Summary
We undertook an audit in a rural Ugandan hospital that describes the epidemiology and mortality of 5147 patients admitted to the intensive care unit. The most frequent admission diagnoses ...were postoperative state (including following trauma) (2014/5147; 39.1%), medical conditions (709; 13.8%) and traumatic brain injury (629; 12.2%). Intensive care unit mortality was 27.8%, differing between age groups (p < 0.001). Intensive care unit mortality was highest for neonatal tetanus (29/37; 78.4%) and lowest for foreign body aspiration (4/204; 2.0%). Intensive care unit admission following surgery (333/1431; 23.3%), medical conditions (327/1431; 22.9%) and traumatic brain injury (233/1431; 16.3%) caused the highest number of deaths. Of all deaths in the hospital, (1431/11,357; 12.6%) occurred in the intensive care unit. Although the proportion of hospitalised patients admitted to the intensive care unit increased over time, from 0.7% in 2005/6 to 2.8% in 2013/4 (p < 0.001), overall hospital mortality decreased (2005/6, 4.8%; 2013/14, 4.0%; p < 0.001). The proportion of intensive care patients whose lungs were mechanically ventilated was 18.7% (961/5147). This subgroup of patients did not change over time (2006, 16%; 2015, 18.4%; p = 0.12), but their mortality decreased (2006, 59.5%; 2015, 44.3%; p < 0.001).
We have measured the radiation tolerance of poly-crystalline and single-crystalline diamonds grown by the chemical vapor deposition (CVD) process by measuring the charge collected before and after ...irradiation in a 50 m pitch strip detector fabricated on each diamond sample. We irradiated one group of sensors with 800 MeV protons, and a second group of sensors with 24 GeV protons, in steps, to protons cm−2 and protons cm−2 respectively. We observe the sum of mean drift paths for electrons and holes for both poly-crystalline CVD diamond and single-crystalline CVD diamond decreases with irradiation fluence from its initial value according to a simple damage curve characterized by a damage constant for each irradiation energy and the irradiation fluence. We find for each irradiation energy the damage constant, for poly-crystalline CVD diamond to be the same within statistical errors as the damage constant for single-crystalline CVD diamond. We find the damage constant for diamond irradiated with 24 GeV protons to be and the damage constant for diamond irradiated with 800 MeV protons to be . Moreover, we observe the pulse height decreases with fluence for poly-crystalline CVD material and within statistical errors does not change with fluence for single-crystalline CVD material for both 24 GeV proton irradiation and 800 MeV proton irradiation. Finally, we have measured the uniformity of each sample as a function of fluence and observed that for poly-crystalline CVD diamond the samples become more uniform with fluence while for single-crystalline CVD diamond the uniformity does not change with fluence.
Chemical Vapour Deposition (CVD) diamond is being considered as a material for particle detectors in a harsh radiation environment. This article presents beam test results of 3D pixel detectors ...fabricated with poly-crystalline CVD diamonds. The cells of the devices had a size of 50µm×50µm with columns 2.6µm in diameter. The cells were ganged in a 3×2 and 5×1 pattern to match the layouts of the pixel read-out electronics currently used in the CMS and ATLAS experiments at the Large Hadron Collider, respectively. In beam tests, using tracks reconstructed with a high precision tracking telescope, a tracking efficiency of 99.3% was achieved. The efficiency of both devices plateaus at a bias voltage of 30V. Also irradiated poly-crystalline CVD diamond pad detectors were investigated. In high rate beam tests with particle fluxes up to 20MHz/cm2 and irradiations up to 8 ⋅ 1015n/cm2 it was shown that the pulse height of irradiated poly-crystalline CVD diamonds does not depend on flux to the O2%.
