Comparison of procalcitonin and CrP in the postoperative course after lung decortication

OBJECTIVE: The objective of this prospective study was to compare the clinical value of procalcitonin (PCT) and C-reactive protein (CrP) plasma concentrations in their postoperative course after decortication. METHODS: Twenty-two patients requiring surgery for pleural empyema were chosen for this prospective study. Routine blood samples including CrP and PCT plasma concentrations were taken before the operation and on the 1st, 2nd, 3rd, and 7th postoperative day. RESULTS: Due to infection PCT and CrP were elevated preoperatively. In the postoperative course both PCT and CrP reached peak-levels on day 2 with values up to 43.55 ng/ml and 384.00 mg/l, respectively. In PCT the rise was followed by a clear decrease in 20 (90.9 %) patients until day 7. In contrast the CrP levels decreased slowly and only seven (54.5%) patients had values of 100 mg/l or below on day 7. PCT showed a better correlation with the clinic in case of septic course than CrP does. CONCLUSIONS: PCT reflects postoperative clinical course more accurately than CrP. Therefore, PCT is a more appropriate laboratory parameter to monitor patients after surgery for pleural empyema.

Non-robotic thoracoscopic internal mammary artery preparation in the pig. A training model

Notwithstanding non-robotic, thoracoscopic preparation of the internal mammary artery (IMA) is a difficult surgical task, an appropriate experimental training model is lacking. We evaluated the young domestic pig for this purpose. Four domestic female pigs (30-40 kg body weight) were used for this study. Bilateral thoracoscopic preparation of the IMA was carried out under continuous, pressure controlled CO(2) insufflation. A 30 degrees rigid thoracoscope was inserted through a 10-mm port in the 5th/6th intercostal space (ICS) dorsally to the posterior axillary line. The dissection instrument (Ultracision Harmonic Scalpel) was inserted (5-mm port) in the 7th ICS at the posterior axillary line and the endo-forceps (5-mm port) in the 5th ICS at the posterior axillary line. Thoracoscopic IMA preparation in pig resulted more difficult than in man. A total of seven IMAs were prepared in their full intrathoracic length. A change in the preparation technique (lateral detachment of the endothoracic muscle) improved the safety of the procedure, allowing all four respective IMAs to be prepared safely, while the initial technique ensued an injury for 2 out of 3 vessels. The described young domestic pig model is suitable for experimental training of bilateral thoracoscopic IMA preparation.

A Note on the Use of Sum in the Logic of Proofs

The Logic of Proofs~LP, introduced by Artemov, encodes the same reasoning as the modal logic~S4 using proofs explicitly present in the language. In particular, Artemov showed that three operations on proofs (application~$\cdot$, positive introspection~!, and sum~+) are sufficient to mimic provability concealed in S4~modality. While the first two operations go back to G{\"o}del, the exact role of~+ remained somewhat unclear. In particular, it was not known whether the other two operations are sufficient by themselves. We provide a positive answer to this question under a very weak restriction on the axiomatization of LP.

Social stressors at work and sleep quality on sunday night – The mediating role of psychological detachment

Purpose Recovery is a critical link between acute reactions to work-stressors and the development of health-impairments in the long run. Even though recovery is particularly necessary when recovery opportunities during work are insufficient, research on recovery during weekends, is still scarce. To fill this gap we tested, whether the inability to psychologically detach from work mediates the effect of social stressors at work on sleep quality on Sunday night. Design/Methodology Sixty full-time employees participated in the study. Daily assessment included diaries on psychological detachment and ambulatory actigraphy to assess psychophysiological indicators of sleep quality. Results Hierarchical regression analyses revealed social stressors at work to be related with psychological detachment and with several sleep quality parameters on Sunday night. Furthermore, psychological detachment from work mediated the effect of social stressors at work on sleep quality. Limitations Methodological considerations regarding the use of actigraphy data should be taken into account. Research/Practical Implications Our results show that social stressors at work may lower resources just before people get started into the new working week. Originality/Value This is the first study to show that social stressors at work are an antecedent of psychological detachment on Sunday evening and of objective sleep quality on Sunday.

CAOR: Context-aware Adaptive Opportunistic Routing in Mobile Ad-hoc Networks

Opportunistic routing (OR) employs a list of candidates to improve wireless transmission reliability. However, conventional list-based OR restricts the freedom of opportunism, since only the listed nodes are allowed to compete for packet forwarding. Additionally, the list is generated statically based on a single network metric prior to data transmission, which is not appropriate for mobile ad-hoc networks (MANETs). In this paper, we propose a novel OR protocol - Context-aware Adaptive Opportunistic Routing (CAOR) for MANETs. CAOR abandons the idea of candidate list and it allows all qualified nodes to participate in packet transmission. CAOR forwards packets by simultaneously exploiting multiple cross-layer context information, such as link quality, geographic progress, energy, and mobility.With the help of the Analytic Hierarchy Process theory, CAOR adjusts the weights of context information based on their instantaneous values to adapt the protocol behavior at run-time. Moreover, CAOR uses an active suppression mechanism to reduce packet duplication. Simulation results show that CAOR can provide efficient routing in highly mobile environments. The adaptivity feature of CAOR is also validated.