Rapid detection of pneumothorax by ultrasonography in patients with multiple trauma

INTRODUCTION: Early detection of pneumothorax in multiple trauma patients is critically important. It can be argued that the efficacy of ultrasonography (US) for detection of pneumothorax is enhanced if it is performed and interpreted directly by the clinician in charge of the patients. The aim of this study was to assess the ability of emergency department clinicians to perform bedside US to detect and assess the size of the pneumothorax in patients with multiple trauma. METHODS: Over a 14 month period, patients with multiple trauma treated in the emergency department were enrolled in this prospective study. Bedside US was performed by emergency department clinicians in charge of the patients. Portable supine chest radiography (CXR) and computed tomography (CT) were obtained within an interval of three hours. Using CT and chest drain as the gold standard, the diagnostic efficacy of US and CXR for the detection of pneumothorax, defined as rapidity and accuracy (sensitivity, specificity, positive predictive value, negative predictive value), were compared. The size of the pneumothorax (small, medium and large) determined by US was also compared to that determined by CT. RESULTS: Of 135 patients (injury severity score = 29.1 ± 12.4) included in the study, 83 received mechanical ventilation. The time needed for diagnosis of pneumothorax was significantly shorter with US compared to CXR (2.3 ± 2.9 versus 19.9 ± 10.3 minutes, p < 0.001). CT and chest drain confirmed 29 cases of pneumothorax (21.5%). The diagnostic sensitivity, specificity, positive and negative predictive values and accuracy for US and radiography were 86.2% versus 27.6% (p < 0.001), 97.2% versus 100% (not significant), 89.3% versus 100% (not significant), 96.3% versus 83.5% (p = 0.002), and 94.8% versus 84.4% (p = 0.005), respectively. US was highly consistent with CT in determining the size of pneumothorax (Kappa = 0.669, p < 0.001). CONCLUSION: Bedside clinician-performed US provides a reliable tool and has the advantages of being simple and rapid and having higher sensitivity and accuracy compared to chest radiography for the detection of pneumothorax in patients with multiple trauma

2-(3-Oxo-2,3-dihydro-1,2-benzothia­zol-2-yl)acetic acid

In the title compound, C9H7NO3S, the benzoisothia­zolone ring system is essentially planar, with a maximum deviation of 0.013 (2) Å. In the crystal, mol­ecules are linked via O—H⋯O hydrogen bonds, forming chains along [010]. In addition, weak inter­molecular C—H⋯O hydrogen bonds are present

2,2-Dimethyl-5-[(2-nitro­anilino)methyl­idene]-1,3-dioxane-4,6-dione

The crystal of the title compound, C13H12N2O6, contains a bifurcated intra­molecular hydrogen bond between the N—H group and one of the O atoms from both the nitro group and the dioxane-4,6-dione moiety. In addition, mol­ecules are linked by a series of inter­molecular C—H⋯O secondary inter­actions. The dihedral angles between the benzene ring and the nitro group and the conjugated part of the dioxane-4,6-dione moiety are 19.1 (2) and 17.89 (7)°, respectively

N-Cyclo­hexyl-4-[(2-nitro­anilino)­meth­yl]thio­phene-2-sulfonamide

In the title compound, C17H21N3O4S2, an intra­molecular N—H⋯O hydrogen bond involving the proximate amine and nitro groups is observed. In the crystal, inter­molecular N—H⋯O hydrogen bonds involving the amine and SO2 groups occur. One of the notro O atoms is disordered over two conformations with occupancies of 0.578 (12) and 0.422 (12)

5-(1H-Indol-3-yl­methyl­idene)-2,2-di­methyl-1,3-dioxane-4,6-dione

In the title compound, C15H13NO4, the conjugated double-bond system between the two rings adopts a cis configuration and there is an intra­molecular indole–ketone C—H⋯O inter­action. The indole N—H group forms an inter­molecular hydrogen bond with a ketone O-atom acceptor, giving a chain structure along the ab direction. The O-heterocyclic ring adopts a boat conformation and makes a dihedral angle of 16.72 (6)° with the indole ring system

Strangelets at finite temperature: nucleon emission rates, interface and shell effects

We investigate the properties of strangelets at finite temperature $T$, where an equivparticle model is adopted with both the linear confinement and leading-order perturbative interactions accounted for using density-dependent quark masses. The shell effects are examined by solving the Dirac equations for quarks in the mean-field approximation, which diminish with temperature as the occupation probability of each single-particle levels fixed by the Fermi-Dirac statistics, i.e., shell dampening. Consequently, instead of decreasing with temperature, the surface tension extracted from a liquid-drop formula increases with $T$ until reaching its peak at $T\approx 20$-40 MeV with vanishing shell corrections, where the formula roughly reproduces the free energy per baryon of all strangelets. The curvature term, nevertheless, decreases with $T$ despite the presence of shell effects. The neutron and proton emission rates are fixed microscopically according to the external nucleon gas densities that are in equilibrium with strangelets, which generally increase with $T$ ($\lesssim 50$ MeV) for stable strangelets but decrease for those that are unstable against nucleon emission at $T=0$. The energy, free energy, entropy, charge-to-mass ratio, strangeness per baryon, and root-mean-square radius of $\beta$-stable strangelets obtained with various parameter sets are presented as well. The results indicated in this work are useful for understanding the products of binary compact star mergers and heavy-ion collisions

An oligonucleotide microarray for microRNA expression analysis based on labeling RNA with quantum dot and nanogold probe

MicroRNAs (miRNAs) play important regulatory roles in animals and plants by targeting mRNAs for cleavage or translational repression. They have diverse expression patterns and might regulate various developmental and physiological processes. Profiling miRNA expression is very helpful for studying biological functions of miRNAs. We report a novel miRNA profiling microarray, in which miRNAs were directly labeled at the 3′ terminus with biotin and hybridized with complementary oligo-DNA probes immobilized on glass slides, and subsequently detected by measuring fluorescence of quantum dots labeled with streptavidin bound to miRNAs through streptavidin–biotin interaction. The detection limit of this microarray for miRNA was ∼0.4 fmol, and the detection dynamic range spanned about 2 orders of magnitude. We made a model microarray to profile 11 miRNAs from leaf and root of rice (Oryza sativa L. ssp. indica) seedlings. The analysis results of the miRNAs had a good reproducibility and were consistent with the northern blot result. To avoid using high-cost detection equipment, colorimetric detection, a method based on nanogold probe coupled with silver enhancement, was also successfully introduced into miRNA profiling microarray detection