Background Terlipressin bolus infusion may reduce cardiac output and global oxygen supply. The present study was designed to determine whether dobutamine may counterbalance the terlipressin-induced ...depression in mixed-venous oxygen saturation (Svo2) in patients with catecholamine-dependent septic shock. Methods Prospective, randomized, controlled study performed in a university hospital intensive care unit. Septic shock patients requiring a continuous infusion of norepinephrine (0.9 µg kg−1 min−1) to maintain mean arterial pressure (MAP) at 70 (sd 5) mm Hg were randomly allocated to be treated either with (i) sole norepinephrine infusion (control, n=20), (ii) a single dose of terlipressin 1 mg (n=19), or (iii) a single dose of terlipressin 1 mg followed by dobutamine infusion titrated to reverse the anticipated reduction in Svo2 (n=20). Systemic, pulmonary, and regional haemodynamic variables were obtained at baseline and after 2 and 4 h. Laboratory surrogate markers of organ (dys)function were tested at baseline and after 12 and 24 h. Results Terlipressin (with and without dobutamine) infusion preserved MAP at 70 (5) mm Hg, while allowing to reduce norepinephrine requirements to 0.17 (0.2) and 0.2 (0.2) µg kg−1 min−1, respectively vs1.4 (0.3) µg kg−1 min−1 in controls at 4 h; each P<0.001. The terlipressin-linked decrease in Svo2 was reversed by dobutamine at a mean dose of 20 (8) µg kg−1 min−1 Svo2 at 4 h: 59 (11)% vs 69 (12)%, P=0.028. Conclusions In human catecholamine-dependent septic shock, terlipressin (with and without concomitant dobutamine infusion) increases MAP and markedly reduces norepinephrine requirements. Although no adverse events were noticed in the present study, potential benefits of increasing Svo2 after terlipressin bolus infusion need to be weighted against the risk of cardiovascular complications resulting from high-dose dobutamine.
Radiation tolerance of diamond detectors Bäni, L; Artuso, M; Bachmair, F ...
Journal of physics. Conference series,
11/2022, Letnik:
2374, Številka:
1
Journal Article
Recenzirano
Odprti dostop
Diamond is used as detector material in high energy physics experiments due to its inherent radiation tolerance. The RD42 collaboration has measured the radiation tolerance of chemical vapour ...deposition (CVD) diamond against proton, pion, and neutron irradiation. Results of this study are summarized in this article. The radiation tolerance of diamond detectors can be further enhanced by using a 3D electrode geometry. We present preliminary results of a poly-crystalline CVD (pCVD) diamond detector with a 3D electrode geometry after irradiation and compare to planar devices of roughly the same thickness.
Mycobacterium avium ssp. paratuberculosis (MAP) causes Johne’s disease (JD) in ruminants and is shed into the milk of infected cows, which contributes to the controversial discussion about a possible ...link between MAP and Crohn’s disease in humans. The aim of the study was to investigate the risk for the entry of MAP in the food chain via milk from dairy farms with subclinical JD. Therefore, the occurrence of MAP in the milk of a dairy herd with a low prevalence of JD was studied in single and bulk tank milk samples over a period of 23mo and compared with MAP shedding into feces. Milk, fecal, and blood samples were taken from all cows older than 1.5yr of age at the beginning and the end of the trial and analyzed for MAP or specific antibodies. In addition, 63 cows (33 MAP infected and 30 MAP noninfected) were selected for monthly sampling. Raw and pasteurized bulk tank milk samples were collected on a monthly basis. The milk samples were tested for MAP by real-time quantitative PCR (qPCR), and the fecal samples were tested for bacterial shedding by qPCR or solid culture. Based on the results of the herd investigations, the prevalence of cows shedding MAP was around 5%; no cases of clinical JD were observed during the study period. The results of the ELISA showed high variation, with 2.1 to 5.1% positive milk samples and 14.9 to 18.8% ELISA-positive blood samples. Monthly milk sampling revealed low levels of MAP shedding into the individual milk samples of both MAP-infected and noninfected cows, with only 13 cows shedding the bacterium into milk during the study period. Mycobacterium avium ssp. paratuberculosis was not detected by qPCR in any raw or pasteurized bulk tank milk sample throughout the study. A significant positive association could be found between MAP shedding into milk and feces. From the results of the present study, it can be concluded that MAP is only shed via milk in a small proportion of cows with subclinical JD for a limited period of time and is diluted below the detection level of qPCR within the bulk tank milk of these herds. These findings indicate that dairy herds subclinically infected with JD pose only a minor source for human MAP consumption with milk and milk products.
