433 research outputs found

    Predictive ability of the ISS, NISS, and APACHE II score for SIRS and sepsis in polytrauma patients

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    Purpose: Systemic inflammatory response syndrome (SIRS) and sepsis as causes of multiple organ dysfunction syndrome (MODS) remain challenging to treat in polytrauma patients. In this study, the focus was set on widely used scoring systems to assess their diagnostic quality. Methods: A total of 512 patients (mean age: 39.2±16.2, range: 16-88years) who had an Injury Severity Score (ISS) ≥17 were included in this retrospective study. The patients were subdivided into four groups: no SIRS, slight SIRS, severe SIRS, and sepsis. The ISS, New Injury Severity Score (NISS), Acute Physiology and Chronic Health Evaluation II (APACHE II) scores, and prothrombin time were collected at admission. The Kruskal-Wallis test and χ2-test, multinomial regression analysis, and kernel density estimates were performed. Receiver operating characteristic (ROC) analysis is reported as the area under the curve (AUC). Data were considered as significant if p<0.05. Results: All variables were significantly different in all groups (p<0.001). The odds ratio increased with increasing SIRS severity for NISS (slight vs. no SIRS, 1.06, p=0.07; severe vs. no SIRS, 1.07, p=0.04; and sepsis vs. no SIRS, 1.11, p=0.0028) and APACHE II score (slight vs. no SIRS, 0.97, p=0.44; severe vs. no SIRS, 1.08, p=0.02; and sepsis vs. no SIRS, 1.12, p=0.0028). ROC analysis revealed that the NISS (slight vs. no SIRS, AUC 0.61; severe vs. no SIRS, AUC 0.67; and sepsis vs. no SIRS, AUC 0.77) and APACHE II score (slight vs. no SIRS, AUC 0.60; severe vs. no SIRS, AUC 0.74; and sepsis vs. no SIRS, AUC 0.82) had the best predictive ability for SIRS and sepsis. Conclusion: Quick assessment with the NISS or APACHE II score could preselect possible candidates for sepsis following polytrauma and provide guidance in trauma surgeons' decision-makin

    Einfluss der Sakrumfraktur auf das funktionelle Langzeitergebnis von Beckenringverletzungen

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    Zusammenfassung: In der Akutphase umfasst die Behandlung der Beckenringverletzung mit Beteiligung des iliosakralen Komplexes die effiziente Blutungskontrolle und Stabilisierung des Beckenrings. Für das Langzeitresultat sind jedoch neurologische Ausfälle, Fehlverheilungen des hinteren Beckenrings mit tieflumbalen Schmerzen und urologische Komplikationen entscheidend. Zwischen 1991 und 2000 wurden in unserer Klinik 173Patienten mit Sakrumfrakturen behandelt. Diese wurden im Rahmen einer lateralen Kompressionsfraktur (AO-Klassifikation TypB2) oder einer "vertical-shear-" (Typ-C-)Verletzung mit einer Dislokation von 1cm wurden operativ (n=33, 19%) versorgt. 112Patienten wurden nach durchschnittlich 4,9Jahren nachkontrolliert. Von den 39Patienten mit neurologischen Ausfällen (35%) zeigten lediglich 4 eine vollständige neurologische Erholung. Chronische tieflumbale Schmerzen traten selten (n=8, 7%) und nur bei einer Typ-C-Verletzung auf. Die geringe Inzidenz an lumbalen Schmerzen rechtfertigt die konservative Therapie wenig dislozierter (<1cm) Sakrumfrakturen. Entscheidend für das Langzeitergebnis sind neurologische Defizite, die bei 30% aller Patienten persistiere

    A Website to help the International Students Experience (WISE)

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    Our VCU campus has been steadily expanding its international student population and has become an increasingly global university community. We have identified together with GEO, the need to build tangible resources that can support faculty and staff to more effectively educate our international student population. The creation of online content to be added to GEO’s current webpage seems to best fit the existing need. Our project outlines a blueprint for this online content by means of identifying data and resources that should be included as well as determining cost, sustainability and feasibility plans. Ultimately, the goal is to pave the way for centralized online content that can connect faculty and staff with important resources to optimize the academic experience and success of international students at VCU

