of the spin-orbit interaction. The currents induced by structure-, bulk-, and interface-inversion asymmetry are investigated. The photocurrent excitation spectra caused by spin splittings in both conduction and valence bands are calculated.Comment: 7 pages, 3 figure