A study of potential serum markers for a diagnosis of gram-positive and gram-negative bacterial sepsis

Sepsis continues to be a major cause of morbidity and mortality as it can readily lead tosevere sepsis, septic shock, multiple organ failure and death. The onset can be rapid and difficult to define clinically. Despite the numerous candidate markers proposed in the literature, to date a serum marker for sepsis has not been found. The aim of this study was to assay the serum of clinically diagnosed patients with eithera Gram-negative or Gram- positive bacterial sepsis for elevated levels of nine potentialmarkers of sepsis, using commercially produced enzyme linked immunosorbent assays(ELISA). The purpose was to find a test marker for sepsis that would be helpful toclinicians in cases of uncertain sepsis and consequently expose false positive BC'scaused by skin or environmental contaminants. Nine test markers were assayed including IL-6, IL-I 0, ILI2, TNF-α, lipopolysaccharide binding protein, procalcitonin, sE-selectin, sICAM -1 and a potential differential marker for Gram-positive sepsis- anti-lipid S antibody. A total of 445 patients were enrolled into this study from the Queen Elizabeth Hospital and Selly Oak Hospital (Birmingham). The results showed that all the markers were elevated in patients with sepsis and that patients with a Gram-negative sepsis consistently produced higher median/range serum levels than those with a Gram-positive sepsis. No single marker was able to identify all the septic patients. Combining two markers caused the sensitivities and specificities for a diagnosis of sepsis to increase to within a 90% to 100% range. By a process of elimination the markers that survived into the last phase were IL-6 with sICAM -1, and anti-lipid S IgG assays Defining cut-off levels for a diagnosis of sepsis became problematic and a semi-blind trial was devised to test the markers in the absence of both clinical details and positive blood cultures. Patients with pyrexia of unknown origin and negative BC were included in this phase (4). The results showed that IL-6 with sICAM-l are authentic markers of sepsis. There was 82% agreement between the test marker diagnosis and the clinical diagnosis for sepsis in patients with a Gram-positive BC and 78% agreement in cases of Gram-negative Be. In the PUO group the test markers identified 12 cases of sepsis and the clinical diagnosis 15. The markers were shown to differentiate between early sepsis and sepsis, inflammatory responses and infection. Anti-lipid S with IL-6 proved be a sensitive marker for Gram-positive infections/sepsis.

Fault diagnosis scheme for open-circuit faults in switched reluctance motor drives using fast Fourier transform algorithm with bus current detection

Reliability of power converters is of crucial importance in switched reluctance motor drives used for safety-critical applications. Open-circuit faults in power converters will cause the motor to run in unbalanced states, and if left untreated, they will lead to damage to the motor and power modules, and even cause a catastrophic failure of the whole drive system. This study is focused on using a single current sensor to detect open-circuit faults accurately. An asymmetrical half-bridge converter is considered in this study and the faults of single-phase open and two-phase open are analysed. Three different bus positions are defined. On the basis of a fast Fourier transform algorithm with Blackman window interpolation, the bus current spectrums before and after open-circuit faults are analysed in details. Their fault characteristics are extracted accurately by the normalisations of the phase fundamental frequency component and double phase fundamental frequency component, and the fault characteristics of the three bus detection schemes are also compared. The open-circuit faults can be located by finding the relationship between the bus current and rotor position. The effectiveness of the proposed diagnosis method is validated by the simulation results and experimental tests.