    An Atlas of Warm AGN and Starbursts from the IRAS Deep Fields

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    We present 180 AGN candidates based on color selection from the IRAS slow-scan deep observations, with color criteria broadened from the initial Point-Source Catalog samples to include similar objects with redshifts up to z=1 and allowing for two-band detections. Spectroscopic identifications have been obtained for 80 (44%); some additional ones are secure based on radio detections or optical morphology, although yet unobserved spectroscopically. These spectroscopic identifications include 13 Sy 1 galaxies, 17 Sy 2 Seyferts, 29 starbursts, 7 LINER systems, and 13 emission-line galaxies so heavily reddened as to remain of ambiguous classification. The optical magnitudes range from R=12.0-20.5; counts suggest that incompleteness is important fainter than R=15.5. Redshifts extend to z=0.51, with a significant part of the sample at z>0.2. The sample includes slightly more AGN than star-forming systems among those where the spectra contain enough diagnostic feature to make the distinction. The active nuclei include several broad-line objects with strong Fe II emission, and composite objects with the absorption-line signatures of fading starbursts. These AGN with warm far-IR colors have little overlap with the "red AGN" identified with 2MASS; only a single Sy 1 was detected by 2MASS with J-K > 2. Some reliable IRAS detections have either very faint optical counterparts or only absorption-line galaxies, potentially being deeply obscured AGN. The IRAS detections include a newly identified symbiotic star, and several possible examples of the "Vega phenomenon", including dwarfs as cool as type K. Appendices detail these candidate stars, and the optical-identification content of a particularly deep set of high-latitude IRAS scans (probing the limits of optical identification from IRAS data alone).Comment: ApJ Suppl, in press. Figures converted to JPEG/GIF for better compression; PDF with full-resolution figures available before publication at http://www.astr.ua.edu/keel/aoagn.pd

    Extended X-ray emission in the IC 2497 - Hanny's Voorwerp system: energy injection in the gas around a fading AGN

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    We present deep Chandra X-ray observations of the core of IC 2497, the galaxy associated with Hanny's Voorwerp and hosting a fading AGN. We find extended soft X-ray emission from hot gas around the low intrinsic luminosity (unobscured) AGN (Lbol10421044L_{\rm bol} \sim 10^{42}-10^{44} erg s1^{-1}). The temperature structure in the hot gas suggests the presence of a bubble or cavity around the fading AGN (\mbox{E_{\rm bub}} \sim 10^{54} - 10^{55} erg). A possible scenario is that this bubble is inflated by the fading AGN, which after changing accretion state is now in a kinetic mode. Other possibilities are that the bubble has been inflated by the past luminous quasar (Lbol1046L_{\rm bol} \sim 10^{46} erg s1^{-1}), or that the temperature gradient is an indication of a shock front from a superwind driven by the AGN. We discuss the possible scenarios and the implications for the AGN-host galaxy interaction, as well as an analogy between AGN and X-ray binaries lifecycles. We conclude that the AGN could inject mechanical energy into the host galaxy at the end of its lifecycle, and thus provide a source for mechanical feedback, in a similar way as observed for X-ray binaries.Comment: 9 pages, 5 figures, accepted for publication in MNRA

    Recent Developments in Smart Adaptive Structures for Solar Sailcraft

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    The "Smart Adaptive Structures for Solar Sailcraft" development activity at MSFC has investigated issues associated with understanding how to model and scale the subsystem and multi-body system dynamics of a gossamer solar sailcraft with the objective of designing sailcraft attitude control systems. This research and development activity addressed three key tasks that leveraged existing facilities and core competencies of MSFC to investigate dynamics and control issues of solar sails. Key aspects of this effort included modeling and testing of a 30 m deployable boom; modeling of the multi-body system dynamics of a gossamer sailcraft; investigation of control-structures interaction for gossamer sailcraft; and development and experimental demonstration of adaptive control technologies to mitigate control-structures interaction