The epithelial glycoprotein Ep-CAM is overexpressed in colon cancer and breast cancer. We assessed the frequency and prognostic significance of Ep-CAM in tissue specimens from 205 patients with ...invasive breast cancer, by immuno-histochemical staining with a monoclonal antibody specific for the Ep-CAM antigen. Ep-CAM overexpression was found in 35·6% of samples and was associated with poor disease-free and overall survival.
Arginine-vasopressin (AVP) might be a potent vasopressor agent in catecholamine-resistant postcardiotomy shock. However, its use remains experimental because of considerations about deleterious ...effects on the heart. We report on the effects of continuous AVP-infusion on cardiac performance, biomarkers of myocardial ischemia, and systemic hemodynamics in catecholamine-resistant postcardiotomy shock.
Retrospective study.
Twenty-one-bed general and surgical intensive care unit.
Forty-one patients with catecholamine-resistant postcardiotomy shock.
Continuous infusion of AVP.
Heart rate (HR), heart rhythm, mean arterial pressure (MAP), central venous pressure, mean pulmonary arterial pressure, cardiac index (CI), stroke volume index (SVI), left ventricular stroke work index (LVSWI), systemic vascular resistance (SVR) as well as milrinone and norepinephrine requirements were collected before and 1, 4, 12, 24, and 48 h after start of AVP infusion. Creatine kinase MB and troponin-I serum concentrations were measured daily. During AVP administration we observed a significant decrease in HR (-14.8%), milrinone (-17.5%), and norepinephrine requirements (-54.9%) as well as biomarkers of cardiac ischemia and a significant increase in LVSWI (+46.2%), MAP (+41.8%) and SVR (+60%). CI and SVI remained unchanged. Forty-five percent of postoperative new-onset tachyarrhythmias (TA) converted into sinus rhythm during AVP infusion.
AVP was devoid of adverse effects on the heart in these patients with catecholamine-resistant postcardiotomy shock. The significant reduction in HR, vasopressor, and inotropic support suggest a substantial improvement in myocardial performance. These findings are supported by a significant decrease of cardiac enzymes and cardioversion of TA into sinus rhythm in 45.5% of patients with new-onset TA.
The purpose of this study was to determine how often physician-performed high-resolution sonography can detect nonpalpable breast lesions not revealed by mammography. A sonographic classification ...scheme was tested for its accuracy in predicting malignancy of incidentally detected breast lesions.
Six thousand one hundred thirteen asymptomatic women with breast density grades 2-4 and 687 patients with palpable or mammographically detected breast masses underwent sonography as an adjunct to mammography. All sonographically detected, clinically and mammographically occult breast lesions that were not simple cysts were prospectively classified into benign, indeterminate, or malignant categories. Diagnoses were confirmed by sonographically guided fine-needle aspiration or core needle biopsy.
In 6113 asymptomatic women, 23 malignancies in 21 patients were detected with sonography only (prevalence, 0.31%). Five additional malignant lesions were found in patients with a malignant (n = 3) or a benign (n = 2) palpable or mammographically detected index lesion. The mean size of invasive malignancies detected only by sonography was 9.1 mm, which was not significantly different from the mean size of invasive cancers detected by mammography (p = .07). The sensitivity of the prospective sonographic classification for malignancy was 100%, and the specificity was 33.5%.
The use of high-resolution sonography as an adjunct to mammography in women with dense breasts may lead to detection of a significant number of otherwise occult malignancies that are no different in size from nonpalpable mammographically detected lesions. Prospective classification of these lesions based on sonographic characteristics results in a significant reduction in number of unnecessary biopsies performed.
A 3D diamond detector for particle tracking Artuso, M.; Bachmair, F.; Bartosik, M. ...
Nuclear instruments & methods in physics research. Section A, Accelerators, spectrometers, detectors and associated equipment,
07/2016, Letnik:
824
Journal Article
Recenzirano
Odprti dostop
In the present study, results towards the development of a 3D diamond sensor are presented. Conductive channels are produced inside the sensor bulk using a femtosecond laser. This electrode geometry ...allows full charge collection even for low quality diamond sensors. Results from testbeam show that charge is collected by these electrodes. In order to understand the channel growth parameters, with the goal of producing low resistivity channels, the conductive channels produced with a different laser setup are evaluated by Raman spectroscopy.
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