The long term outcome of head-injured patients depends not only on the primary brain lesions but also to a large extent on the secondary lesions. The diagnosis of many secondary lesions, and ...specially that of brain ischemia, is based on simultaneous monitoring of several intracranial and systemic variables. Continuous intracranial pressure (ICP) monitoring is currently considered indispensable in the management of all patients with a severe head injury and intracranial lesions. However, the information provided by this technique is insufficient to diagnose some of the complex physiopathological processes that characterize traumatic brain lesions. Consequently, the use of methods to estimate cerebral blood flow such as transcranial Doppler and jugular oximetry to complement ICP monitoring is becoming increasingly widespread. Nevertheless, determining the effect of tissue lesions and therapeutic measures on cerebral metabolism currently requires direct access to the brain parenchyma at the bedside. In this review we focus on three methods of regional cerebral monitoring: oxygen tissue pressure (PtiO(2)) monitoring, microdialysis and near-infrared spectroscopy. The bases of each method and reference values for the variables analyzed will be discussed. We also make a series of recommendations on how results should be interpreted in light of current knowledge.
We experimentally demonstrate a 5G digital fronthaul network that relies on multi-adaptive bandwidth/bitrate variable transceivers (BVTs) and an autonomic software-defined networking (SDN) control ...system for partially-disaggregated wavelength division multiplexing (WDM)/space division multiplexing (SDM). Transmission of 256-QAM 760.32 MHz orthogonal frequency-division multiplexing (OFDM) radio signal is performed, with a total radio transmission capacity of 5.667 Gb/s. Digitized signal samples are carried as a 22.25 Gb/s digitized radio-over-fiber (DRoF) data stream and transmitted over a WDM/SDM infrastructure including 40-wavelength 100-GHz arrayed waveguide gratings (AWGs) and 19-core fiber. The autonomic SDN controller deploys a control loop for the multi-adaptive OFDM-based BVTs that monitors the per-subcarrier signal to noise ratio (SNR) and assigns the optimal constellation based on the actual signal degradation. An error vector magnitude (EVM) below the targeted 2.1% is achieved while setting up connections in less than 5 s.
In this randomized, multicenter, controlled, double-blind, sequential trial, 381 patients undergoing primary total knee replacement were randomly assigned to receive subcutaneous injections of either ...3500 IU anti-factor Xa of bemiparin sodium, first dose 6 h after surgery, or 40 mg of enoxaparin, first dose 12 h before surgery, followed by daily doses for 10 +/- 2 days, for the prophylaxis of venous thromboembolism. The primary efficacy endpoint was venous thromboembolism up to postoperative day 10 +/- 2, defined as deep vein thrombosis detected by mandatory bilateral venography, documented symptomatic deep vein thrombosis and/or documented symptomatic pulmonary embolism. The primary safety endpoint was major bleeding. Eighty-seven percent of all randomized patients (333 of 381 patients) were evaluable for efficacy. The incidence of venous thromboembolism was 32.1% (53 of 165 patients) in the bemiparin group and 36.9% (62 of 168 patients) in the enoxaparin group. The absolute risk difference was 4.8% in favor of bemiparin 95% confidence interval (CI), -15.1% to 5.6%; non-inferiority P-value: 0.02; superiority P-value: 0.36. The incidence of proximal deep vein thrombosis was 1.8% (three of 165 patients) in the bemiparin group and 4.2% (seven of 168 patients) in the enoxaparin group. Major bleeding occurred in six patients (three in each group). There were no deaths during the study. This trial shows that bemiparin started postoperatively is as effective and safe as enoxaparin started preoperatively in the prevention of venous thromboembolism in patients undergoing total knee replacement.
We report on our multi–pronged approach to understand the structural and electrical properties of an InAl(Ga)N(33nm barrier)/Al(Ga)N(1nm interlayer)/GaN(3μm)/ AlN(100nm)/Al2O3 high electron mobility ...transistor (HEMT) heterostructure grown by metal organic vapor phase epitaxy (MOVPE). In particular we reveal and discuss the role of unintentional Ga incorporation in the barrier and also in the interlayer. The observation of unintentional Ga incorporation by using energy dispersive X–ray spectroscopy analysis in a scanning transmission electron microscope is supported with results obtained for samples with a range of AlN interlayer thicknesses grown under both the showerhead as well as the horizontal type MOVPE reactors. Poisson–Schrödinger simulations show that for high Ga incorporation in the Al(Ga)N interlayer, an additional triangular well with very small depth may be exhibited in parallel to the main 2–DEG channel. The presence of this additional channel may cause parasitic conduction and severe issues in device characteristics and processing. Producing a HEMT structure with InAlGaN as the barrier and AlGaN as the interlayer with appropriate alloy composition may be a possible route to optimization, as it might be difficult to avoid Ga incorporation while continuously depositing the layers using the MOVPE growth method. Our present work shows the necessity of a multicharacterization approach to correlate structural and electrical properties to understand device structures and their performance.