    II Zwicky 23 and Family

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    II Zwicky 23 (UGC 3179) is a luminous, nearby compact narrow emission line starburst galaxy with blue optical colors and strong emission lines. We present a photometric and morphological study of II Zw 23 and its interacting companions using data obtained with the WIYN 3.5-m telescope in Kitt Peak, Arizona. II Zwicky 23 has a highly disturbed outer structure with long trails of debris that may be feeding tidal dwarfs. Its central regions appear disky, a structure that is consistent with the overall rotation pattern observed in the H-alpha velocity field measured from Densepak observations obtained with WIYN. We discuss the structure of II Zwicky 23 and its set of companions and possible scenarios of debris formation in this system.Comment: 5 pages, 2 figures. To appear in the proceedings of ESO Astrophysics Symposia: "Groups of Galaxies in the Nearby Universe", eds. I. Saviane, V. Ivanov, J. Burissova (Springer

    The fundamental solution and Strichartz estimates for the Schr\"odinger equation on flat euclidean cones

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    We study the Schr\"odinger equation on a flat euclidean cone R+×Sρ1\mathbb{R}_+ \times \mathbb{S}^1_\rho of cross-sectional radius ρ>0\rho > 0, developing asymptotics for the fundamental solution both in the regime near the cone point and at radial infinity. These asymptotic expansions remain uniform while approaching the intersection of the "geometric front", the part of the solution coming from formal application of the method of images, and the "diffractive front" emerging from the cone tip. As an application, we prove Strichartz estimates for the Schr\"odinger propagator on this class of cones.Comment: 21 pages, 4 figures. Minor typos corrected. To be published in Comm. Math. Phy

    Carbon allocation and carbon isotope fluxes in the plant-soil-atmosphere continuum: a review

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    The terrestrial carbon (C) cycle has received increasing interest over the past few decades, however, there is still a lack of understanding of the fate of newly assimilated C allocated within plants and to the soil, stored within ecosystems and lost to the atmosphere. Stable carbon isotope studies can give novel insights into these issues. In this review we provide an overview of an emerging picture of plant-soil-atmosphere C fluxes, as based on C isotope studies, and identify processes determining related C isotope signatures. The first part of the review focuses on isotopic fractionation processes within plants during and after photosynthesis. The second major part elaborates on plant-internal and plant-rhizosphere C allocation patterns at different time scales (diel, seasonal, interannual), including the speed of C transfer and time lags in the coupling of assimilation and respiration, as well as the magnitude and controls of plant-soil C allocation and respiratory fluxes. Plant responses to changing environmental conditions, the functional relationship between the physiological and phenological status of plants and C transfer, and interactions between C, water and nutrient dynamics are discussed. The role of the C counterflow from the rhizosphere to the aboveground parts of the plants, e.g. via CO&lt;sub&gt;2&lt;/sub&gt; dissolved in the xylem water or as xylem-transported sugars, is highlighted. The third part is centered around belowground C turnover, focusing especially on above- and belowground litter inputs, soil organic matter formation and turnover, production and loss of dissolved organic C, soil respiration and CO&lt;sub&gt;2&lt;/sub&gt; fixation by soil microbes. Furthermore, plant controls on microbial communities and activity via exudates and litter production as well as microbial community effects on C mineralization are reviewed. A further part of the paper is dedicated to physical interactions between soil CO&lt;sub&gt;2&lt;/sub&gt; and the soil matrix, such as CO&lt;sub&gt;2&lt;/sub&gt; diffusion and dissolution processes within the soil profile. Finally, we highlight state-of-the-art stable isotope methodologies and their latest developments. From the presented evidence we conclude that there exists a tight coupling of physical, chemical and biological processes involved in C cycling and C isotope fluxes in the plant-soil-atmosphere system. Generally, research using information from C isotopes allows an integrated view of the different processes involved. However, complex interactions among the range of processes complicate or currently impede the interpretation of isotopic signals in CO&lt;sub&gt;2&lt;/sub&gt; or organic compounds at the plant and ecosystem level. This review tries to identify present knowledge gaps in correctly interpreting carbon stable isotope signals in the plant-soil-atmosphere system and how future research approaches could contribute to closing these gaps
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