Climate change is expected to alter the geographic distribution of many plant species worldwide. However, there is still no clear evidence showing a generalised direction and magnitude of these ...distribution shifts. Here, we have surveyed, in nine mountainous regions in Spain, an array of tree species along entire elevational ranges, as surrogates of their global climatic ranges, to test for elevational shifts towards cooler locations. We analysed the distribution recruitment patterns of five dominant tree species, recording the abundance and measuring the primary growth of juveniles in 306 plots. Three of the species have a temperate-boreal distribution with populations at their southern edge in the Mediterranean mountain ranges: Pinus sylvestris, Pinus uncinata and Fagus sylvatica; and the other two species have a Mediterranean distribution: Quercus ilex and Pinus nigra. Despite the contrasting phylogenies and biogeographies, we identified a similar pattern in recruitment abundance across species, with an asymmetric distribution of juveniles (more recruits in the middle-upper elevation of their range), but higher annual growths at lower elevations. This survival-growth trade-off at the early recruitment stage may potentially counterbalance at population level the negative effect of global warming on recruit survival at the lower edge of species ranges. These findings suggest a demographic stabilisation process at the early recruitment stage of these tree species, and highlight the importance of considering the different demographic stages across the whole climatic range to understand the effects that climate change may exert on species distributions and population dynamics.
In the investigated InAlN/GaN layers, it is shown that the surface morphology and the crystallinity of the alloy critically depend on the In composition. Atomic force microscopy analysis points out ...that step flow growth is not easily attained in this system. When the InAlN or AlN interlayer thickness is increased, the growth mode becomes three‐dimensional. However, the formed islands are hundred of nanometers apart, and were not observed in the transmission electron microscope.
Porous GaN polycrystalline layers with n-type conduction characteristics were catalytically grown from Mg films formed by decomposition of a Mg2N3 precursor typically employed for activating p-type ...conduction in GaN. After being exposed to oxygen, the Mg film oxidized to a polycrystalline high-κ oxide between the ohmic alloy interlayer contact and the porous GaN, while maintaining a clean interface. Electrical measurements on devices coupled to composition analysis and electron microscopy of the component layers confirm that a MOS-type porous GaN diode on silicon can be formed by chemical vapor deposition in a single growth regime.
Disaggregation in optical networks is particularly relevant to be considered for the deployment of 5G services and towards the support of 6G. Particularly in the metro area network (MAN), this is ...especially crucial, as is the adoption of suitable photonic technologies enabling dense integration to design a sustainable network architecture. Furthermore, to dynamically allocate the ever-increasing traffic, supporting multiterabit capacity, an optimal usage of the available resources by properly exploiting the multiple dimensions (including the spectral and spatial ones), with programmable and adaptive data plane solutions, is key. In this work, we assess the capabilities of a disaggregated MAN that relies on new photonic devices, node architectures, and sliceable bandwidth/bit-rate-variable transceivers, approaching wavelength division multiplexing and space division multiplexing. A hierarchical network topology is attained and the feasibility of a cross-hierarchy optical continuum is demonstrated. In fact, we experimentally demonstrate the successful transmission of multiterabits/second capacity across multiple nodes corresponding to different hierarchy levels that have different implementation schemes and support different technologies. For the top tier hierarchy level nodes, we demonstrate the transmission of up to {8} \times {11} = {88} spatial/spectral channels, for a total capacity of 1.676 Tb/s, employing a node architecture able to handle up to 2560 spatial/spectral channels at different aggregation levels and granularities.
The optimal distribution between physical activity (PA) levels and sedentary behaviour (SB) for the greatest benefits for body composition among older adults with overweight/obesity and chronic ...health conditions remains unclear. We aimed to determine the prospective association between changes in PA and in SB with concurrent changes in body composition and to examine whether reallocating inactive time into different physical activity levels was associated with 12-month change to body composition in older adults.
Longitudinal assessment nested in the PREDIMED-Plus trial. A subsample (n = 1564) of men and women (age 55-75 years) with overweight/obesity and metabolic syndrome from both arms of the PREDIMED-Plus trial was included in the present analysis. Participants were followed up at 6 and 12 months. Physical activity and SB were assessed using validated questionnaires. Out of 1564 participants, 388 wore an accelerometer to objectively measure inactive time and PA over a 7-day period. At each time point, participants' body composition was measured using dual-energy X-ray absorptiometry (DXA). Standard covariate-adjusted and isotemporal substitution modelling were applied to linear mixed-effects models.
Increasing 30 min of total PA and moderate-to-vigorous physical activity (MVPA) was associated with significant reductions in body fat (β - 0.07% and - 0.08%) and visceral adipose tissue (VAT) (- 13.9 g, and - 15.6 g) at 12 months (all p values < 0.001). Reallocating 30 min of inactive time to MVPA was associated with reductions in body fat and VAT and with an increase in muscle mass and muscle-to-fat mass ratio (all p values < 0.001).
At 12 months, increasing total PA and MVPA and reducing total SB and TV-viewing SB were associated with improved body composition in participants with overweight or obesity, and metabolic syndrome. This was also observed when substituting 30 min of inactive time with total PA, LPA and MVPA, with the greatest benefits observed with MVPA.
International Standard Randomized Controlled Trial (ISRCTN), 89898870 . Retrospectively registered on 24 July 2014.
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